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Chemo or not???


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I've posted this query elsewhere but would like as much feedback as possible.

I have stage 1a adinocarcinoma and am having a lobectomy next week.

Currently my surgeon is suggesting no chemo or radiation following the operation.

Some people obviously feel very strongly regarding the follow-up chemo.

I would like input from anyone who has been in the same situation using either treatments .



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I went into surgery with the same plan, but came out with a different diagnosis and plan including chemo and radiation. I would love to skip the chemo and would have IF I stayed 1a. If you are lucky enough to have caught the beast while it is not invasive and the docs don't recommend chemo, thank your lucky stars. If you question the treatment plan at all, a second opinion might be worth it. Most insurance plans will cover one too.

Will your surgery be VATS?

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I had chemo post surgery and I was staged at 1B. At the time, chemo for my stage was showing to improve survival by 5-10%, which is a lot, in my opionion. Now, studies have shown different statistics which might not show it to be as effective as that, but we didn't know that then.

I did the chemo, and probably would make the same decision today, because you can only go for a cure the first time around with this. But, I think it's something you should carefully consider before you go ahead with it.

It comes with a variety of side effects, some that go away in time, some never do. For example, cisplatin caused a hearing loss for me, and that will never improve. For the year after I had chemo, I was constantly sick with upper respiratory infections. I think that the chemo compromised my immune system, and while it's better now, I don't know if it's back to the way it was before chemo.

During chemo, I continued to work, but I didn't feel good most of the time, and the weekends were spent laying on the couch. And I did well with chemo, some people get really really ill.

I would still do it again in my case because of the characteristics and location of my tumor and because this was my second round with cancer (I had breast cancer two years prior) and because I was otherwise very, very healthy. But, I think it's a decision that should not be taken lightly and all advise of your medical team should be considered.

Good luck with your plan, whatever you decide.


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Hi Ted ... as a 1A I was not even given the option for treatment other than surgery as chemo, etc. is not something that is given in Canada for 1A (at least that is what I was told).

I recall that Dr. West, an oncologist in Seattle who runs the GRACE website (www.cancergrace.org) had answered a similar question about 1A and chemo.

I think, though, the pathology and the spectrum of well-differentiated to poorly differentiated may make some difference as well. You will have a much better outlook on this question once you get the surgery done and the pathology report completed.

Good luck on the upcoming surgery and keep us posted.


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While the doctors thought my cancer was stage I, I wasn't going to do chemo. When the biopsy after surgery showed it to be stage II, I did the chemo.

Good luck, whatever you decide!

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I was dx with sclc had an upper left lobectomy, surgeon also removed surronding lymph nodes, no other cancer was found either in the surrounding lung tissue or the lymph nodes. My OCN still wanted me to follow up with chemo. Not sure if it was because it was sc or to just be sure. Either way I'm glad I did the chemo.

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  • 2 weeks later...

I was stage 1A --all margins clear. Went for two or three opinions, all suggested no chemo as it would cause more harm than good.

You can ask Dr. West, but their is no indication nor statistics that it increases survival for anyone at stage 1A. I am sure if I searched around, I could have found an onco to do it, but I trusted my doc. Obviously chemo does not stop it from coming back--it just holds it in check. Otherwise chemo would hold all the cancer at any stage.

I do not feel at stage 1A that it does anything. My feelings at 1A is if it did come back, I needed to save my stamina for the chemo at that point.

I am still alive ( much to the annoyance of others)

but get several opinions and read up on stats


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My best friend just had the exact same diagnosis last year- stage 1a- (she had a 1.2 cm nodule in her left lung)......she had half her left lung removed- and during surgery the doctor removed several lymph nodes- all blood work showed no spread- and the doctor said she doesnt need chemo or radiation- just to keep going back regularly for her CT scans- she is doing great back to walking three miles per day and religious about her appointments.

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It's a hard call. When I had my lobectomy and was staged IIa the standard of care was no chemo or rad; I had a second opinion and was given the same information. All was well for 6+ years. Just had a recurrence and have started Tarceva. Who knows if chemo would have negated the recurrence or extended remission??

As others have said, the pathology reports may be very instructive. I went into surgery as a Ia and came out a IIa.

One thing we DID do was make darn good use of those interim years!

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