Dad has adenocarcinoma - confused about stages

[Guest sandrakay]

My dad was diagnosed earlier this month with adenocarcinoma. His doctor suspected stage IV, so I spent time researching the stages while waiting for the results of the scans. I thought I understood them fairly well, but he got the results today and either he's confused or I am (or both!). The cancer is in the lung and in the lymph nodes in the lining of the lung, so it was also found in the fluid secreted by the lymph nodes. I thought this made it stage II, but he said his doctor still called it stage IV, even though it was not found anywhere else in the body. I asked him to have his doctor confirm the stage at the next visit, but don't think I can wait that long. Can anyone shed some light? I don't think Dad knows the significance of the stages, but I'm well aware and don't want to set alarm bells off for him by insisting he call his doctor for clarification. Any explanation I can get would be greatly appreciated.

Thank you - Sandra

[dadstimeon]

Hi Sandra,

Sorry to hear about your father. I’m at stage IV. I have it in both lungs, adrenal glands and bloodstream. See my signature below. I’ve had great success with chemo. It is best to take one step at a time and one day at a time. I would call the doctor for clarification rather then speculate so you know. Treatment depends on what the stage is. It’s a lot to take in when first told. Have dad take notes when he has his doctor’s appointments or perhaps someone can go with him. Research as much as you can. Stay positive and focused. Stay with us. Great people with lots of info and support to offer and positive stories. Hope this helps. Peace, take care and God Bless.

Rich

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The Power Of People Helping People / The Power Of Knowledge / The Power Of God / The Power Of Believing / The Power Of Positive Thinking / The Power Of Never Taking No For An Answer / That’s The Key

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[kimblanchard]

Stage I: A tumor that is surrounded by healthy lung tissue, and has not spread to nearby lymph nodes.

Stage II: A tumor that has spread to nearby lymph nodes within the lung, or is invading the chest wall, diaphragm, or is touching (but not invading) vital structures in the center of the chest.

Stage III: A tumor that is difficult, or impossible, for a surgeon to remove because it invades vital structures in the center of the chest, or has spread to lymph nodes outside of the lung, shed cancer cells into fluid around the lung, or spread to lymph nodes on both sides of the body.

Stage IV: Any tumor that has spread to another part of the body such as the brain, bones, adrenal glands, liver, or kidneys

[Andrea B.]

Hi Sandra,

So sorry to hear about your dad. My mom's cancer was diagnosed at stage IIIB...it too had spread to nearby lymph nodes and was deemed inoperable. I think Jim's message gave good definitions of the stages. There is a lot of success in treating all stages, so remain positive and keep hope. Blessings to you.

[Guest DaveG]

When I was restaged to Stage IV, this past April, I asked my doctor "why Stage IV". Although it had spread to my lymph nodes, it was systemically throughout my lymphatic system and had spread outside of the chest. Had it involved only the medialsteinal lymph nodes I would have been Stage III. Through 6 cycles of carplatin/taxol, over 18 weeks, plus a clinical trial, my lymph nodes were clear, 3 weeks after the last chemo on September 2. Since then, however, a CT Scan, on November 4, revealed another recurrence, this time with a tumor in my liver.

I have entered into a Phase II Trial, testing the efficacy of a new drug (ZD6474) against Iressa. The trial is being conducted by Asta Zeneca, the manufactorer of Iressa. I am getting one of the two drugs, but which one I don't know. I just started on the Trial December 9.

Lung cancer is survivable, as you have probably already realized, as there are many members of this group who are long term survivors 4-7 years out, and several at 10 or more years. As you see by my signature, I am now a 2 year survivor.

I highly believe in two things for survivorship - attitude and spirituality. I also believe highly in clinical trials. New drugs are being tested all the time. I have confidence in my medical team and the institution I have chosen for my care - U of Wisconsin Comprehensive Cancer Center with Dr. Joan Schiller as my Oncologist. It is important to feel comfortable with the medical team, which not only includes the oncologist, but the nurse and any assistants the oncologist may have, especially for research. The clinical research assistant that has been assigned to me is great. She is very dedicated and has taken the time to get to know me, and has been very open about her background and goals.

A good strong support network is also important. This can include such things as face to face groups, on-line groups (such as this group), other caregivers and the family members of others facing lung cancer.

Welcome to our big family of Lung Cancer Survivors for Change. Please visit us often.

[john]

Once it gets to the pluera of the lungs it is also stage considered stage IV. Usually stage IV means distance mets (brain, bones, liver, adrenal are the most common sites)

Make sure the plural effusion is malignant. If it isnt he really isnt stage VI

I think doctors will use talc or bleomycin for the effusion. You have to ask the Dr though since I am not a doctor

http://www.findarticles.com/cf_dls/m098 ... html?term=

The above data suggest a difference between malignant and nonmalignant pleural effusions associated with NSCLC. A pleural effusion is considered malignant if the findings of cytologic testing are positive or, in the event of negative results of cytologic testing, the fluid is exudative and/or bloody. In rare instances, pleural effusions will be transudative and nonbloody, will have negative results of cytologic testing, and can be considered as reactive, in which case the tumor stage would be T1-3. Sugiura et al[6] compared the survival of 197 patients with stage IIIB disease, with and without pleural effusion, and stage IV disease. They found that the median survival time for patients with stage IIIB disease who had pleural effusions was comparable to that of patients with stage IV disease (7.5 and 5.5 months, respectively) and was significantly worse than that for patients with stage IIIB disease who did not have pleural effusions (median survival time, 15.3 months). Among the patients with pleural effusions, there was no difference in survival time whether the results of fluid cytology testing were positive or negative, provided the latter patients had either bloody and/or exudative fluid that was clinically judged to be the result of the underlying lung cancer.

The above data suggest a difference between malignant and nonmalignant pleural effusions associated with NSCLC. A pleural effusion is considered malignant if the findings of cytologic testing are positive or, in the event of negative results of cytologic testing, the fluid is exudative and/or bloody. In rare instances, pleural effusions will be transudative and nonbloody, will have negative results of cytologic testing, and can be considered as reactive, in which case the tumor stage would be T1-3. Sugiura et al[6] compared the survival of 197 patients with stage IIIB disease, with and without pleural effusion, and stage IV disease. They found that the median survival time for patients with stage IIIB disease who had pleural effusions was comparable to that of patients with stage IV disease (7.5 and 5.5 months, respectively) and was significantly worse than that for patients with stage IIIB disease who did not have pleural effusions (median survival time, 15.3 months). Among the patients with pleural effusions, there was no difference in survival time whether the results of fluid cytology testing were positive or negative, provided the latter patients had either bloody and/or exudative fluid that was clinically judged to be the result of the underlying lung cancer.

[john]

It usually would be stage II or III depending on what lymph nodes are affected. However, once it gets to the pluera it is sometimes considered stage IV.

Make sure the pleural effusion is malignant. Sometimes they are not malignant.

http://www.findarticles.com/cf_dls/m098 ... icle.jhtml

Best of luck

[Guest sandrakay]

Thanks to everyone who responded - Dad's oncologist confirmed that he is in stage III B. I think the confusion resulted from Dad seeing the T IV category circled on his lab report - a reference to the tumor classification, not the stage. I guess that explains why his doctor was being so encouraging - and giving statistics that didn't fit with stage IV. When we thought he was stage IV, I couldn't decide whether my dad knew the prognosis and was trying not to let on to us kids, or whether he didn't know. I was getting ready to call the oncologist to find out exactly what she'd told him!

It would be hard to tell with Dad - he is the most positive person I've ever met and never has an unkind word about anyone. I hope this wonderful attitude will carry him through; I figure it can't help but have a positive influence on his illness.

[DMLB35]

So sorry about your dad! My dad lives about 45 minutes from yours in Ohio. My dad has stage IV BAC, was diagnosed in Aug. 2003 and has unsuccessfully been through 2 chemo treatments ( meaning he got so sick, anxious, then got pneumonia and was expected to die) He's a fighter and pulled through. The doctors give him 6 months so we took him to Alabama Center for Ablation. It's perfect for those who have no options for surgery or radiation, and in my dad's case, not-withstanding chemo well. The doctors found the spot a YEAR ago and blew it off so by the time they did diagnose him we were feeling our options were limited. The doctor actually destroys the tumor so it is NO MORE! Unfortunately, my dad's has mets now on the right side. The blessing is that on the CT it only appears as a hazy area, not yet a tumor mass. We are optimistic the Iressa (chemo pill) will take care of it. I know how scary it is! Dad's are so special and I think you will gain a lot of great knowledge and support at this site! Keep the faith!

DEE