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Denise C

Stage IIIA Lung Cancer

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My husband had a broncoscopy performed at MSK yesterday afternoon.  The Thoracic surgeon said the lymph node she biopsied was suspicious for cancer.  She went on to say that she took several other biopsies of other lymph nodes but they did not look suspicious.  She then went on to say that he had stage IIIA lung cancer and the treatment would be aggressive chemo followed by the removal of the upper half of his left lung to remove the 1.1 CM nodule located in his left lung. 

I specifically asked if his cancer was curable and she responded yes.    She stated that he can live a normal life with ½ his lung removed and would not require oxygen.

We are still waiting on the pathology results to determine type of cancer etc.

What questions specifically should I be asking when we meet with the oncologist?  Where can I obtain reliable information on stage IIIA lung cancer?  I am staying far away from Google but I do want to educate myself on this disease so I am prepared with questions and can also make an informed decision on treatment.

Still in shock as my husband is 41 years old is a never smoker and has not been exposed to chemicals that we are aware of. 

Many thanks,

Denise

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Hi Denise,

A great resource to look at is LUNGevity's Lung Cancer 101  here.   This information is kept up to date and will take you through what to expect throughout diagnosis, treatment, after, etc.  There are also great checklists of questions to ask the doctor.  

While this may be a very grim time for you and your family, know that there is hope and many treatment options are available depending on the type of lung cancer.  My mom was diagnosed with non-small cell lung cancer adenocarcinoma over 4 years ago.  Despite the removal of her right upper lobe and a cancer recurrence, she is still alive an relatively well, living her life to the fullest - my mom was 60 at her diagnosis and not in perfect health.

Finally, please don't be shocked if the oncologist tells you that your husband's lung cancer is not curable, but instead uses the term "No Evidence of Disease/NED".   Lung cancer can be so sneaky that it often pops up again, which is why people receive follow-up scans for awhile after treatment.  This is one reason why oncologists use "NED/No Evidence of Disease".  With a later stage diagnosis, you may be hearing this term rather than "cure".  Don't let it trip you up, it's just a reminder of how we need to be vigilant in keeping an eye on the cancer.

I don't know if any of this helps...hope some of it does.  

Take Care,

Steff

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Steff,

Thank you.  I feel that any and all information helps.  I appreciate you taking the time to respond.

We are still wating on the pathology results which will hopefully be available in the next 5 to 7 business days.

Until then we are living our lives and trying to gather as much information as possible.

Denise

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Hi Denise, 

Welcome, I'm glad you found us.  It's a great idea to stay away from Dr. Google, it's a terrible rabbit hole that can not account for the fact there have been more advances in lung cancer treatment in the last five years, than in the last 50 years.  In edition to the link Stephanie provided above, you may also want to look at the GO2Foundation (formerly known as the Bonnie J Addairo Foundation).  In these two sites you will find very reliable and current information.  

There has been an 87% increase in never smoker lung cancers in the past five years, there is no known environmental or genetic cause.  I'm one of those who was diagnosed last September.   In younger patients,  75% of the lung cancers  are caused by a "driver mutation", most commonly EGFR, ALK or ROS1. This is done through molecular aka bio-marker testing.   At MSK they are most likely in the process of evaluating this.   It's an important factor as a known driver mutation dictates the treatment plan.  As Steff has cautioned above, there are some murky (but not too many)  issues in lung cancer treatment.  It's very rare to be diagnosed at Stage IIIa, there isn't a strong consensus on how to proceed with treatment.  Once the testing is completed, depending on the results, you may also want to seek a second opinion.  I would want to know the molecular study results, then if surgery is the primary intervention, what is the recommended treatment plan, the supporting evidence, risks and benefits of each.  There also may be some clinical trials available.  

It's easier to ask questions when you have clarification about the diagnosis, right now, this is a data collection period designed to personalize the treatment plan.  

This is a marathon, not a sprint so it's important not to get too far ahead of yourself, give  yourself permission to grieve and adjust to the new normal.  Right now, your husband's only priority is to focus on getting well.  I would seriously considering filing for short term disability (if this is feasible).  Lungevity also has a peer mentor program, it's really very helpful to have someone to talk.   Each passing day will get a little easier, in the interim, we're here to support you. 

Michelle 

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Denise,

Welcome here.

Here are some lessons learned from a 15-year survivor of non small cell, squamous cell, lung cancer diagnosed at Stage IIIB.  I had my right lung removed, and I've lived a near normal life since. My bottom line: if I can live, so can your husband.

While there is no "cure" for lung cancer, surgery is the best path to NED and given the size of your husband's tumor and early discovery, you've got a wide path.  But since lung cancer is so persistent, my questions would center around the plan to deal with a recurrence.  Michelle's information about driver mutations and their discovery is an important discussion with your husband's oncologist. This is essential: ensure his tumor biopsy is sent for detailed laboratory testing to discover mutations and immunotherapy indicators. Moreover, after surgery at Stage III, it is common to have a course of adjuvant chemotherapy to sweep the blood stream and lymphatic systems of cancer cells. In light of recurrence frequency, I would advise you not decline this treatment.

Read into Lung Cancer 101. Share it with your husband if he is inclined (I completely understand if he is not). Knowledge is power in addressing lung cancer and one of the two of you need to be informed enough to ask the "terribly perceptive" question. If you have questions during or after reading, this is the place for answers. There are many, many years of accumulated NED time on this forum.

Stay the course.

Tom

 

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Michelle,

Thank you for the response.  i will take a look at the G02Foundation you have provided above.  I did not realize that a Stage IIIa diagnosis was very rare. 

Waiting on a confirmed diagnosis and a treatment plan.

Denise

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Tom,

Thank you for the response.  I will be sure to read Lung Cancer 101 as I am trying to gather as much information as I can in preparation for our meeting with the oncologist.

Denise

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Hi Denise I was diagnosed with stage 3A and had my bottom left lobe removed and followed by adjuvant chemo and I had no idea that its a rare grade ...

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I had the same diagnosis, IIIA/B because I had it in my lymph nodes also, at the same age, but I was a smoker and around chemicals. 

I had the upper right lobe removed and lead a pretty normal life and the only time I notice it is climbing stairs at the football game in the high altitude, partly because of the missing lobe and mostly because I'm out of shape. 

This is beatable, there's plenty of us here that can attest to that. 

 

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