Stage 4 surgery

[Claudia]

Good Morning Everyone,

I was diagnosed with stage 4 Squamous Cell lung cancer on Jan 31.2019. I had a 3cm mass in the lingual area of the left lung. I also had mets to lymph nodes in my left groin. After chemo and Keytruda for 3 months my pet scan came back clear in the lymph nodes and the mass in lung had shrunk to 1.3 cm. I was told in the beginning that I was not now and never will be a candidate for surgery. Now that the mets to the groin are gone I was wondering if staging is ever changed and why would a stage 4 patient be unable to have surgery. Yes, I could ask my Dr but I don't have an appointment for 3 weeks.Does anyone have any thoughts on this?

Have a Beautiful Day,

Claudia

[Tom Galli]

Claudia,

Your question on why a Stage 4 Squamous cell survivor does not qualify for surgery is a good one. I'm not a doctor nor a research biologist but I do have squamous cell NSCLC and have done quite a lot of reading about this form or cancer.  In Siddhartha Mukherjee’s superb book The Emperor of All Maladies, Mukherjee describes Squamous cell as genetically more complex than adenocarcinoma and it mutates faster. So surgeons are reluctant to expose survivors to the risk of surgery for a type of cancer that is known for rapid recurrence.  But, keep in mind, that is my supposition.  Ask your surgeon this question for a more professional answer.  You might also read the book; it is easily available online.

I've known stage IV folks who've had precision radiation that acts like surgery with good results without attendant invasive risk. One member, Judy M posted a blog about here experience with SBRT precision radiation on stage 4 tumors. Others have also reported good results with precision radiation. So I'd ask your surgeon for a consultation with a radiation oncologist to explore the possibility of frying that reluctant lung mass.

Stay the course.

Tom