mc20 Posted March 2, 2021 Share Posted March 2, 2021 My wife (29 F - never smoker) was diagnosed with lung cancer last week. She had mild cough for few months, primary care physician prescribed anti-biotics/steroids/omprezol. Later x-ray,ct-scan revealed ~2CM nodule in the RUL. Biopsy confirmed NSCLC (Adenocarcinoma).We did not expect this and rather shocking for us. PET scan did not show other abnormalities. After reviewing the PET, doctor clinical staged it as 1A2. The recommended treatment option is to lobectomy in couple of weeks. I have few questions, please answer if you can. 1. Type of surgery. Doctor provided two options VATS and RATS. Based on research I found out that RATS recovery is better, but there are few papers mentioning that VATS is more effective in removing the Cancer. We are not sure which one to choose OR better.Please share your experience/opinion. 2. Once the lobe is removed, is there any adjuvant therapy to make recurrence less likely ? I read that chemo is recommended for stages 2+ , but did not find any details for adjuvant therapy for stage 1. 3. Any resources/blogs/post I can read that would help in understanding OR dealing with lung cancer would be greatly appreciated. Link to comment Share on other sites More sharing options...
LexieCat Posted March 2, 2021 Share Posted March 2, 2021 Hi there, Wow, yeah, 29 is young for this. Sorry you guys are dealing with it. VATS and RATS are virtually identical surgeries. My surgeon said it's really a matter of the surgeon's preference. He liked the hands-on VATS surgery, while his colleague liked using the robot. Incisions are the same, basic procedure the same, recovery the same, result the same. I'd go with whichever one your surgeon is most comfortable with. I was Stage 1b originally, and I was offered the option of adjuvant chemo but turned it down (now I'm Stage IV, but nobody knows if this was a recurrence or a completely separate cancer). My understanding is that chemo is virtually never recommended for 1A because statistically it's as likely to do harm as good. She will get regular scans ever few months for a while so any recurrence/spread should be caught early. The stage may change after surgery, too--that sometimes happens. The doc will re-evaluate after the tumor and a sample of lymph nodes are examined. There's a ton of info on this site explaining the basics, including a really good list of tips for surgery pulled together by our member Lou: https://forums.lungevity.org/topic/47249-thoracic-surgery-tips-and-tricks/. The surgery (VATS or RATS) is really pretty simple. Most people go home within a day or two. My C-section hurt worse, and longer, than my lobectomy. Link to comment Share on other sites More sharing options...
Tom Galli Posted March 2, 2021 Share Posted March 2, 2021 mc, Welcome here. Twenty nine--wow a lung cancer diagnosis (heck any cancer diagnosis) is tough to deal with at that age! Lexie's answer about VATS and RATS is a good one. As far as adjuvant chemo after surgery, I'd suggest you find a medical oncologist before surgery to consult with. The medical oncologist will be the doctor attending post surgical screening to ensure recurrence (hopefully none) is found early. Please ensure you follow up with the diagnosing physician to ensure biopsy material is submitted to a lab for testing to determine targeted therapy or immunotherapy suitability should you be faced with a recurrence. Unfortunately, the reason lung cancer is so dangerous is its tendency to recur. Here is information about a study on lung cancer recurrence by diagnosis stage. So in light of the recurrence probability, I'd ask your medical oncology about the risk verses benefits of adjuvant treatment. I truly hope your surgery is one and done! But, you almost certainly will have post surgical scans and may have questions about issues down the road. If so, this is the place. Stay the course. Tom Link to comment Share on other sites More sharing options...
LouT Posted March 2, 2021 Share Posted March 2, 2021 MC, You've already got some great information and advice so I'll just welcome you here and reinforce what Tom said about any questions you may have. The good news for your wife is that it was found early and that is a game-changer. Lou Link to comment Share on other sites More sharing options...
LUNGevityKristin Posted March 2, 2021 Share Posted March 2, 2021 I'm so sorry to hear about your wife's diagnosis. We also have a Facebook Group for Younger Adults that have been diagnosed with lung cancer. https://www.facebook.com/groups/YASlung/ I'll echo what was previously said about biomarker testing. It is really important to have that information for the future. Please feel free to ask any questions you have, we are here to support you! Link to comment Share on other sites More sharing options...
ChiMama Posted March 3, 2021 Share Posted March 3, 2021 Welcome and sorry for the unexpected diagnosis. I had RATS upper left lobectomy in July. My Doctor is expert in RATS and VATS and said both would get the job done equally as well. He was prepared to do either based on the availability of the equipment on the day. Link to comment Share on other sites More sharing options...
TJM Posted March 3, 2021 Share Posted March 3, 2021 I can only echo how unfair it is to get cancer at such a young age. But you have received some really good advice. There are really caring and knowledgeable folks on this board. I am so happy I found it as well. As far as lung cancer goes she has the "best" flavor. The numbers are all on her side and they caught it early. I am 14 months out from my VATS. Removed the lower right lobe. I am feeling very good at the moment, dang near back to normal. Will get my next scan in about a week. Probably stress me out but I expect good results! Keep us in the loop. I would probably skip adjunctive chemo/radiation. I did not have an option unfortunately. My reasoning is after surgery you will be NED ( no evidence of disease). My cancer has limited choices of a good second line treatment so it would be nice to have that treatment back...but listen to your oncologist Peace Tom Link to comment Share on other sites More sharing options...
mc20 Posted March 4, 2021 Author Share Posted March 4, 2021 Thank you all for the support. I have read though all the comment/links are they are very useful. I have discussed with Surgeon and he echoed that both RATS and VATS are identical and they depend on the Surgeons preference. Our surgeon mentioned he would perform RATS. He also mentioned that the NGS will be performed on the removed lobe to look for mutations. The plan is to wait for the results and meet with medical oncologist to discuss any adjuvant therapy. Link to comment Share on other sites More sharing options...
LexieCat Posted March 4, 2021 Share Posted March 4, 2021 All that makes perfect sense to me--sounds like your docs are on the ball. Oh, and Lou put together a pretty helpful set of tips for getting through surgery: https://forums.lungevity.org/topic/47249-thoracic-surgery-tips-and-tricks/ What was most helpful to me, personally, was the wedge pillow and doing the breathing exercises. Those can be tough right after--they make you cough--but that's a good thing because it helps clear the lungs. Good luck to you both and keep us posted. Link to comment Share on other sites More sharing options...
Claudia Posted March 4, 2021 Share Posted March 4, 2021 Hi mc20. I am sorry that you needed to find us here. I was stage IV when I had my left upper lobectomy using the RATS method last November. I had a PET scan last Tuesday and got my first NED results. I have been on Keytruda for 2 years (along with chemo and alone)and so far so good. I’m not going to say it was easy but it sure beat the hell out of having lung cancer. It’s great that you caught it so early. Hopefully the surgery goes well and your wife goes on to live a long and uneventful life. Peace, light and great scans to all. Claudia Link to comment Share on other sites More sharing options...
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