Looking for answers and praying for everyone

[Prayerful]

Hello. I’m the spouse of a lung cancer survivor. I am seeking support from a community who understands. My husband was first diagnosed with NSCLC in May. 2019. He was Stage 1B, 4cm. His upper right lobe was removed. He had 4 rounds of adjuvant chemo (as a precaution since he had some visceral plural (sp.) invasion). Two years later, July 2021, a 1.4 cm tumor was picked up on a scan near where they stitched his lung from the previous surgery. He had option of surgery or radiation. He chose surgery again. The tumor was the size of a pea and they scooped out the size of a quarter. He is choosing not to do adjuvant chemo this time. Also , his cancer has no biomarkers. My question to the community is where do we go from here. Does this recurrence mean we should brace for more.? Are there cases of recurrences that never come back a third time? Does the fact that he has no biomarkers mean there are no treatment options beyond chemo. Looking forward to hearing from the community. Thank you for listening. I’m scared.

[LouT]

Hi Prayerful,

Sorry you have to be here, but glad you found us.  I can understand that your husband's decision may have you concerned.  I personally was diagnosed at Stage 1a and did not have adjuvant treatment, but every case can be different and with his recurrence the doctors may well recommend that he submit to that follow up care.  Did he have strong side-effects from the last chemo post-surgery treatment?  If it were a recurrence I would opt to strongly consider the adjuvant approach, but that would be my personal choice.  What are his doctors recommending?  I would strongly have him consider their recommendation.  I've found a listing of personal responses from some of our forum family and a study on the topic in a search of our forums and that can be found here.  You'll hear what others have said on the subject.  I'm well aware that some of our members have had more than one recurrence and I'm sure that you'll be hearing from many of them soon.  In the meantime I hope that this helps you a bit.  You and your husband will be in my thoughts and prayers.

Lou

[Tom Galli]

Prayerful,

Welcome here.

To your questions: does a recurrence mean there will be more? One of the nasty things about lung cancer is its propensity to recur. After reading a National Cancer Institute study on recurrence, I wrote this blog years ago. I've had 5 in my treatment history! I can't forecast this tendency for your husband, but he's already had one. 

Does having no biomarkers mean there are no other treatments but chemo? No. There are two general types of biomarkers: those collectively called driver mutations and markers for Immunotherapy. Driver mutations are indications that some forms of adenocarcinoma will respond to certain drugs, collectively called targeted treatment. Immunotherapy treatments can be effective against all forms of lung cancer. Here is more information about biomarkers. You didn't tells us the type of your husband's NSCLC. There are three types: adenocarcinoma, squamous cell, and large cell. Some types of immunotherapy are effective if someone has no expression of the marker PDL-1. Moreover, there is precision radiation that can be very effective treating recurrences. Here is more information about radiation treatments for lung cancer.

I completely understand your fear. But even with high recurrence rates, there are many of us here. In February, I will have lived 18 years after diagnosis and more than three years of constant treatment. That statement intends to suggest that if I can live, so can your husband.

Stay the course.

Tom

[Prayerful]

Thank you Lou and Tom. He did have strong effects from previous chemo. His kidney took a hit also. He has NSCLC adenocarcina.