Questions about "downstaging" after surgery...???

[karenb]

I just wondered if anybody has any knowledge about downstaging in general but more more specifically after surgery. My dad started out at a IIIa but after two rounds of chemo and radiation he had surgery and had his rt lung completely taken out and in the path report they found a remaining 1 cm tumor and 1 active hilar node. His PET scan prior to surgery showed no other evidence of disease so technically he is NED right?? So why, at his pulmonoligist appointment to follow up after his surgery did the doctor tell him he is now downstaging him to a IIA?? Why not Stage 0000000!!!! How does that work or is it just a title or how does that go.

Anybody w/info or input on this. My dad was taken back by this because he thought he was clear (at least for now). I say forever though because I'm an undying optimist !!. Thanks for your input!!!

[-Cheryl-]

Karen,

I had that very same question after I had my surgery. My surgeon told me there was no such thing as down staging? Yet, I have heard different on this board. I too would like to know the answer to this question?

Cheryl

[chloesmom]

I'm just guessing, but maybe it was because of the node involvement? That would definately make it a stage 2.

For example, I was a 1--the tumor was surgically removed and I have no evidence of disease now because of the surgery, but that doesn't take me back to a Stage 0.

I don't know--I'm just guessing....this is what makes sense to me. I don't think staging represents current status necessarily--it's what the surgery and pathology found it to be.

[john]

Downstaging is found in references all over the net.

http://www.cancerhelp.org.uk/help/default.asp?page=2978

Staging will change based on the best information. My mom was stage I before her surgery. She had a negative PET scan.

However, during surgery they found positive lymph nodes which made her stage IIIa. Even after the surgery where everything was take out I think she was still stage IIIa.

I think after the "induction" chemo what is done is a restaging via the PET scan. It isnt perfect and won't show every thing. After the surgery they can tell exactly what is there. Since there were a few hilar nodes positive it is IIa.

So I don't think I would worry about the "stage", since she had the surgery and no N2 or N3 lymph nodes were positive, I think this is good.

For sure, it is better to go down than up in stage

Since you have a specimen you can ask about the grade, etc of the tumor, this information will allow you to select the best followup therapy.

Also since you have a specimen it is possible to make vaccines (via clinical trials) for the cancer