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NSCLC Stage IIB - Followup ???


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My husband just had an right upper lobectomy in March 2003 which was diagnosed at Stage IIB, T2,N1,M0. We are on our second oncologist with no one making any definitive suggestion for followup care except for "high dose" chemo and radiation which the surgeon says is too dangerous and too extreme and not required since he is cancer free at this time. I agreed with this conclusion as soon as the treatment was suggested and that oncologist basically told us to find someone else to take care of my husband. The second oncologist is not much better and wants to do basically the same treatment but without the radiation. After I suggested "low dose" chemo (as suggested by the surgeon) and followup with an "AMAS" blood test periodically, he indicated he had no knowledge of either and left it up to us to take all the necessary steps and he would be "happy" to followup based on our results. Obviously there will be no assistance here. I'm running out of options and would gladly like to hear from others who have been in our situation. It appears that I have still not found a Cancer Center interested in treating and not just making money. It appears that as soon as we do not agree with their suggestion, they don't want to know us and suggest we go elsewhere. HELP!!! I'm at my wits end and getting very exhausted fighting with the so called "experts".

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The study that DaveG posted awhile ago seems to indicate that adjunctive chemo may be usefull for early stage lung cancer.

Here is a clinical trial that you may want to investigate.

http://www.clinicaltrials.gov/ct/show/N ... 99?order=3

What is the grade of the tumor? If it is a high-grade (aggressive) tumor then it may be better to treat it aggressively.

Also there are other prognostic indicators, such as vascular invasion in the tumor. You could try to find out from the Dr or Path about the different prognostic indicators for your husbands tumor. Based on that

it may help what course to take.

K-ras and P53 mutations are associated with poor prognosis. There are some vaccines that target these mutations, though.

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Hello and my best to you and your husband;

I was also dx.'ed stage IIB, T2 N1, Squamous type NSCLC. I had a left pneumonectomy on may 2nd, 2001. Like your husband, I was told by my surgeon that I was cancer free . However, for me he recommended no chemo. or radiation. I followed that up with a 2nd opinon from a highly regarded oncologist. He concurred with the surgeon so for the last 2 years I have recieved check-ups only which consisted of ct scans of the chest, abdomen, and head every 3 to 4 months for the first year. Bloodwork and X-rays were also done. I continue to see my onc. every 3 months or so but scans are done every 6 months now along with the bloodwork.

I see my onc. tomorrow and intend to ask him about the new ASCO recommendations. However, I think John is right on with his comments about tumor grade and aggressiveness as well as vascular invasion. So, bottom line it just isn't that simple.

I really think it is an ABSOLUTE MUST that you find an oncologist that you respect and are comfortable with. So, I know your frustrated but your doing the right thing. I assume you have discussed this with your surgeon, if not I certainly would. I'll also see if I can find a center for you, my sister in law is a nurse and lived just outside of Lauderdale.

Hope this helps some.

God bless, be well, and hang in there

Bobmc - NSCLC- stageIIB - left pneumonectomy- 5/2/01

" absolutely insist on enjoying life today!"

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Yes, bob made a good point. You have to feel comfortable with the Dr and feel like he is willing to work with you not "At" you. And unfortunately, you'll get different opinions from different doctors. DaveG seems to have a good relationship with his Dr. This is probably ideal, where the dr will work in a collaborative manner.

Best of luck with finding your answers.

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