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General thoughts on surgery for NSCLC IIIA?


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Welcome Mandy, sorry you have the need to find us, but I'm very glad you did.

As to your question, my uneducated answer is: HOG WASH!! WIVES TALE!! NOT TURE! This information I am sharing with you came from several doc's that I have talked to over the years and although these are NOT the political correct words they used, they ARE the words I use being I'm NOT a doctor. :wink:

I had my left lung removed 9 years ago, and.......... I'm cancer free still today! There are MANY people just like me!

God Bless and Best Wishes to your Mom.

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From experience:

I was not considered a possible IIIa prior to surgery, neither was Hebbie. DURING surgery, the "possible I or II" was re-staged as a IIIa. Surgery was continued, treatment for the two of us was different after that...

Another person that had IIIa discovered during surgery was closed back up to do chemo and radiation prior to surgical removal. The second surgery never happened.

Others that are known to be IIIa prior to surgery seem to be treated prior to surgery and then again after surgery...

I guess it all just depends, nothing is black and white - except that cancer is BAD.

Different tumors, different doctors, different procedures...same fight...

...and I don't think cancer is spread by surgery nor exposure to oxygen. I believe that debate has gone on before on the board...

Take care,


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I agree with everything said above. If I had it to do all over again, I would have had those doctors take out everything they could get their hands on, heal up, do the chemo and the radiation and the iressa and everything else on the back end, and take our chances. I don't know that it would have made any difference. And if Becky had died that why, I would probably be saying that we should have done the chemo first. But I agree with Heather and Becky and think that if surgery is an option at all, go for it and see what happens next.


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We have had the oxygen/tumor conversation a few times here on the boards. Here is a link http://lchelp.com/community/viewtopic.php?t=10856, but everyone above is correct that it is a "myth".

As Becky mentioned, I had my surgery, presumed to be Stage I, which removed my upper right lobe, along with about 12 lymph nodes in the mediastinum area. Turns out the final pathology tested 5 nodes to be positive, hence the restaging to IIIA.

I had originally consulted with a surgeon at another hospital who told me they would do a quick "sampling" of a few nodes, and if none tested positive, they would proceed with the surgery; if any tested positive, they would close me up and surgery would not be an option -- chemo/radiation only.

When I met with the surgeon at the other hospital (whom I ultimately chose), he did things a little differently. He said that he removed every node he saw in there at the time of the lobectomy, and didn't do a "sampling" first -- he just took them all to be tested.

After surgery, from the looks of things, it still appeared to be Stage I....3 weeks later, a restaging based on the final pathology.

I have often wondered.....if I had gone with the original surgeon.....and the few that they "sampled" right before surgery had turned up normal....they would have proceeded with surgery and not taken any further nodes.....which would have left 5 positive nodes in me!

I have no regrets about having the surgery and following it up with chemo and radiation. I know it is controversial with my stage, but I would do it again in a heartbeat.

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Hi Mandy,

I was diagnosed with nsclc IIIA in Feb of this year. I went through 5 weeks of chemo and radiation (chemo weekly, radiation daily) I was told that surgery would probably not happen. But after the 5 weeks I had another pet scan done and to my surgeons amazement the surgery was possible. Be careful though no one told us that there is an amount of radiation that you cannot go over if you are planning to possibly have surgery. I had my surgery in May and am now having follow up chemo to get anything that may have been hiding. According to my surgeon he was able to get all of the tumor in my right lung and the infected lymph nodes in my chest. Hope this helps. Hope all goes well with your mother. Please research and learn everything you can about this disease to be informed. We found out alot of things that we were not told by any of our doctors and we were able to feel like we were able to take some control ourselves. If you would like more info you are welcome to email me at cridley@comcast.net.


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My treatment before surgery helped to shrink down the cancer, thus making me a candidate for surgery. If the cancer is encapsulated, that makes the tumor easier to take; however, if cancer has already spread and too evasive, chemo is about all that can be done, no radiation if the area is to extensive. I imagine that surgeons must be careful to not leave behind microscpoic cancer cells, which is always a possibility. Once in the blood stream or lymphatic system there is potential for metastisis to receptive sites within the body. But surgery can actually cure cancer! Right now it is our best option.


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I was dx'd IA prior to surgery. The surgeon told me that if the nodes they tested were positive they would close...give me chemo and then try again. In frozen section the nodes were negative so he proceeded and took the upper left lobe and 17 nodes. During the final pathology testing they used a fairly new stain and found that one of the 17 nodes was positive using that stain. That changed me over to IIA. My onolcogist then told me that he prefered to treat me as though I was IIIA so as not to skemp on any treatments. I was given chemo (3/3day sessions, done every 3 weeks) then I was given 37 radiation treatments to the mediastinum. I am still NED after 18 months later. I feel as though I did the right thing. Dr Joe knows much more about this than I do though. You might want to see an oncologist first.


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Certainly listen to the advice of the medical professional you have the appointment with, and get a second opinion if you feel the need, but, if given a choice, I've always been told that surgery offers the best possible chance of a cure, and, I don't know about everyone else, but that would be the selling point for me.


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When we went for a second opinion on surgery the oncologist explained that surgery will make the cancer worse if they are unable to remove it all.. He said they need to be able to get "a clean field" around the cancer. If they cannot do that, surgery could spread the cancer and make it worse. Because John's tumor is so close the the vena cava they could not get a clean field and surgery was out of the question.


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