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Question For Oncodoc


luvmydog2

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When I was dx in 2003, a scan showed small spot on 2 lymph nodes. I can't remember if it was CT or PET or which scan it was. My question is this...My oncologist said that the spots were less then 1 cm. He said he considered anything less than 1 cm not abnormal. When I had lung removed the surgeon took the 2 nodes out. I think he said he went ahead while he was there. My other question is that I was never given a stage. Oncologist said path report did not state a stage. Have you ever heard this and especially on the "less then 1 cm" statement. Oncologist described it sort of like surface rust. This staging has been eating at me for some time now. Also, PET showed nothing no where else. Thanks for your time Joe.

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Bruce.

Pathology reports aren't used to stage, well, they are in the sense if they say which and how many lymph nodes are involved.

Based on the size of the tumor,you are at least a Stage II, and then if there was lymph node involvement, it would be some kind of III. It depends on which lymph nodes were involved (where they were located)

So if you know the location of any node involvement, if any, I think the Dr. could give you a better idea.

The important thing is that you are NED. You now have a new middle name. You are Bruce NED.

Good to meet you!

elaine

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Actually from your profile you appear to be Stage 1B (T2N0M0). I'm assuming that the lymph nodes removed did not have cancer in them or surely your doctors would have told you so.

It is true that criteria for abnormal lymph nodes in the chest is larger that 1cm. It is normal to be able to see lymph nodes in the chest, they have to be larger than 1cm to be considered suspicious. That is why CT scans are so limiting because certainly lymph nodes smaller than 1cm can harbor cancer cells.

I'm not sure what your oncologist means by not being able to stage by the path report, that along with your scans is how stage is determined. To be stage 2 requires either involvement of local structures (diaphragm, chest wall, etc) or involvement of a regional lymph node. Size of the tumor alone is not enough.

So at least from your profile, sounds like you are stage 1!

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Oh my, I am so sorry. I did think that anything over 3cm was stage II. As a matter of fact, that is what I was told based on my chest xray alone--that I couldnt be less than a II because of tumor size. Just another one of my glorious Drs incompetence.

Ry, Pls fine me for practicing medicine without a license!

Well, this leads me to another question. If the lymph nodes were involved before radiation and chemo but if radiation and chemo kills the cancer in them, and at surgery, they are found not to have evidence of disease but they lit up on a PET scan previously, how is staging done?

Thanks

elaine

PS

Bruce, you also might want to edit your profile because you say you had a tumor in your right lung, but your left lung was removed!!! That sounds like something the Doctors here in hickville would do!!!!!

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Our policy is that abnormal lymph nodes on PET scan alone is inadequate evidence, unless it is not feasible, we always confirm with a biopsy. PET scans can have false positive results (looks like cancer but it ain't) by some studies up to 20% of the time. If the nodes are assumed to be positive or proven to be positive and then become negative after preop treatment (a "pathological complete response"), they are still for staging purposes considered positive. Gets confusing though because in some studies you will see reference to "downstaging" i.e. taking someone from stage 3 to stage 1 with treatment. But in most circles, would go with the highest stage.

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Thanks for your imput on my stage Joe. I think I speak for others on this board....WE ARE SO HAPPY TO HAVE YOU.

Bruce, you also might want to edit your profile because you say you had a tumor in your right lung, but your left lung was removed!!! That sounds like something the Doctors here in hickville would do!!!!!

Thanks for pointing this out Elaine. That is the "school teacher" in you I guess. English was my least favorite subject BTW. :lol::lol::lol:

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