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Forum Name: Lung Cancer

Question: Will it come back


 Blaze100 - Thu Feb 09, 2006 11:28 pm

Hi, I was dx'd with BAC lung cancer 5 years ago at age 46. I had upper right and middle right lobes removed, plus chemo and radiation due to 0.1mm margin in hilar region. No nodal involvement. My tumor was 10cm. All pets/ct's in last 5 years have proved OK, although some false alarms between scans. I never smoked.

Recently a cardiologist mentioned to me that he wasn't a cancer expert, but he thought all lung cancer eventually came back. When I asked my oncologist at my last visit if I was going to live, she just laughed and said "you already have" , still I'm scared from what the other doctor said to me.

This has been bothering me tremendously. Is it true, does all lung cancer always come back? What percent does come back after 5 years with no problems?

Thanks, Barb.
 Dr. A. De la Guerra - Sat Feb 11, 2006 2:26 am

User avatar Hi Blaze100,

Is not true, not all lung cancers return.

There are two main types of lung cancer, small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC represents almost 80% of lung cancers, and has 4 subtypes. Adenocarcinoma is the most frequent type of NSCLC (also have 4 subtypes). Bronchioloalveolar adenocarcinoma (BAC) is a special type of adenocarcinoma that tends to be slow growing and seems less likely to metastasize than other forms of NSCLC. For this reason, BAC has a more favorable prognosis than other forms of NSCLC. As well, BAC has a higher incidence in women than men compared with other lung cancer types. Women tend to be younger at diagnosis, and never-smokers. Overall survival is higher for BAC compared with other lung cancers, especially in female patients.

To predict outcome, oncologists consider specific factors related to the patient, to the tumor, and to the treatment (the prognostic factors). I will try to correlate these prognostic factors with the information you provided.

1. Patients with early stage BAC who undergo curative surgery have a better survival.

- I don’t have all the information necessary, but from what you wrote I’m pretty sure you had an early stage lung cancer, possibly stage I B, and underwent curative surgery.

2. Survival for patients who undergo major resections (lobectomy) is higher than those who have minor surgical resections.

- You had upper and middle right lobes removed.

3. Patients with a right lung tumor have a longer survival than those with a left lung tumor.

- Yours was in the right lung.

4. Survival is better for patients with no nodal involvement.

- Your lymph nodes were negative.

5. Female patients have a better prognosis than male patients.

- You’re women.

6. The longer the disease-free survival, the longer the overall survival.

- You were treated 5 years ago, and all your tests came out okay.

Nobody can predict the future, however, because of all the above, I strongly agree with your oncologist.

Sincerely,

Dr. Alberto de la Guerra.
 Blaze100 - Sun Feb 12, 2006 12:14 am

Yes, stage 1B. Thank you Dr. De la Guerra for your thoughtful reply. I will print and tape it to the wall above my computer and review frequently, especially around test times. Thanks again for the help. . Barb
 Dr. A. De la Guerra - Mon Feb 13, 2006 3:25 pm

User avatar Thank you Barb for your nice words.

Dr. Alberto de la Guerra

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