Lymph node activity found during lobectomy

[MissyD1]

Hi all

I gave a question that hopefully someone will be able to help with! My mum was told last week that during her right lower lobectomy the surgeon completed a "frozen section" which showed "activity" in the lymph nodes on her right side. I believe he did 3 samples. I know this means cancer in the lymph nodes as my mum has been told she will need chemo but does anyone know if the surgeon will have removed all of the lymph nodes that contain cancer? We should have asked this at the time, but didn't think until after...

thanks in advance x

[Spainy]

I had lymph nodes removed during my upper right lobectomy. It is my understanding it is just a "sampling" to see if the cancer has spread. Check back with your surgeon for a complete answer. Best to your Mom!

[jars1943]

If the lymph nodes are contain in the lobe he will probably remove them. I had a upper left lobe removed there was one node attached to my pulmonary artery and a couple of others that weren't as concerning. I had chemo and radiation. More radiation than chemo since my cancer would react better with radiation. Hope this helped a little. Best to your mother.

[JeanE41]

I agree with Spainy. Check with the surgeon. Your mother might need additional therapies to treat the cancer. Prayers for you and your mom.

[MissyD1 in reply to JeanE41]

Thank you jeane41. The surgeon did say she will be offered chemo but we weren't sure if he will have removed all of the affected lymph nodes or he only biopsied a few and found cancer but there could be some remaining. We will ask him in a few weeks at her follow up. Thank you everyone for your replies and all the best xx

[Linshom]

Hi, I had a composite basilar segmentectomy of the small ( 9 mm x 7 mm) malignant (NSCLC/adenocarcinoma) in my lower left lobe in Dec, 2014, as well as a bronchoscopy at the same time. The pathology report came back immediately (while I was still under anesthesia) as Stage 1a TN0, meaning the one lymph node my surgeon had removed showed no signs of malignancy. Then all the tissue and tumor and one lymph node that had been removed were frozen. No further lymph nodes were sampled. Genomic testing, however, done after the surgery, revealed that the genetic mutation driving my cancer was KRAS (subtype G12A). KRAS is the commonest type of mutation (and the first oncogene ever discovered in 1982), and just beginning to be unraveled in the past few years. I hope your tumor was genetically analyzed, and I hope you know what genetic mutation was/is driving your lung cancer. I suggest asking your oncologist. I needed no intervention (chemo or otherwise), but am followed with CT scans ever since surgery, and am still in remission. I wish you good luck with all your treatment and a king and good remission.

[MissyD1 in reply to Linshom]

Thank you Linsholm we haven't been told anything about genetic mutation as yet but will definitely ask about this at the follow up appointment. Best wishes to you too x

[Linshom in reply to MissyD1]

HI MissyD1, Thank you for your message--I wish you all the best, and thank you for your good wishes. Genomic testing in lung cancer (and many, many other cancers) is routine and important now--targeted therapies can be directed to specific genetic mutations and treatment outcomes have enormously improved with this knowledge and ongoing therapeutic discoveries..

P.S. I meant to type at the end of my post above: "and a long and good remission."

[Denzie Moderator Volunteer]

It's my understanding that they test the nodes radiating out from the location of the primary mass and keep going until they find no more obvious signs of activity. Please know that doesn't mean it hasn't spread past that, just that there is no evidence of active cancer there.

Too often I read posts by people who were offered chemo at an early stage who turned it down only to learn later that something did get past the nodes.

Please let us know what your mom decides.

[MissyD1 in reply to Denzie]

Thank you Denzie. She is definitely going to do chemo and is meeting the oncologist on june 5th x

[pmsusan99]

Call and ask it's important you have the answers.