Is chemo necessary?

[Snuggle49]

4.8 squamous cell carcinoma was removed with right upper lobe along with 16 lymph nodes. All margins of tumor were clear, all lymph nodes were negative. Was Stage IIa strictly because tumor was over 4 cm. Is chemo necessary?

[Steph60]

I was stage 1B, and had a genetic testing done which showed that if I just had the surgery there was a about 1/3 chance that I would not be here 5 years later. I chose to have chemo, 4 rounds, and in 2 days it will be 7 years since my surgery and have been cancer free. When I was trying decide if I should do chemo I found the following statement that my oncologist confirmed- if I did not do chemo and it came back it would never be stage it was when it was initially found. Doing chemo was 3-4 months of my life, which I decided was not that much in the scope of the rest of my life. Everyone needs to make the decision that is right for them.

[Denzie Moderator Volunteer]

A 1cm tumor has about 100 million cancer cells. Each time it doubles in size it more than doubles in cell count. Each time one of those cells divides there’s an opportunity for the tumor to shed cells.

When a tumor reaches 3cm it establishes its own blood supply. So in addition to shedding cells that can attach to a nearby organ, it now has the ability to shed cells into your circulatory system. Once it’s in the blood it can travel anywhere in the body. Brain and bones are the places it most often travels to.

In the decade that I have been surviving with stage 4 nsclc and participating on patient boards like this, I have read the experiences of too many people who were diagnosed at stage 2a that progressed to stage 4 within a year. Not everyone will progress, mind you, but many do.

If this was my body I would opt for chemo. It’s not the nightmare it used to be. Some tolerate it well and others not do much.

Please let us know what you decide.

[JanetteR57]

I had a 7cm tumour removed but the specific type I had (rare/mucinous BAC now reclassified as IMA) I was told by the surgeon didn't respond to chemo so my follow on treatment to lobectomy was 'surveillance' - in other words regular check ups and chest x-rays. My surgery was Dec 2010 and diagnosis in Jan 2011. since then it has been recommended that tumours over a certain size are offered chemotherapy as adjuvant treatment but during covid 19 pandemic a lot of this has been stopped as only up to 5% benefit for most but can result in side and late effects from the treatment. I would expect your consultant and surgeon to explain the benefits and potential side/late effects to you to help you reach a decision. many patients I've met since becoming involved in cancer research in 2014 say they wish the side effects had been properly explained to them at the time. as others say, important for you to make the best decision for you but that does require having all the necessary information to make that decision. good luck whatever you decide.

[Feelingblessed2013]

I was told by my thoracic surgeon that my first LC was stage 2 because there were 2 tumors. He removed the upper left lobe, all lymph nodes tested were negative, he said no more treatment necessary. I went to Roswell for a second opinion, and was told chemo would increase my chances of staying cancer free. Unfortunately, I didn't tolerate it well and had to stop half way through (probably due to having been through 4 major surgeries in less than a years time). I was diagnosed with a new LC about 3 years later. I was stage 1a, but was never told they found cancer cells in the plura. I should have done chemo this time, but by the time I saw my new/old oncologist, a year had past. We could all tell you what we would do or have done (if given the option, I would have done the chemo), but only you can decide what is best for you.

Good luck.

[judg69]

I won’t bore you with my history ( you can read it in my profile ), but I am extremely fortunate to be alive. Without aggressive treatment I would be long dead, having been given at best a 1 in 10 chance of living 5 years. It’s been 8 1/2 years now and I’m still alive. Cancer is nasty, and cancer treatments are nasty. I really don’t think there is an ‘easy’ way around it. My advice, listen to your Dr’s, get 2nd opinions if you can do so in a matter of a week or two, then proceed with the best medical advice to kill the cancer and leave you among the living to enjoy your life, judg69