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Questions re: post op chemotherapy for stage 1b (T2A)

j_p_b
Posts: 1
Joined: May 2012
May 09, 2012 - 1:02 pm

My father (75, smoker) just underwent a VATS lobectomy of his lower left lobe where a 4cm tumor was located. His diagnosis - stage 1b (T2A) adenocarcinoma. The surgery went well and his recovery is progressing nicely although he'd tell you he feels exhausted much of the time (on par with what the doc said). His doc is recommending adjuvant chemotherapy based on the positive results of the CALGB 9633 clinical trial for patients with tumor sizes >= 4cm. My understanding is that the chemo drugs will be a combination of paclitaxel and carboplatin - at least those are the drugs that were used in the CALGB 9633 study. We have an appointment with an oncologist tomorrow and will learn a lot more. My father has indicated that he won't go through the chemo unless the his 5 year life expectency is increased significantly (~20%) because he fears the side effects may be too much for him. Outside of lung cancer, he is healthy - no heart issues or other diseases. Getting information from doctors is one thing but hearing it from those with first hand experience is another.

Has anyone on this board with diagnosis similar to my father's experienced post-op chemotherapy? If so, what were the drugs prescribed and what were the side effects? Any additional words of wisdom are also appreciated. By the way, his doc said that the chemo would likely be administered on an outpatient basis in 4 cycles over a 3 month period.

Thanks!

jpb
Ex_Rock_n_Roller's picture
Ex_Rock_n_Roller
Posts: 251
 Joined: Mar 2011
May 09, 2012 - 6:27 pm
I have no experience with chemo after surgery ...

... since I was not a candidate for surgery (chemo and rads only, IIIB), so I can't give you firsthand experience on that. Somebody else probably will.

I will comment on: "My father has indicated that he won't go through the chemo unless the his 5 year life expectency is increased significantly (~20%) because he fears the side effects may be too much for him."

If he's in good health otherwise, he may want to re-think that for a couple reasons:

(1) 20% would be a big improvement for most comparative studies I've seen. That seems like a pretty high bar. It also looks like CALGB9633 is considered flawed to begin with, so if it came up with a lower improvement percentage, that might not be indicative of real effectiveness. This appears in a few different places via Google:

"CALGB 9633 was underpowered to detect small but clinically meaningful improvements. A statistically significant survival advantage for patients who had tumors > or = 4 cm supports consideration of adjuvant paclitaxel/carboplatin for stage IB patients who have large tumors."

(2) Many of us have undergone fairly onerous dual-chemo (even along with radiation) regimens with no hint of real problems. That describes my case. The chemo itself was pretty much a day at the beach for me (radiation was another story).

Obviously age comes into it (I was