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

j_p_b

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

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 59 at the time), and not everybody is as lucky, but I'd encourage your dad to consider giving it a try. He can always stop. Then again, since he's getting the major advantage by having surgery to begin with, at his age, he may just want to go for maximum quality of life. That's a personal decision and equally valid in my opinion, but I just wanted to offer up that the chemo may not be as bad as he foresees.

All the best to Dad!

joep531857

stage 1b
Hi my name is Joe. I was diagnosed in dec 2010. Had VATS for upper left lobectomy. The tumor was just touching my pleura sack so i was staged at 1b. I underwent 4 mos of adjuvant chemotherapy. My drugs were cisplatin and vinorelbine. It did cause me to have alot of nausea, tiredness and weakness but I was able to finish the therapy. I have some issues with neuropathy in hands and feet from it that require medication. I believe it significantly increased my 5 yr survival rate. I am now on 6 mo scans and appts. I have been ned( no evidence of disease) for just about a year now. I am feeling very well and continue to get stronger. Everyone is different so I would recommend that he should give it a shot, just a personal opinion and I am glad i did it.


Sincerely,
Joe

catcon49

joep531857 said:

stage 1b
Hi my name is Joe. I was diagnosed in dec 2010. Had VATS for upper left lobectomy. The tumor was just touching my pleura sack so i was staged at 1b. I underwent 4 mos of adjuvant chemotherapy. My drugs were cisplatin and vinorelbine. It did cause me to have alot of nausea, tiredness and weakness but I was able to finish the therapy. I have some issues with neuropathy in hands and feet from it that require medication. I believe it significantly increased my 5 yr survival rate. I am now on 6 mo scans and appts. I have been ned( no evidence of disease) for just about a year now. I am feeling very well and continue to get stronger. Everyone is different so I would recommend that he should give it a shot, just a personal opinion and I am glad i did it.


Sincerely,
Joe

jpb
Sorry to hear about Ur father. I did not receive chemo; but my 76 year old mom did although she had ovarian cancer. Her side effects were minimal. She has neuropathy in her feet. She has survived stage 3c for 4 1/2 years. Just celebrated her 60th bday