Lung Cancer Prognosis

My father was diagnosed with lung cancer last week. He is 62 years old. His liver is free of cancer and his gerneral health is considered good. He has never smoked. They think it has spread to his lymph nodes but not to a significant extent if that makes any sense. I havent spoken to the doctor so i am relying on what he is telling me. He is starting chemotherapy tomorrow. He will do three days of treatment then two weeks off. He is scheduled for 4 of these treatments. Im guessing that since they are not operating and has spread to a small extent to the lymph nodes that is is a stage 3B cancer. The doctor told him that the type of cancer he has responds well to chemotherapy, that there is a good chance they can force it into remission but that it is also likely to reoccur. Im pretty scared. Based on the treatment regime and the fact that it has spread to his lymph nodes what would you think his prognosis is? Thanks for your help.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The prognosis of lung cancer depends on the type of cancer, the stage of cancer, general condition of the patient, and some genetic/mutation characteristics.
Staging of the lung cancer depends on many features. First, we need to establish the type of cancer. Lung cancers are essentially divided into "small cell lung cancer" (SCLC) and "non-small cell lung cancer" (NSCLC).
Additionally we need to know the size of tumor (T), the lymph nodes (N) involved (number, and group) and if there is involvement of distant organs (M). NSCLC is then staged according to the TNM system. SCLC is merely divided into limited stage and extensive stage.
My guess, from the few details you have provided, is that your father has SCLC (limited stage), and that he is getting cisplatin-etoposide combination chemotherapy. However, you need to confirm with your treating doctor if this is indeed the case. Additionally, you may like to discuss the plan for incorporating radiation therapy into the treatment schedule.
All the best, and God Bless!

[worriedman92591]

Thanks doctor. If it is limited stage small cell cancer what is his prognosis like?

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
Please discuss the diagnosis with your doctor first, and then we can talk in detail about prognosis etc. I can of course understant your anxiety, and your need to know, however vaguely, what possibly lies ahead for your father. THis must be a difficult time for you and your family.
Once we know for sure which cancer we are dealing with, and its stage, then we can have a more meaningful discussion.
Please keep me posted.
All the best!

[worriedman92591]

Thanks Doctor. I am 5000 miles away from my father which makes things even more difficult. He has small cell lung cancer. I dont know whether the doctors have told him if it is limited or advanced other than they have said that his health is good in general, that they think it is in his lymph nodes and that his liver is completely clear. He started chemotherapy yesterday will get more today and tomorrow and then 2 weeks off. I have heard no mention of radiotherapy. Is the fact that radiotherapy has not been mentioned a bad sign? Im sorry to bug you. I am terrified that i will never see him again.

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
The fact that his liver is not involved is a good sign. His lymph nodes, however, are involved. Radiation therapy is often added on after the second cycle or sometimes even a bit later in patients who are getting chemotherapy for limited stage small cell lung cancer. Treatment for extensive stage SCLC is with chemotherapy only.