chemo or not

[Claudelle]

recently my father has been diagnosised with stage I lung cancer(Nsclc) He has been given the decision to have chemo or not, He is a very viable 73 year old, who lives a good life, and looks like he is 60. No real medical problems, just on meds for high blood pressure.  He had a lobectomy, with no spread to the lymph nodes.
NO one can tell us, should he take the preventative chemo, or not !   I (his daughter) am very concerned about problems that the chemo could cause. What is  your advice!!!!!!!!   I am looking for anything that will sway us one way or the other, I have checked the stats , and even they do not help.
Thankyou, for any info you could provide us with.

[Claudelle]

Thank you for your response,
I do not believe you added to the confusion, but gave a bit of validity to our stats,and verified the decision that we have made.  I can only hope it is the right decision.
In our case, the risks out weights the benifit.  
Thank you

[HeinrikMD]

Hi,

While lung cancer is pretty common, capturing the disease at an early stage is uncommon. The experience with chemotherapy after removal of a stage 1 cancer is muddled because patients with more advanced disease like stage 2 and stage 3 are likewise included. Hence, while the overall experience of these patients favors giving chemotherapy, the benefit received likely decreases inversely with cancer stage. If you try to isolate the effect of treatment per stage, there are suggestions that the group of  stage one may not have any effect. I use the term suggest, because, these sub-analyses cannot provide a conclusive estimate of treatment benefit.

There is interest in genetic signatures (characteristics that modulate DNA repair mechanisms) for sensitivity of certain cancer subgroups. If the particular cancer is sensitive to the available chemotherapies – there may be a clearer role for treatment. There may be a relationship between the genetic signature and prevention of recurrence. At the present time though, this particular theory has not been adequately tested. What further makes matters difficult is that the role of the signature is uncertain as it may predict a response to the drugs, but may not mean improvement in survival overall. Hence, the implications of the signature, its presence or absence is not yet clear.

What it all comes down to is a value judgment based on personality. If you are conservative and demand clear evidence, you would perhaps choose not to accept the risks if the size of the benefit is not certain (or if it is there at all). A mathematical model published in Lung Cancer August 2006 estimates the gain in survival for a stage 1 would be about 4% at 5 years. Without chemotherapy, about 66% are expected to survive. With chemotherapy, the percentage would be about 70%.

Hope I did not add more confusion.