How Long Will My Treatment Last?

Among of the first things a newly diagnosed lung cancer patient wants to know is how long his or her treatment is supposed to last. This is a very legitimate question and well worth the asking, though the answer might not be as black and white as a patient might hope. Just as every cancer is unique, every patient must be approached as an individual, outside the generalities of statistics and average expectations. In cancer care, simple questions tend to have complex responses.

Length of treatment may be unpredictable.

Before even guessing at how long a patient might be in treatment, some basics must be assessed. Regardless of the type of lung cancer, the diagnosis is given in various "stages" that identify how far the tumor growth has progressed. This stage, along with the tumor's location, help the medical team determine whether surgery or radiotherpy is an option, or whether the patient will be better served by chemotherapy or the newer targeted or immunotherapy options. Then there is always the question of how well the patient responds to whatever therapy is chosen. Two patients with the same basic diagnosis could have entirely different responses to an identical treatment. An oncologist could suggest a range of outcomes, but until a course of action is tried and scans can be compared, there is no real way of estimating a timeframe.

As an example, I was diagnosed with a "fairly unremarkable" form of adenocarcinoma. That is to say, the DNA analysis showed no actionable mutations. My cancer had already metastasized, so surgery was not a real option. Instead we decided to go with chemotherapy and, after I consulted for a second opinion, I began taking carboplatin and pemetrexed. While this combination made me feel pretty crumby, at the end of three months I went in for a scan and learned that there had been a notable reduction in the tumor size -- but the tumor was still there. We had achieved a partial remission, to use the most optimistic terminology; the fact was, my tumor was responsive to the chemo and though carboplatin is generally only given for up to six rounds, pemetrexed was easy enough to tolerate for much longer. The revised timeline that I was given for treatment at that point was "indefinitely." Or, more accurately, until it stopped working. That happened after more than two and a half years, at which point a new treatment cycle began, with a new drug and a new, open-ended timeline.

No One-Size-Fits-All Answer

Other patients have different stories. I have met stage IV patients who have gone into full remission, with no evidence of disease, though they must consistently go back for scans to ensure that the cancer has not come back in another part of the body. In this sense, while some patients may be able to achieve full cures for early stage cancers (through surgery or radiation), others will see some version of treatment ongoing for many years.

It seems like it should be simple question. But, as with many things in a lung cancer patient's life, the answer is complex and personal. It is often best for a patient to enter the discussion expecting an open-ended answer. After all, life is open-ended as long as we are continuing to live it. For most patients, that is the end result we are hoping for.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.