Would you still take chemo?

Hi Katherine55 - that is certainly a very personal decision. I personally chose chemo as an extra "insurance policy." I am very glad I did as my cancer spread which led me to immunotherapy. I've had no growth for 20 months so I gladly go every two weeks for therapy. Best of luck to you. Jennifer, LungCancer.net team

Katherine55,

If you had Stage 2B NSCLC and were lucky enough to have a 6cm tumor removed, then I am very happy for you, indeed. As you probably know, most lung cancers are not diagnosed until more advanced stages.

Now, I am NOT a doctor, so please do not construe this as medical advice. But I would STRONGLY suggest that you talk this over in detail with your oncologist and perhaps even get a second opinion on the subject. As I understand Stage 2B, there is a strong chance that the cancer may have begun to spread. I do not say this to be alarmist -- you already know that there is a chance the cancer will return. So why consider chemotherapy, even if there would still be a chance of recurrence?

Well, chemo can prevent or significantly delay recurrence. Depending on where the potential rogue cancer cells might be and how susceptible they are to the chemotherapy, treatment could kill them before they have a chance to continue to grow or form a tumor somewhere else. Certainly, this is not a guaranteed end-result. Not every cancer responds equally to chemo. Not every patient responds the same to chemo, either. It is pretty crappy for the first few months, but then it gets better and soon you will probably forget that it was even that bad at all.

I was on chemotherapy for 40 rounds -- every three weeks for over 2.5 years. Most of that was "maintenance" therapy, with only one chemo drug and a few shots each month, and it was no where near as harsh as when I was doing my first 6 rounds of platinum based chemo as well. There are a LOT of combinations of chemotherapy depending on the type of cancer (I have an adenocarcinoma, but there are many flavors), and also depending on what the purpose of the chemo is (sometimes it is meant to be curative, sometimes it is not).

If I was in your position, I would not hesitate to do the chemo unless you had some life-threatening reason for not doing it. While you might feel ill for a few months or you might lose some hair, these side effects go away -- hair returns (albeit often differently) and you stop feeling sick. Some side effects like neuropathy might linger, though this tends to be worse for patients who are on treatment longer. And the side effects vary dramatically based on what chemo is being used, SO BE SURE TO ASK ABOUT THAT. Still, knowing what I know about the experience I had, it would be very easy for me to say that, yes, going through chemo is definitely worth doing if the patient can handle it.

To me, the bottom line is that I would not mess with cancer. I would be aggressive in my treatment. And I would not personally want to give the cancer a chance to grow if there is something that I could be doing about it.

Now, you have had surgery and presumably, the entire tumor was removed. There is no evidence of disease. When you say that the chance of the cancer returning is the "same" either way, I don't know the context of that statement. If the odds of return are less than 1% either with or without chemo, I might avoid it and go with the 1% risk. But I would need more context if there was, for instance, a 30% chance of recurrence either with or without chemo, because that does not make sense. Chemo lowers the chance of recurrence, and therefore there should be a clear advantage to undergoing that therapy. In order for recurrence to be equal between patients using chemo and those not using it, there must be other variants involved that affect outcomes, whether that involves patients of different stages, or groups in patients who have not had surgical interveintion, etc. I don't have the data your statement was based on, so I cannot comment on it.

The bottom line, though, is that I truly believe from all the data I have seen, the historical outcomes, and my own personal experience, that chemotherapy is a highly effective and worthwhile treatment. It may not always be a walk in the park, but it is still a journey worth taking when there is a clear advantage for doing so.

As part of my blog and podcast, I have interviewed other patients who have undergone chemo for various cancers, too. Not one of them regretted having done it. Even a patient who had struggled through several different cancers over an eight year period showed no signs of regret for his chemotherapy treatments. He, like I do, credited chemo with allowing him to be around a lot longer than he would have otherwise, and able to enjoy a decent quality of life in the process.

Chemo is not perfect, but I think the fears are overstated and we, as humans, are usually more resilient than we give ourselves credit for.

Best of luck to you with your final decision.

In a word…no. Like you, my tumor was large, 5 centimeters. I was staged at 1B. I had an old-fashioned thoracotomy that removed two-thirds of my right lung. And, like you, I researched the matter and realized that subjecting my body to that poison offered little to no benefits. However, my oncologist very strongly advised that I undergo chemo. In my case, there had been a study suggesting chemo for stage 1B patients offered a slight survival benefit. As it turned out, almost immediately after completing my chemo regiment, my oncologist explained that a new study had debunked the first one. Therefore, for me, there was no benefit to the chemo. I had many unpleasant side effects from the chemo.

Even so, some would say, since I am alive 12 years after my diagnosis maybe the chemo helped. Perhaps. Nevertheless, unless the evidence showed a significant increase in survival, I would decline the “opportunity” next time.

By design, chemo is poison. It is meant to kill cancer cells; in doing so, it inevitably kills healthy cells, also. Even so, for most, surgery is not an option; nor is targeted therapy. Chemo may be the only option for many.

I trust you understand I am not advising you or anyone else about whether or not to take chemo. This is a very personal decision. I would encourage everyone to do their own research, talk to their doctor and/or get a second opinion. In the end, everyone must do what they believe is best for them. For me, the short answer is no.

Best of luck to you, Katherine! 😀

Dusty--LungCancer.net Team

I have the same problem. I had a 3.6 cm adenocarcinoma in my upper left lobe. I had a robotic assisted lobectomy. It had not spread to my lymph nodes. That was in October. I am supposed to meet with the oncologist on November 30. I have a lot of mixed feelings about chemo.