Can Stage IV Lung Cancer Patients Have Surgery?

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Topics include: Understanding

From our Ask the Expert series, Dr. David Odell answers the question, â??Can some stage IV patients have surgery?â?? Dr. Odell dispels the belief that once a lung cancer patient is stage IV, they are no longer surgical candidates. He discusses oligometastatic disease and patients receiving targeted therapies.

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Transcript

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Janet Freeman-Daily:

So one of our patients, Bridgett, asks, can some stage IV patients have surgery? 

Dr. Odell:

That's a great question. I'm really glad that Bridgett brought that up, because it's one of the misnomers that's out there especially in the community, that if you have stage IV disease that's it, there's nothing else that we can do. And there's actually in lung cancer very good data in the setting of what with you call oligometastatic disease, in other words where you have stage IV to a single site. 

And where this is best studied is when you have a stage IV tumor where the metastasis is in the brain, where that tumor that travels to the brain, and oftentimes these are things that are discovered when folks present with neurologic changes.  They get dizzy, they have changes in vision or they have a seizure, and the brain mass is actually how their lung cancer is discovered. In many of those patients, we're treating that single site in the brain, giving them chemotherapy and then attacking the primary tumor in the lung either surgically or with other local therapies like radiotherapy. 

Janet Freeman-Daily:

Some patients on targeted therapies might develop one site of progression.  Can you treat that with surgery?  

Dr. Odell:

We can, and one of the debates that we often have in that situation is has this tumor transformed?

Is our therapy that was targeted to a biopsy sample that we had six months ago, 12 months ago no longer effective in that one area, because that tumor has developed a slightly different cellular type? So surgery in that setting is very useful both to help guide that progression of medical treatment but also to potentially render that last area of known demonstrated disease that we can see on imaging free. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on November 1, 2016