One of my sisters got disagnosed yesterday after a biopsy at UT Southwestern with Stage 3 lung cancer. I understand there are basically four types and I don't know what hers is yet. There are substages 3A, 3B, and 3C. Don't know which or if it's in both lungs. She's calling me soon basically to get my opinion of whether she should go to UT Southwestern in Dallas or MD Anderson in Houston.
Thoughts?

What type? I have had 3 relatives lost to it and it I seem to recall there were many different types with different prognoses.

Asked the docs I work with what they'd do. If she's located in DFW, I'd start with UTSW. 1st line treatment of cancers is pretty standardized across the board. Now if they need to do something more specific or surgery is involved, then start looking from more specialized care.

What Wangus said...

Lost my father-in-law to it and lost my mom (COPD - but had her cancer had come back).

I was amazed at the job of the onocologist. There are treatment protocols on a decision tree. They just follow the decision tree. Was not impressed by the level of skill needed to be an oncologist. If you meet XYZ on being fairly fit, then there is one treatment (my father in law). If you are in poor general health, there is another (my mom). In the case of my FIL (stage 4 never smoked), he was treated at Scott and White in Temple. He was in great health and was eligible for experimental treatments. My mom (stage 3 lifelong smoker), they told her that not treating it was a viable option. Dying of COPD as soon as she did after getting her lung removed, chemo and radiation therapy, I wish the dr would of pushed not doing anything.

FWIW, if y'all don't hate the business of medicine already, y'all will when it is all said and done.

Some unsolicited advice:
You MUST be your own advocate. They see thousands of patients. You are just a number. They don't get that you don't understand what is going on. My mother-in-law was diagnosed with a different type of cancer last year. I had to go in and straighten everything out that they screwed up. My wife and her didn't understand that you basically have to manage your own case.

Also, do not discount homeopathic relief. With my MIL, she was having very low platelets. We got some supplements that were recommended by people who have been through cancer. The clinic was going to give her a very expensive shot. After taking the supplements for a week, her count went way up and didn't need it. I have a friend going through the same thing and just dropped the supplements off last week. Hopefully it will work. Marijuana has also helped a lot with the nausia and overall well being.

I'll probably thing of more, but maybe the most important thing is to hold on to the good things. Put aside petty things. Relationships and people are what is important in life. Don't forget to reach out, visit, laugh, say I love you. You never know when you won't get another chance.

Real quick update (just got a text)...

My friend I took the supplements to last Wednesday got his platelet count up to where they could treat him. I'm not saying the supplements were the answer. I'm just saying that the two people I know that have used it both eliminated their low platelet count and that is the only thing that changed.

Doctors will stear you clear of supplements. They can't make money off of them.

Thank you all for your advice. I'm pretty sure she will go to Southwestern as it is 2 hours closer to her home.
My sister (the patient) called this afternoon. Stories got mixed up but apparently they did NOT do a lung biopsy because they feared of a collapsed lung. They did a biopsy of lymph nodes. Her next appointment is Wednesday. I'm not sure but I'd think the lymph nodes biopsy would tell what type. I'm hoping the middle sister doesn't ask her a million back to back questions. She means well and has been crying hard.
We are hoping it is Stage3A and contained to one lung. Prognosis is something I'll never talk to either sister except my oldest. The 5 year survival rate is only 15 - 30% unless it's small cell type then it goes down to 5 - 15%. She's married and her 2 sisters live in same East Texas town 2 hours East of Dallas. She's coughed up blood and I hated to hear that.
Again, thank ya'll!

Edit: The first opinion was from a small town doc and UT SW was the second opinion. I suggested she might do a consult with MD Anderson. To me that would be a real second opinion. I'm trying to only answer what she asks me.

BartInLA said:

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Thank you all for your advice. I'm pretty sure she will go to Southwestern as it is 2 hours closer to her home.
My sister (the patient) called this afternoon. Stories got mixed up but apparently they did NOT do a lung biopsy because they feared of a collapsed lung. They did a biopsy of lymph nodes. Her next appointment is Wednesday. I'm not sure but I'd think the lymph nodes biopsy would tell what type. I'm hoping the middle sister doesn't ask her a million back to back questions. She means well and has been crying hard.
We are hoping it is Stage3A and contained to one lung. Prognosis is something I'll never talk to either sister except my oldest. The 5 year survival rate is only 15 - 30% unless it's small cell type then it goes down to 5 - 15%. She's married and her 2 sisters live in same East Texas town 2 hours East of Dallas. She's coughed up blood and I hated to hear that.
Again, thank ya'll!

Edit: The first opinion was from a small town doc and UT SW was the second opinion. I suggested she might do a consult with MD Anderson. To me that would be a real second opinion. I'm trying to only answer what she asks me.

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Personally I think MD Anderson is ALWAYS worth an opinion. Their protocols can be administered anywhere.

You can also search Sunshine Act to see records of all payments made from drug/device companies to physicians if someone really wants to be nosy!

I 100% agree
Thank you!

Oh, and I hope it works out for the best, you have my sympathies.

MouthBQ98 said:

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What type? I have had 3 relatives lost to it and it I seem to recall there were many different types with different prognoses.

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She is turning 69 in April, has type 2 diabetes and is overweight so that works against her. We don't know yet if it's in both lungs but it is in at least one lymph node.

3 types of Non-Small Cell Lung Cancer (NSCLC)
A) Adenocarcinoma is the most common lung cancer with a 5 year survival rate of 15 - 30%.
B) At this same survival rate is Squamous Cell Carcinoma. It's the second most common lung cancer about 1/2 the number of cases as "A".
C) Large Cell Carcinoma occurs 1/2 as much as "B. All 3 NSCLC have a 15 - 30% five year survival rate
2. The last basic category is about 15% of all lung cancer rates. Small Cell Lung Cancer (SCLC). It's typically the most aggressive with a 5 - 15% five year survival rate.
Lots of factors, just hope she responds quickly to what will probably be a cycle of radiation and chemo at least. She is strongly Christian and I'm sure that helps her. She has been completely joyful when we last talked. She and I never use Marijuana but if it helps with the nausea better than traditional meds I'm all for it except I'd imagine it could be hard on your lungs. Medical Marijuana may be her route but she can try to get a small medically prescribed before Chemo to have ready if severe nausea occurs.

Thanks again everyone. Hug your friends and family and tell them you love them.