The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013
My friend quit smoking and then later was diagnosed with lung cancer. She is in her early 40's and had 1/3 of her lung removed, but now the cancer has spread into several small tumors in different places. Due to her mother and younger sister previously dying of breast cancer and having side effects from their cancer therapy, she has decided against chemotherapy. What should we advise her?
Barbara Campling, MD, Medical Oncologist, responds:
It is hard to know how to advise your friend without a bit more information. It is interesting that she quit smoking some time before she was diagnosed with lung cancer. This is a peculiar association, which we see very frequently. She initially underwent surgery for her lung cancer. Surgery is generally reserved for patients with localized cancers, which are potentially curable. Now you say that the cancer has spread to several small tumors. Do you know what organs it has spread to? Has it spread outside of the chest? Unfortunately this happens all too often. Generally speaking, once the cancer has spread outside of the chest, there is no form of treatment that is curative. However, it is still treatable. Chemotherapy can often relieve symptoms and prolong survival in patients with lung cancer that has spread outside of the chest. Although chemotherapy also has significant side effects, we are now much better at controlling these side effects. On the other hand, the effects of the tumor can be quite unpleasant, and patients often feel better if their cancer responds to chemotherapy. Some patients have negative ideas about chemotherapy because they have had friends or relatives who have died of cancer and have been on chemotherapy. However, many times it is the cancer that made them sick, and less so the chemotherapy. It is her decision whether she goes ahead with chemotherapy, and no one should force her into it. Regardless of whether she has any form of treatment, it is important that she be followed regularly by an oncologist. There are many symptomatic measures that can be used to relieve pain and make her more comfortable even if the cancer is progressing.