"Remission" of Stage IIIB Non-small Cell Lung Cancer (NSCLC)
My mother was diagnosed with non-small cell lung cancer stage IIIB. She has completed her 6 treatments of chemotherapy (taxol). The tumor has shrunk from 4cm to about the size of a thumbnail. Her doctor has now told us that he will do follow-up scans and blood work and that we will see him in 6 weeks. Is this stage considered remission or must the tumor have completely disappeared? Do you believe that there are any possible treatments that will make the tumor completely disappear? Any information would be much appreciated.
Barbara Campling, MD, Medical Oncologist, responds:
Your mother has stage IIIB non-small cell lung cancer that has been treated with 6 cycles of chemotherapy. Usually, stage IIIB non-small cell lung cancer is not surgically operable. Depending on the situation, chemotherapy or radiation therapy may be used. Often these two forms of treatment are given concurrently to help shrink down or even, in a minority of cases, to eradicate the tumor. In your mother's situation, the tumor has had an excellent response to chemotherapy. This is called a partial remission. A complete remission is when the tumor disappears so that it cannot be seen on imaging. However, unfortunately, even if a lung cancer goes into a complete remission following chemotherapy, it usually eventually starts to grow again.
It is hard to say without having a chance to examine your mother and see all of her scans whether any further treatment would be appropriate at this stage. It is unlikely that any more chemotherapy would cause any further shrinkage of the tumor. If radiation therapy was not recommended at the outset, consider asking your medical oncologist about if your mother would not be a candidate for radiation therapy. If she is a candidate, radiation therapy to her residual primary tumor might be helpful to cause further shrinkage of the tumor and to delay recurrence. The results of her follow-up scans should be helpful in deciding whether any further treatment is indicated.