Life After Lung Cancer Treatment
What does a 'partial remission' of lung cancer mean?
Remission is used to describe the cancer as a response to treatment. In other words, how much of the cancer is actually shrinking. A partial remission implies that the cancer has responded to the treatment that was given. It has shrunk, but there is still residual cancer present.
What's the difference between 'in remission' and 'cured'?
Complete remission implies that the cancer has completely shrung down with responsive therapy and there is no detectible cancer by our current tests and radiologic studies. A cure implies that there is absolutely no cancer that's present. It is difficult to really determine that because there may be microscopic cells that may be present that we are not able to see with our current medical technology. With lung cancer being aggressive comparatively to other types of cancers, we really stay away from the term cure but rather utilize the term remission.
Is a 'complete remission' of cancer the same thing as a 'cure'?
Remission implies response to therapy. Remission is a term that's described to characterize the tumor as it shrinks in response to treatment. There's partial and complete remission, depending on where the residual tumor is present. It is a partial remission versus a complete remission where there's no detectable cancer that's present. Cure implies that there's absolutely no cancer that's present. We stay away from the term cure for lung cancer because it's an aggressive cancer, and because the recurrence rates are around 30%. Also, second lung primaries can occur in about 30% of patients. Therefore, in lung cancer treatment and management we don't use the term sure, but rather remission.
How frequently will I need check-ups once I'm done with lung cancer treatment?
After completing treatment for lung cancer and if there's no evidence of disease by our current studies, you are still at an increased risk of developing a recurrence or developing a second lung cancer primary. As a result, surveillance is an important component of your post-treatment management. However, because there's currently no real endorsed recommended surveillance protocols by any of the major organizations, many physicians have resorted to practical ways of surveillance until one of these definitive recommendations can come in the future. Most physicians will recommend that after undergoing complete treatment for your lung cancer, that every 6 months you get a chest CT scan for the first two years, which is the period at which you're at the highest risk of developing a recurrence or a no lung cancer, and thereafter annually. This is not something which is endorsed by any of the major organizations but rather this is a reasonable practical approach to surveillance until we get more definitive data.
Is it possible to regain the same aerobic fitness I had before lung cancer?
It's possible that you may have the same level of fitness before and after lung cancer treatment. It depends on your underlying lung function, as predicted by our pulmonary function studies, and also on a second test that your physician may order, called a Quantitative Lung Profusion Study. If you have a fairly good pulmonary reserve, you may not feel any difference before and after therapy. On the other hand, if you have a great deal of chronic underlying lung disease, then taking a portion of your lung out surgically and undergoing other treatments may impact you greater than other patients who have relatively normal surrounding lung.
Are there support groups for lung cancer patients?
There are definitely support groups for lung cancer patients. There are national support groups that are readily available and accessible through some of the major organizations like American Lung Association and the American Cancer Society. Both of those websites will list national support groups. Also, locally at your hospitals, your physicians may be aware of local support groups that are available through your hospital.
Is it possible to survive the recurrence of lung cancer?
We certainly have treated patients that develop a recurrence of lung cancer after undergoing full treatment for lung cancer. And although it appeared clinically that they were in complete remission with no evidence of disease, because the risk of getting a recurrence are around 30%, we certainly have treated patients, restaged them radiographically, and have undergone the diagnostic work-up and treated them as if they were undergoing treatment the first time. So, yes it definitely is possible to treat recurrences.