Surgery and Watch & Wait

Surgery

Your local physician / Organ Specialist has identified that you likely have cancer and may have gathered a tissue sample (biopsy) to better understand your disease. Surgery is used to control or remove the cancer entirely.

Before you have surgery, ask if an Oncologist needs to consult with your Surgeon. Depending on the size, extent of the tumor the Oncologist may advise that an adjuvant (complementary) treatment is conducted to shrink the tumor size before surgery or conduct a localized treatment soon after surgery to help contain the growth of the tumor.

Capturing Tumor Tissue

Your tumor tissue is as valuable as Titanium to you and your Oncologist in understanding your specific lung cancer type, as well as its cancer mutation or aberration. A portion of your tumor tissue will be preserved in paraffin for further analysis, future reference by your physicians. In addition, frozen tumor tissue, especially of rare cancers, can be used for further tumor analysis or medical research.

This frozen tumor tissue sample can also play a critical role in further determining the "signature" of your cancer. This tumor tissue sample may be required for genomic analysis which could identify the profile of your cancer.

Ideally, the tissue biopsy of your cancer taken at your initial diagnosis or surgery prior to any chemotherapy treatment is the optimal sample as this tissue exemplifies your tumor's signature in its original form.

“Watch and Wait”

“Watch and Wait” status may occur if the Surgeon and / or your Oncologist feels they may have removed, eradicated the cancer and will follow you and periodically monitor your status with various scans, blood tests etc. “Watch and Wait,” as difficult as it may be dealing with the unknown, is a hopeful status as you may later be deemed cancer free. Otherwise the alternative is to undergo treatment which poses a range of challenges including ongoing therapy. Pursuing “Cure” early on is a goal before the cancer spreads to additional locations.

This Watch and Wait hiatus also gives you time to prepare in case your cancer does progress in the future. Research about your specific disease, identify where the best medical institutions and disease Specialists are located for your specific cancer as different institutions tend to specialize, focus on treating certain cancer subtypes and may have access to more cutting edge treatment opportunities for that cancer subtype.

If you do not have an Oncologist specializing in your cancer type currently, it is a good idea to take this time to identify and make initial contact with them as things move fast if there is progression.

My philosophy is, the more you know about your specific disease, the better informed your decisions, now and in the future.

Questions to Ask your Surgeon Before Surgery

1. Please tell me about your background and experience int treating patients like me.

   
   

2. Please tell me about your experience with this specific surgery.

   
   

3. Please explain what this surgery involves.

4. How extensive will this surgery be?

5. Will there be a need for adjuvant treatment either before or after my surgery?

6. We plan to have genomic testing conducted so please harvest a sufficient amount of tumor tissue to accommodate such additional testing.

7. Will you also be harvesting lymph nodes during my surgery?

Questions To Ask Your Surgeon After Surgery

1. Are you pleased with the outcome of the surgery? Why?

2. What was the extent of the surgery; will my organ still be functional?

3. Were you able to harvest a sufficient amount of tumor tissue?

4. Were the surgical margins clean around the tumor?

5. Were you able to harvest lymph nodes? Did they look normal?

6. Do you recommend adjuvant treatment? If so, what type?

7. Please save, freeze a portion of the tumor tissue for my use so more extensive analysis of the cancer genotype, mutation can be processed if needed, down the road.

8. Can you explain the “Staging” result or is that conversation better left to have with my Oncologist?

9. Will you or the Oncologist order Comprehensive Genomic Profiling (ie CDx) for us so we can identify my specific cancer mutation (ie EGFR etc) as you have access to my tumor biopsy, and or tissue?