Posted: June 6, 2019

For as long as cancer treatment has existed, oncologists have concluded that once you get metastatic lung cancer there is no point in doing more surgery.  All that is about to change.  Starting in 1995 Drs. Sam Hellman and Ralph Weichselbaum, two distinguished Radiation Oncologists from the University of Chicago, have promulgated the idea that selected patients with metastatic disease could benefit from having those lesions removed surgically or eradicated with radiation.  This concept has gradually taken hold, especially in colon cancer, where cures can be obtained by removing metastatic  lesions from the liver.  Conventional wisdom held that metastatic lung cancer was so lethal that it wasn’t worth considering more surgery.

Now come Drs. Gomez and Tang from MD Anderson Cancer Center in Houston who report in the Journal of Clinical Oncology in March 2019  on a study they just completed.  They looked at patients who had been operated on for cure with lung cancer who subsequently developed a few metastatic lesions (3 or fewer). Half got surgery or radiation to remove those lesions and half did not.   Click here for a copy of the abstract.  If you want the whole article Dr. Stark can email it to you.  Just fill out a request form on the right side of this page.

What the authors showed was a dramatic improvement in outcome for patients whose metastatic lesions were removed.  They had a 60% chance of being alive at five years, whereas without surgery that chance was close to zero.

Dr. Stark comments, For years I was a skeptic of this approach knowing its chief architects were radiation oncologists, whose modality would often be used in this setting.  The latest colon, and now these lung, data make a believer out of me.  The use of newer biologic agents after surgery to remove metastatses should further improve outcomes for patients who previously were thought hopelessly ill.