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Father-in-Law just diagnosed with Stage 4 lung cancer

What is the general consensus of everyone concerning the best hospital for the care and treatment of lung cancer? I don't know which type of lung cancer yet, but I want to make sure that my father-in-law  has the highest chance of survival. Are there any tips/recommendations from those who have already traveled this road? Thank you for any help or advice that you may have. My prayers are definitely with everyone's family during your own struggles. God bless!

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Your father-in-law is in what city and state?  Remember that your father will be treated by an oncologist not a hospital so his care hinges, in my opinion, more on the MD's skills than on the hospital's reputation.  Let us know and we can make some care suggestions.



He lives in Muscle Shoals, AL, which is one hour from Huntsville, two from Birmingham and 2 1/2 from Nashville, TN. Thank you


    I don't have a specific hospital to recommend, but it is my opinion that a hospital in a larger metropolitan area (preferably a teaching hospital if possible) and doctor(s) that specialize in Lung Cancer should be a priority.  I live in a small town in NW Pennsylvania where the mass in my lung was treated for 7 months as pneumonia.  I was lucky enough to then get to see a doctor at Brigham and Women's Hospital in Boston who realized it was NOT pneumonia.  I ultimately ended up with a Thoracic Surgeon who specializes in Lung Cancer in women, and I have been No Evidence of Disease (NED a wonderful term you will see on this site) for 4 years.  I think doctors who see LC every day will have more experience and awareness of up-to-date treatments than doctors who deal with it sporatically.


Good luck to you and your father-in-law!  Please keep us posted!



Thanks for the info, Erin. Just out of curiosity, do you know how the stages are defined with lung cancer? He has been told that he has no mass, no lump, just spots in the right lung and a couple in the left(and this was after an initial diagnosis of pneumonia). He is not coughing up blood, no evidence of cancer in the bloodstream, a good appetite, he is active and otherwise healthy. How does that warrant a stage 4? His appt. with the oncologist is Friday and some of these things will be explained then, I'm sure. It just seems a bit premature to say it's stage 4 with none of the classic signs of it. 

First let me say that I am not a an MD and all MD's have different ways of doing things, but if your father-in-law has not had a biopsy, PET scan or blood test that confirms Stage IV, I'd be suspicious of the diagnosis. 

The criteria for staging LC (do you know if your father-in-law has small cell or non-small cell LC?) is usually this:

Stage I - cancer is confined to one lung

Stage II - cancer has spread to nearby lymph nodes

Stage III - cancer has spread to the chest wall or diaphragm; or to the lymph nodes in the mediastinum (space between the lungs); or to the lymph nodes on the other side of the body or in the neck.

Stage IV - cancer has metastasized to other parts of the body.

You will find that the people here have a remarkable amount of knowledge gained thru experience and are very willing to share.  We will all be thinking of you and after Friday when you you know more, will be glad to help.

Thinking of you,


Hi Brad,

Just to add some to what others have said, you can find a list of cancer centers that have lung cancer programs on our website here. These are programs that are either National Cancer Institute-designated Comprehensive Cancer Centers or cancer centers that have received accreditation from the American College of Surgeons Commission on Cancer. UAB has an excellent cancer center with a lung cancer program. If he can get there at least for a second opinion, I think it would be worth trying. There is no one hospital that is "best" for lung cancer. There are many centers that provide excellent care, and even people who go to the high profile cancer centers don't always think they got better care than a local cancer center with a really fantastic lung cancer team. But whenever possible, we recommend getting a second opinion (at least) from a cancer center that has a lung cancer specialist. They are the ones who are most likely to stay up to date on research and less likely to have a "one size fits all" approach. 

You can also find more info about staging here for non-small cell lung cancer and here for small cell lung cancer. Basically, anytime there is cancer in both lungs, it would be considered stage 4 NSCLC and extensive stage SCLC. But there are ways of treating even cancer that has spread. 

It's quite common for someone with lung cancer to have no signs or symptoms even when it is stage 4. I know that's kind of wild to consider but that's why lung cancer is such a sneaky disease. 

Hope that helps! 


Dear AmyLCA,

I know you were answering another person's post but I know how bad this sclc is and how fast it works.  Is it just standard  to do Cisplatin and Etoposide or Carboplatin and Etoposide as the first chemo for sclc in stage 4?  AS I have posted before and I see this has happened to others that the cancer isn't found until it has spread.  I love to read where so many people are getting into remission and I love to talk to them as sometimes it helps, so when you are talking to your onc. you can let them know your feelings.  And knowing of different chemos or regimens that have worked for others gives us a little more knowledge as I know there is no one size fits all approach.  Thanks for any help or advice.

Hi Barbie,

For SCLC, Cisplatin or Carboplatin and Etoposide are considered the best standard of care for the first line treatment (that means the first chemo you get). It's more standard for SCLC while with NSCLC, there is a lot more variety because there is a lot more variation in the types of NSCLC and what they respond to. Does that answer your question? 


Thanks Amy,

I'm just scared to think after they do the six rounds of this chemo and he still has some masses what next?  I know it took 6 ,mo. and 3 different doctors before this was diagnosed after it had spread to the liver.  Do some people who are in stage IV that has spread to the liver with the sclc ever get it to the NED stage?

Hi Brad, I just want to echo what Amy and the rest have said and just add that I have/had stage IIIB lung cancer and am now N.E.D.(No Evidence of Disease). I went to an NCCN center and received the best care possible and would recommend doing the same. More importantly though is that your dad and you are comfortable with wherever you go and can not only feel confident in your doctors, but feel comfortable with talking to them. I went to the Moffitt Cancer Center in Tampa Florida and love the place. I've seen them do some wonderful things for lots of people and would highly recommend them. I think it would probably be about an 8 or 9 hr drive so if that's a possibility, it would sure be worth looking into. As the others said, there are many good facilities.  Look around to find one that best fits all your needs.    M. D. Anderson in Houston is also not too far.   Good luck, God bless and keep the faith...



I just want to update everyone on my father-in-law's prognosis. As of Friday, he found out from the oncologist that there is not any cancer in the lymph nodes, his regular MD checkup was on Thursday and there was no evidence of cancer in the bloodstream, and today he is undergoing a full body nuclear scan (fasting and non-fasting). The oncologist never actually gave a stage of cancer, he just said he wanted make sure that it was not in the liver, bones or brain. I think his exact words were, "let's get a body scan and see what this is"(which I found curious). Congratulations to those of you who are now N.E.D. Thank the Lord; I will continue praying for you and your families. Thank you for all of your kind words and encouragement.



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