Question:

Looking for information on the post surgical follow-up treatment of small cell lung cancer with chemotherapy in persons who are H.I.V. positive. Surgical oncologists assert cancer was completely excised and chemo follow up is unnecessary. Medical oncologists advise follow-up with chemotherapy. Concern about effects of chemo in an H.I.V. positive person--might chemo leave one open to any number of full blown A.I.D.S. infections due to immunosuppressance?
Sincere thanks for any information you might provide.

Answer provided by:

Daniel Lee, M. D.
Assistant Clinical Professor of Medicine
UCSD Medical Center
Owen Clinic

In regards to your question, I must preface my answer by saying that I am not an oncologist, but an HIV specialist who has had many HIV+ patients undergo chemotherapy for many different reasons, including small cell lung cancer. There are obvious concerns with chemotherapy causing worsening immunosuppression in anyone, including HIV positive patients. In my experience, however, having full-blown AIDS does not necessarily prevent oncologists from giving chemotherapy, nor do they decide not to give chemotherapy for fear of further immunosuppression. It is a given that chemotherapy will cause immunosuppression, but often times, antibiotics can be given to help keep people from getting infections or other medications (ie. neupogen (G-CSF) or procrit (erythropoietin)) can be given to help raise someone's white blood cell counts or red blood cell counts to keep them out of the danger zones. In your situation, I would recommend having your medical and surgical oncologists consult with each other to come up with a solution, but I would not let the issue of potential immunosuppression deter you from getting chemotherapy, if it is truly needed. Good luck and take care.

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