Radiation versus Surgery for lung cancer stamped from probate cancer

[westerville]

I have two options either surgery or dart radiation from Dattoli cancer center in Sarasota . Dattoii radiated my cancer when it went to first to my lymph nodes and then to my ribs . So I have been good since 2012 but now I have a nodule in my left lung 2.3 cm after the biopsy . It was stamped for prostate cancer . So far it hasn't spread past that nodule but lung cancer seems different than being elsewhere . I go to the thoracic surgeon Thursday for a consult . Dattoli just called and he has agreed to treat me after seeing all my scans and biopsy . Anyone have any experience with either treatment ?

[Grumpyswife]

My husband had a lung wedge resection because a C11 Acetate scan showed active lesions. It took about a year on ADT before more lesions showed on Axumin scan. They are supposedly in an area that can’t be radiated but I am interested in learning more about pencil proton radiation.

[Tall_Allen]

It depends where in the lungs it is. If it's on the periphery on the right side, radiation may be doable. I would favor stereotactic radiation (SBRT) over what Dattoli uses because of its precision (it was developed originally for brain tumors), its convenience (less than 5 treatments), and they can use an ablative dose. VMAT with respiratory gating is ideal for this purpose.

Surgery is the more classic option, and may have minimal side effects if it's in a place where it can be dissected laparoscopically.

The other option is to treat systemically, perhaps combining docetaxel with carboplatin, which usually has good results in shrinking visceral mets. I think it is important to treat what you cant see, and there is undoubtedly more where that came from.

[Sxrxrnr1 in reply to Tall_Allen]

Sixth year into my PCa diagnosis, I had annual MRI and CT scans. 8 mm lesion showed on upper third lobe on right lung,,,right lung has 3 lobes, left only two.

Question was, is it PCa met or is lung cancer? Biopsy proved NSCLC ADNEOCARCINOMA.

Scheduled for open surgery to remove lobe,,,fairly drastic surgery. Decided further investigation warranted,,no watchful waiting or delay as with PCa allowed.

Consulted with a surgeon(world renown)at UCSF who was early on experimenting with genetic tumor analyses to determine if additionally chemo would be of value, or just a SOC that was always done just because.

I then switched to him and an ex Nebraska football player Physician/Surgeon who consulted with him on surgery. I am originally from Nebraska, go Big Red.

Was decided could also remove tumor via lumpectomy and do so Laparoscopically. Three small holes for instruments, tumor extracted leaving lobe intact, 4 days in recovery went home with a couple of bandages. Minute scaring, no broken ribs, no muscle destruction, etc

Annual CT scans eight years later, all remains clear,,,oh yes,,and no chemo prescribed.

Second opinions can pay off.

I can state that PCa saved my woe-begotten butt,,,what’s more if I had chosen to initially treat my PCa, which I did not, and had not continually submitted to annual CT scans,,,likely too would not have discovered this relatively early stage tumor when still treatable. LC as opposed to PCa is orders of magnitude more serious than is PCa.

[Grumpyswife in reply to Sxrxrnr1]

My husband only spent one night in hospital for wedge resection with a few scar holes. One night in that place was enough. He was lucky to make it out alive with the nursing stupidity I saw.

[cesanon in reply to Tall_Allen]

Tall Allen, I always thought you favored systemic therapy in such situations?

[Tall_Allen in reply to cesanon]

Re-read what I wrote

[cesanon in reply to Tall_Allen]

It seemed pretty lukewarm on the systemic option. Does that accurately represent your sentiments when considering mets in the lung? Are mets in the lung a sufficiently serious localized situation as to deserve consideration of localized treatment in your opinion?

[Tall_Allen in reply to cesanon]

I'm sorry you don't like the way I express myself.

[cesanon in reply to Tall_Allen]

Au contrair, I learn much from you. I think we all do. I was just trying to clarify.

[pjoshea13]

I love it when spell-check makes a Freudian slip. I had to smile when I saw "probate cancer".

Thanks - & best of luck with the procedure you choose.

-Patrick

[MichaelDD]

I have only-only lung metastasis. Found by GA68-PSMA scan at UCSF last year. My largest (nodules are in both lungs) 9mm ,then 7mm, 6mm. Told "more then 10 " after noting these 3. Have a well known Oncologist at UCSF. Told to many to radiate and no surgery possible. If it were one or two radiation could have been a consideration. He said the cancer is in there. No stopping it but as I was told "we (UCSF oncologist) will do a heck of job holding it back". I'm on Zytiga/Lupron. Last 5 months PSA <.006. Both my Oncologists ( local and UCSF ) don't use my PSA as an indicator of treatment failure. I get blood work done every month. It's kind of a look see for both doctors. Scans every 3 months are the determining factor. Last 2 scans show slight shrinkage . Good defense holding it back so far