Standard of Care surgery for 7cm tumor??

[hopejunkie]

My father has a 7 cm LLL tumor and, currently, there are no visible mets to lymph nodes or brain. We are curious if an open surgery would be standard of care? Or something less invasive like the VATS approach or robotically? We are considering a second opinion. Would be grateful for your feedback!🙏❤️

[Janey_H]

I don’t know if it is determined by size but I had a 3.5cm tumour removed via VATS back in 2015. I had a lobectomy (RUL).

Hope this helps and hope your dad’s surgery is successful. Also, second opinions never do any harm - even if just for peace of mind. Is a shame to find an alternative after the event.

Best of luck xx

[kri312 in reply to Janey_H]

Have your scans been clear since. I had vats in 2018. Best of luck to you

[Janey_H in reply to kri312]

I was diagnosed with advanced lung cancer (stage IIIB) so was deemed inoperable at diagnosis. When I had my lobectomy I had already had chemo and a course of radiotherapy. I then had clear scans until late 2017 when a node in my neck showed up. I had surgery again to remove that and another course of radiotherapy. Scans have again been clear since then - although have all routine scans again next week so fingers firmly crossed again!

[kri312 in reply to Janey_H]

will be thinking of you and wishing you clear scans...

[hopejunkie in reply to Janey_H]

Thank for your reply, Janey. ❤️🙏 Yes, I hear you on the 2nd opinion. Did they remove any lymph nodes when they preformed the VATS?

[Janey_H in reply to hopejunkie]

Hi - I had my mediastinal nodes removed during the VATS as the nodes had previously been malignant but had been zapped to ‘inactive’ by radiotherapy prior to surgery. Hope that helps!

[Missy2360]

My 4.5cm was removed via VATS on 3/30/21 and I’m not sure you get an option. If they can do it VATS it’s a much easier rebound. 2-3 weeks for me. Sometimes they just can’t get all to where the want so have to do open. They did the biopsy while I was open. I elected for them to remove as much as possible and do the 4 rounds of chemo. 2 down...two to go. As far as 2nd opinions go...I have an amazing cancer center so I was comfortable and did not feel the need for one...plus lots of amazing answers here from folks who who have been there...done that...and rang the bell! Prayers for Dad!!

[hopejunkie in reply to Missy2360]

Thank you so much Missy!! ❤️🙏What do you mean by that you "elected them to remove as much a possible?" What were you options? Happy to take if off-line, too. All the best to you!!

[hopejunkie in reply to hopejunkie]

Also, did they remove any lymph nodes? Thanks!

[Missy2360 in reply to hopejunkie]

I guess elected was not the correct word choice...I arrived at the hospital not able to breathe...they started all the scans (CT, Ultrasound etc.) and found the obstruction. A 4.5cm tumor that had "flopped" onto my airway ( a freak occurrence per my thoracic surgeon and a lucky one...go figure) Next to Pet and Brain Scan prior to surgery to resection around the tumor to make sure they got it all. They showed no visible hot spots ..they would test 8 lymph nodes while they had me open (VATS). I had no idea if I would wake up with a Hugh incision or the slim line version. Apparently they could get to all the areas of concern without going the distance of the "open" surgery.

My thoracic is one of the best...and pretty sure he "got it all" but if I was his sister...please do the chemo he said...it was the last line of defense and if it ever came back I could at least know with a sound mind that I did everything I could with no regrets. I am happy to talk about it anywhere you are comfortable. My best piece of advise...it's all about the attitude...so go give cancer a piece of your mind and tell it there's a whole lot of people, places and things your Dad still has to do...then convince your Dad of that and how important he is to your life. He will fight even harder. Your Dad is blessed to have you. Keep going!

[JanetteR57]

I had a 7cm tumour removed and upper left lobectomy in Dec 2010 . VATs or robotic assisted surgery were not around then. In the UK VATS has now overtaken open surgery for lung cancer operation - but sometimes the surgeon aims to use keyhole but then depended on the position, may have to convert to open surgery. Surgery is usually determined by the location of the tumour, the general health of the patient and whether it has spread beyond the lung. I was at work and swimming by the end of March 2011 and had no further treatment. Very few patients are clinically eligible for surgery in the UK as often detected too late and at the time the specific type I had, the surgeon said was rare and no evidence of responding to chemotherapy after the surgery but in recent years the optimum lung cancer pathway changed and the size of tumour at 7cm I would have been offered adjuvant (mop-up) chemotherapy. however the pandemic has changed things in the UK so adjuvant chemo has been a discussion with the patient and clinician to explain the odds of treatment (5%) with risk of contracting covid in hospital by frequent trips for chemotherapy. Surgery is the main 'gold' standard for curative intent so I'm unsure what you'd hope to gain by obtaining a second opinion... in my case, no biopsy was done pre-surgery as the 'large mass' showed clearly on all imaging (chest x-ray, CT and PET scan) and was tested frozen section on the day for EGFR but negative - this was the only mutation for which there was a targetable treatment at the time (but that situation has now changed considerably in terms of targets) so sent off to pathology for full analysis so received my diagnosis in Jan 2011. The main difference between open and keyhole are the number/size of incisions, length of stay in hospital and potential risk of infection lower with keyhole. I had no mets either. hope this gives you some hope - I've met patients who are many years out from surgery - including 20+ years and had no idea at the time of my surgery... I've been involved in lung cancer research since 2014... - you may find this information helpful, compiled by the local tertiary surgical centre and Roy Castle lung cancer foundation (the UK's major lung cancer charity) and updated just before last year's lockdown. good luck. roycastle.org/app/uploads/2...

[hopejunkie in reply to JanetteR57]

Dear Janette: Thank you for taking the time to share your story and experience. It's so inspiring! ❤️🙏 I wish you all the best and continued good health.

[JanetteR57 in reply to hopejunkie]

Thank you - best of luck to you too - I'm not unique - but I had no idea there were so many long term survivors around until I became involved in LC research.... the treatment landscape has changed beyond recognition in recent years so never give up...

[katherineNED]

If it hasn't spread and the doctor thinks he's a candidate for surgery go for it! One and done. I had my upper left lung removed and 15 lymph nodes with VATS. Even though they didn't show up on the PET scan 2 nodes the surgeon removed had cancer so I had to do chemo. The recovery from the surgery was easier than chemo treatment. I was almost back to normal within 2-3 weeks of surgery and did a 3 mile hike after 8 weeks. To get back to 'normal' after chemo was almost 6months!

[judg69]

Go with whichever the surgeon recommends and prefers . Depending on the situation and/or location sometimes one or the other is the preferred option. I had an open thoracic lobectomy nine years ago and with the proper exercise on my part I recovered fine. I had full radiation also with no real problems. My biggest issues were with the two years of chemo I required, of which I did have some real issues, but it was all necessary, and all worked out. Best Wishes, judg69