Original Title: Dilemma: choose radiation or second lobe surgery removal.

Please comment and advise me.Confirmed: December 21st. is the darkest day of the year, after a CT scan my lung surgeon toll me that lung cancer is back.I hate to give my wife this Xmas present, I will tell my kids in January.I am a tall 69 year old canadian male, never smoked but had NSCLC adenocarcinoma 5.5=cm tumor stage IIB pT2N1 removed with right upper lobe in Jan 2005. Before that had 1 month of Iressa and after surgery had Adjuvant chemo Cisplatin and Vinorelbine for 3 months. Great surgery In Princess Margaret Hospital Cancer Center and fast recuperation, discomfort and failure with chemo. Now have to do Blood work, MRI brain, bone scan, lung biopsy (my request), abdominal ultrasound, pulmonary functions test and see a Radiation Oncologist. If tests are OK I need to make the best choice: a.- Surgery: remove 2nd right lobe and end with 60% lung capacity, my volume was always high and good. Minor concern a few experiences of atrial fibrillation controlled with daily half atenolol, blood pressure low OK. or b.- Radiation: New for me. Does it cure or just reduces size and spreading of cancer tumors? Concern about my esophagus, I had stomach reflux for a few years, controlled with Ranitidine or Zantac. Does radiation burns and damages good areas? Any info or experience with Image Guided Radiotherapy (IGRT) or Stereotactid Body Radiation Therapy (SBRT)?? c.- Other type of Chemo? Thanks for your info and have a good holiday season. Guillermo Berazadi

Thanks for all the information and support.
After additional tests PET scan found only a 18 x 13 mm soft tissue nodule (with an SUV of at least 3.5 ?)associated with right major fissure and prior lobectomy suture. Also the right fourth rib is worrisome with a focus (with an SUV up to 2.8 ?), waiting for thorax MRI results, can be benign trauma.
Oncologists did not recommend SBRT in my location, can not use strong doses without damaging organs.
So on Feb 26th. I will have right middle lobe removed with the traditional larger cut operation. My tested lung capacity surprisingly is the same as before the first lobectomy, lung expanded, and 125% of expected for my body and age! So I'm going to be average after 2 lobectomies... Optimist, hope is a cure and buys me more enjoyable time, feel very well, traveled a lot in the last 2 years and had one daughter married and other finishing university!!!
I'm also lucky treated in Toronto, Canada in one of the world 5 major cancer centers with all expenses paid by OHIP Ontario Health Insurance Plan.
Good luck to all of you. Carpe Diem

Guillermo passed away July 13, 2011, wife and two daughters by his side. I met him online through another blog. He was insightful, funny, and often brilliant. RIP

Thank you for the update, though I am very saddened to read this post. My condolences to family and friends.

Carol

_________________
Carol
64 Year old former smoker
1/4/05 at age 56 DX NSCLC, upper right lobe.
Staged IIA by PET Scan.
Restaged to IIIA by surgeon prior to surgery, after he examined PET and CT Scan results.
4/7/05 Completed 6 weeks of radiation and chemotherapy (taxol/carboplatin).
4/29/05 CT Scan.
5/21/05 PET Scan.
5/31/05 Met with surgeon, PET Scan showed nodule in left lung lit up that never lit up before.
6/9/05 Biopsy=OK nodule is scar tissue.
7/1/05 BRONCHOSCOPY,
MEDIASTINOSCOPY, THORACOTOMY SURGERY=ALL MARGINS CLEAN, 20 LYMPH NODES REMOVED. PLUS ONE RIB BONE. ALL NEGATIVE FOR CANCER.
8/9/05 & 9/1/05 ADJUVANT CHEMO. 10/4/05 1ST CT SCAN="Defined patchy density at the superior segment of the right lower lobe. Findings are most likely related to recent surgery and/or posttreatment change, however, this should be followed on subsequent studies".
1/3/06 Brain CT=Clear;Chest CT=Scar Tissue.
1/4/06 ONE YEAR SINCE DIAGNOSIS
4/1/06 Brain & Chest CT=NED. 6/13/06 XRAY=NERD.
7/1/06 ONE YEAR SINCE SURGERY.
10/25/06 CT=NED.
1/4/07 TWO YEARS SINCE DIAGNOSIS
5/3/07 CT=NED.
7/1/07 TWO YEARS SINCE SURGERY.
11/6/07 CT=NED
PLEASE continue to keep me in your prayers.WHEN PRAISES GO UP, BLESSINGS COME DOWN.[/size]
1/4/08 THREE YEARS SINCE DIAGNOSIS
3/20/08 CT=NED
6/20/08 X-RAY=NED
7/1/08 THREE YEARS SINCE SURGERY.
10/27/08 CT=NED
1/4/09 FOUR YEARS SINCE DIAGNOSIS
3/26/09 X-RAY=NED
7/1/09 FOUR YEARS SINCE SURGERY.
9/17/09 CHEST X-RAY CEA BLOOD TEST=NED
1/4/10 FIVE YEARS SINCE DIAGNOSIS
3/29/10 X-RAY=NED
10/5/10 CT=NED
4/1/11 X-RAY=NED
7/1/11 SIX YEARS SINCE SURGERY
10/10/11 X-RAY=NED
4/15/12 CT/PET=NED
4/18/13 CT=NEW 3MM NODULE FOUND ON UPPER LEFT LOBE

Stephanie, my condolences. I know the passing of online friends can hit as hard as someone we interact with in the physical world.

Judy in KW

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Cytology report on fluid removed from lung after pleural effusion and pneumonia Sep 07 showed adenocarcinoma cells. Dx IIIb NSCLC Oct '07 at MDACC, Orlando. Fol 6 rounds Taxol/Carboplatin/Avastin and 2 Avastin, CT/PET 4/1/08 pleural thickening gone and no active cancer cells. 11/3/08 STILL NEVD. CT/PET/MRI 5/4/09 Cancer back, still in the pleura and chest wall, small amt of fluid, all in left lung.
5/11/09 Start on Alimta every three weeks.
7/13/10 Had Alimta on road in Corning NY.
8/24/09 Scans show some improvement. Continue on Alimta.
9/14/09 Chemo on road in Mt Holly NJ.
10/6/09 Started regular Alimta infusions in Key West.
11/3/09 CT and PET scans showed significant improvement. Some issues already resolved.
2/3/2010 No evidence of residual or recurrent disease. NED! Stay on Alimta.
5/6/10 Am considering myself still NED until/unless proven otherwise in July. Rabid radiologist thinks he sees something suggestive of similar to some abdominal cancer. No light up on the PET. Am hoping for the best. Stay on Alimta and scan in 9 wks instead of 3 mos.
7/8/10 Chest CT unchanged (NED Feb '10). Infiltration in the region of the omentum is probably slightly more prominent than before. Diverticulosis requiring antibiotics.
Jul, Aug, Sep, continued Alimta in Corning NY, Portsmouth OH and Mt Holly NJ.
10/14/10 Chest CT unchanged from Feb '10. Findings likely representing progressive nodular peritonal carcinomatosis in the midabdomen. Treatment changed to Tarceva started in Nov.
12/15/10 Chest CT unchanged. Abdomen changes compatible with peritoneal carcinomatosis again identified with mild progression noted.
3/16/11 CT chest unchanged. CT abdomen progression ascites (fluid). Progression of soft tissues nodularity on the peritoneal surface anteriorly with diffuse omental involvement.
4/13-15/11 Hospitalized at MDA. Removed 4 1/2 litres (8-9 lbs) of fluid from abdomen 4/14. Started on taxotere before release on 4/15.
5/16/11 Hospitalized for fever, neutropenic. Treated with intravenous antibiotic and antiviral. Given blood transfusion. Note that KW Cancer Center did not give me my Neulasta shot after my chemo on May 6. Onc had me cancel my 5/26 chemo until after my scan on Jun 6. Was discharged on oxygen. Test w/Dr Gerth 5/26 indicated I could go off sitting and sleeping O. Will do walking test 6/2.
6/2 Did not get requisite numbers on walking test. Left for Orlando 6/5 still on oxygen.
6/6/11 MRI normal; CT stable. Taxotere and Neulasta at MDA 6/7 and 6/8.
6/13/11 Appointment with Dr Olham in KW. Off oxygen week of 6/16.
8/8/11 CT scan showed stable with perhaps some lessening of fluid. Stay on Taxotere.
10/10/11 CT chest still clear, CT abdominal lining stable. Stay on taxotere.
12/19/11 CT chest clear, CT abdominal lining stable, MRI clear. Stay on taxotere.

I'm so sorry to read this update. My condolences and prayers for his family and those who knew him.

_________________
- Katie Brown, Co-Founder and Director of LCSC-

15 yr cancer survivor.

"Any of us who have experienced the cancer journey- and survived it-
have an obligation to make the path clearer and aid those that come after us."
- Lance Armstrong

In memory of Jessee Dewey, SCLC
December 29, 1938 - September 6, 2003
Lisa Dewey- Jan. 22, 2007
my parents are together in heaven


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