SBRT with curative intent

[Maia]

Hey Jeff! You know I was 'here' all the time
Read about your insurance issues. Bastards.
Just in case you also forget this, what about the Colorado trial "whatever it takes"... do you remember? viewtopic.php?f=1&t=45812#p333314 Definitive Therapy for Oligometastatic Solid Malignancies. Since you have less tumour burden now, and also because usually trials take even people without insurance -and insurance companies are quite obliged to cover trails or you can give them hell... Just brainstorming here.
(Damn... so painful to read Lisa in that thread. But at least she finally went for Dr Morris and had some more months because he operated her )

[singingholly]

I don't understand Angela: WHO said that SBRT doesen't cure...?!
Olivia

[AngelaN]

Hi Holly -

"Mojo_qize - Our onc says we are still on a curative intent path, but the SBRT doc made it clear the procedure is for local tumor control (there is no systemic component).
She told us they are seeing local control up to 90% at two years (the tumor treated is under control; does not mean disease is not progressing elsewhere)."

"under control" doesn't mean treated, eliminated, destroyed to me...maybe I am splitting hairs. I understand that SBRT is to only treat the tumor but if there is a question I would prefer for DH to have his RUL removed and be done with it. Althougth that would limit our options for later on. But DH doesn't think there will be anymore and my talk about 50% recurrence is offensive and negative....

[singingholly]

Ah, ok... Yes of course sbrt is not systemic as a therapy and just like surgery is local. Surgery is safer but sbrt can be definitive as well, there are cases of lesions gone forever after sbrt, aren't they?
Olivia

[mojo_qize]

Holly,
Sorry if my post caused concern. To be clear, our docs indicated that SBRT can definitely be used to eradicate specific tumors, with success rates (that specific tumor being eradicated and not progressing) near those of RFA and other techniques.
Our docs (UCH in Denver, Colorado) just like to be very specific in their communication, thus statements like "this procedure (SBRT for her lung nodules) is not curative, but meant for local tumor control", meaning that doctor is intending to eradicate those specific tumors, but is not making claims that it will cure her (her oncologist who is overseeing the grand plan still considers her to be on a curative intent path because he is orchestrating the entire care plan).

[singingholly]

It's perfrctly clear, mojo, nevermind! My question was infact about the success rate of SBRT on a single lesion, to make a comparison with surgery. I've always known that it has not systemic effects! Thank you for your answers!
Olivia

[Rob in PA]

...I'll also add that a word that's been thrown around by the radiation doc doing the SBRT on me is "oligometastatic". He believes that I've gone long enough with no tumors in my primary area(rectal) and liver (four years since resection) that it is just "hanging around in my lung". The SBRT was used on me with the hope that it would eradicate those that we could see and not small cancer cells that we could not see.

In fact, the two different times I had SBRT done the docs made it a point to remind me that the same "preciseness" of the SBRT procedure that makes it a great treatment option for visible tumors, can turn around and "bite me in the ass" because of that preciseness in terms of missing microscopic tumors that could be as close as a half inch away from the tumor being treated. Hope that makes sense

In short, I've had six tumors zapped by SBRT over the last three years and NONE of them have come back...they are fried. BUTT, i have had recurrence within a year of both of my SBRT treatments in close but not exactly the same areas of the lung. My hope is that the VATS lobe resection I had last month will take call of the problem area for good. This is the first time I qualified for VATS.

[singingholly]

Thank you Rob, I'm sure VATS will do the job!