Radiation for lungs???

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Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Radiation for lungs???

Postby Pita » Sun May 22, 2016 3:06 pm

I really need some opinions/advice please.
Finished with chemo for now, expecting to have surgery completed by first week of July to remove what's left of the tumor and lymph glands, recovery time then back on chemo.
Now it's time to decide what to do about the 3 spots/mets on my lungs (2 are active). Both medical and radiologist oncologists think I should have radiation, 5 sessions per spot (they may not touch the inactive spot, just watch it). They want to start next week.
This makes me really nervous, seems so many side effects from radiation and I don't have the best lungs. Smoked for over 45 years, quit for 9+ years now, have 25+% emphysema which acts up occasionally, had a partial lung collapse during the biopsy and I have some atherosclerotic vascular disease.
The spots are all under 5cm and are not near my heart. Radiation will conform to the shape of each spot.
Monday I am scheduled for a CT simulation and they will compare it to my previous CT scans and PET/CT scan to see if the spots have shrunk from the chemo. If they have shrunk I think I could choose chemo instead of radiation even though chemo will be so much slower then radiation.
I have great trust in my oncologist, he's open, talkative and doesn't hide any scenario. The radiologist is a quiet man and presents the facts without much speculation but if I have the questions he answers them all and then opens up. Both trained at the best cancer centers here and my oncologist worked at one and is still active teaching there. I feel that they are as good if not better then the docs at the cancer centers and very important is that they are close to my house. Even with this degree of trust I have in them my husband and I still need to form our own opinion(s).

So...which will be worse for my body? What amount of shrinkage should influence my decision? Has anyone gone through this type of radiation?
I'm in ok shape, though no exercise since this all started but have lost 15 pounds and down to 114 now, not sure that's enough body weight/energy to go thru so much more.
Think I'll change my name to "Nervous Nellie" for awhile. TIA for your valued opinions/advice.
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

Lee
Posts: 5974
Joined: Sun Apr 16, 2006 4:09 pm

Re: Radiation for lungs???

Postby Lee » Sun May 22, 2016 5:19 pm

I don't have experience with lung mets, butt I do know there are other option's out there. From what others have said, radiation can have some serious side effects on the lung. If you have not already done so, get a 2nd opinion at a major cancer treatment center. These places have the latest and up to date procedures on dealing with cancer spread.

Hopefully other will chime in who have been down your road. Because it's the weekend, many people are not on the board.

Best to you,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

khadars
Posts: 13
Joined: Wed May 04, 2016 2:03 pm
Facebook Username: khadar2k1

Re: Radiation for lungs???

Postby khadars » Sun May 22, 2016 10:31 pm

I will post my two cents here. Take my advice/comments with a grain of salt, since I am not a medical oncologist or radiologist.
Having said that, a lot of board members here have had SBRT (I am assuming this is the kind you will have) on their lung mets. This seems to have been very successful, and they seem to have reached NED.

There are a few disadvantages of radiation. I'll list a few here. Any sort of radiation, while it may have beneficial short term effects (stopping the growth of METS, or even frying them to a crisp), can have long term repercussions. Of course, as a Stage IV, reaching many years of long life is our eventual goal, so this is sort of a chicken and an egg type of thing. Any sort of radiation, even focused radiation can hit other areas of your body that may not be intended. If your mets are on your lung close to your heart, some can of the targeted radiation can leak into the heart. As with any cancer treatment, you have to weigh all your options.

If you are otherwise healthy and strong, I would suggest the surgical route. Consult with a lung specialist, and you can potentially have them wedge it out (using conventional surgical techniques). There are a few doctors in europe that operate on pulmonary modules with a laser.

There is also the infamous RFA technique, which basically heats up small lung modules and frys up the surrouding tissue so that the tumor dies. There is also a cryoablation technique that can also be used to freeze the tumor and destroy it.
3/2015 - Rectal Cancer @ 26yr old.
5/2015 - Clinical Trial (FOLFOX Only)
9/2015 - LAR with TME (Stage IIIB, RC) w/ Loop Ileostomy
2/2016 - Ileostomy Reversal
5/2016 - Stage IVb

missjv
Posts: 1416
Joined: Tue Sep 12, 2006 10:38 am
Location: FLORIDA

Re: Radiation for lungs???

Postby missjv » Mon May 23, 2016 10:10 am

you should look into proton therapy or radio frequency ablation for lung mets. proton therapy is a form of radiation but uses protons instead of xray beams and is supposedly more accurate with less chance of doing damage to surrounding areas.

missjv

Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Re: Radiation for lungs???

Postby Pita » Mon May 23, 2016 2:00 pm

Thank you for the information. Besides what you have told me I am going with my gut and am not going to start the radiation this week and explore other options though I will go ahead with the CT simulation in an hour.
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Re: Radiation for lungs???

Postby Pita » Tue May 24, 2016 9:28 am

Has anyone else had radiation on their lungs that could share their experience please? Thx
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

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Jack&KatiesMommy
Posts: 599
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: Radiation for lungs???

Postby Jack&KatiesMommy » Wed May 25, 2016 11:58 am

Just a note: You have a lot to think about and I storngly suggest that you seek a second opinion at a major cancer cetner. While your doctors may be as good as any at a major cancer center the major cancer centers have all fot he newest researcha nd informationa nd tools at their hands. Another note: Chemotherapy will not cure you. Radiation can in certain cases or at least get a person to NED. Chemotherapy for colon cancer (regardless of where it is) is palliative.
Cynthia
Cynthia
Mommy to Jack (8) now (16) and Katie (4) now (12)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new lymph mets lung:
05/18: Keytruda (MSS w/Intermediate TMB): CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8, .8, 1.1, 1.1
Clear CTs
CEA up to 4.5 Single Node lighting up (mildly)

MarkS.
Posts: 206
Joined: Wed Jul 21, 2010 9:19 am
Location: Chicagoland Area

Re: Radiation for lungs???

Postby MarkS. » Thu May 26, 2016 2:26 pm

Here's my .02....

I just had Cyberknife radiation completed for a 17mm lung tumor. I opted for this because it was non-invasive, required only 3 session of 45 minutes each, and had little to no side affects. Could I have had surgery? Yes. (And I still can if there is anything that needs to be addressed at the follow up CT). My surgery option requires a 3 day in-patient stay and roughly 2 weeks of recovery. Cyberknife required NO change to my current lifestyle whatsover. For that matter I actually ran a half marathon with the best time I have ever had between sessions 2 and 3. I consider myself to be a very active person.

So obviously the scenarios vary by person, but for me I liked this course of action.
5/2010 DX'd Sigmoid CCr
6/2010 Colectomy. Sigmoid Colon
Stage 3C.T3 N2 M0; 6/14 Lymph Nodes
8/2010 FOLFOX: 12 Rounds
6/2011 NED
8/2012 Avastin/5FU Lung Mets
3/2013 CT/PET Normal
6/2013 Xeloda/Avastin Maintenance
2/2014, 9/2014 CT/PET Clear
4/2016 17mm Lung Met
5/2016 CyberKnife
6/2016 85% Tumor Reduction

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Rob in PA
Posts: 1995
Joined: Wed Dec 09, 2009 9:16 pm
Location: Pennsylvania

Re: Radiation for lungs???

Postby Rob in PA » Thu May 26, 2016 10:35 pm

SBRT extended my life. Period. Butt, not without costs. My right diaphraghm was paralyzed at the phrenic nerve. Would I do it again? Absolutely! I prefer being on this side of the dirt :D
dx 11/07 crc IIIb @ 39
Xelox/Rad/ temp colostomy
LAR/J-pouch/ temp ileo
Folfox-8
Failed reversal
2/09 liver mets; liver resect/ileo reversal
Folfiri/Avastin - 12
2/11 5 lung mets
Folfiri/Avastin 2011
SBRT 3/12
Lung met 5/13/ said NO to more chemo
SBRT 8/13
2 lung mets 5/14, VATS 8/14, NED

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Nik Colon
Posts: 5210
Joined: Thu Jan 08, 2015 3:35 pm
Location: MN

Re: Radiation for lungs???

Postby Nik Colon » Thu May 26, 2016 11:29 pm

Rob in PA wrote:I prefer being on this side of the dirt :D

Just had to say, love that!!! Sorry for interupting tho
KRAS-mut G12V,MSS
Stage IVa Sig CC 2 lvr mets 1/12 Ln
(3, =<3 lng spots at dx til 5/16)
=T3N1aM1a 4cmX4mm (lng not included)
dx 12/2014 at age 39
CEA 1/15-4.9, 12/16-4.9 again
neoadj FOLFOX 1/15-3/15 (4tx, 3w/1wo oxi)
Col/Lvr surg 4/23/15 NED
adj FOLFIRI start 6/15-9/15 (8tx, 5w/3wo iri)
1 sml lvr spot/cyst
12/6/16 multi lung spots/mets?
No longer NED :(
My tx ongoing-start 1/20/15
Adding your SIGNATURE, etc

Lee
Posts: 5974
Joined: Sun Apr 16, 2006 4:09 pm

Re: Radiation for lungs???

Postby Lee » Thu May 26, 2016 11:46 pm

Nik Colon wrote:
Rob in PA wrote:I prefer being on this side of the dirt :D

Just had to say, love that!!! Sorry for interupting tho


Ditto :D . says it all :D .

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Re: Radiation for lungs???

Postby Pita » Sat May 28, 2016 1:50 am

Well Rob thanks for that great saying, think it might become a Colon Club regular. :lol: I prefer being on this side of the dirt :D

Thank you all so much for your responses, it has really given me a lot to think about. I have cancelled the radiation on my lungs for now until we pursue other avenues and opinions really soon!
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

coolzan71
Posts: 11
Joined: Mon Dec 01, 2014 11:06 pm

Re: Radiation for lungs???

Postby coolzan71 » Sat May 28, 2016 9:37 pm

Pita,
just wanted to relay my experience with radiation. In 2012 I was diagnosed with 2 brain mets. I had SRT and did absolutely fabulous with a complete response. In Oct of 2014 my PET scan showed a very small active lymph node in the left hilar region of my chest. Since it was the only new activity in my body I elected to get SBRT instead of waiting to see if the chemo would work since my brain radiation went so well. Worst choice I have made in my 8 year cancer journey. I had 5 very short treatments and subsequent PET scans showed the lymph nodes activity disappear. While at the same time my left lower lung lobe was becoming more active on my PET scans. I talked to my Oncologist and Radiologist and they agreed I had radiation pneumonitis. Which is basically active inflammation of the lung tissue. Keep in mind this "targeted" radiation did not cross that area of my lung. Well, long story short, after a year of increased phlegm and coughing and two rounds of steroids my left lower lung collapsed permanently due to the lower bronchi scarring shut. My upper bronchi also has scarring which has already been opened twice since Oct. and I am having done again in two weeks. This is going to be a lifelong disability for me with the real potential to have a total lung collapse as the bronchi will continue to scar and let me tell you it's hard enough to breath with only 75% of your lungs. So if I were you I would think long and hard about radiation and check into all alternatives before making a decision. I certainly wish I had.

Best of luck,
Suzanne
Dx: 1/4/2008 36 yo stage iv Mcrc 12 liver mets Folfiri/Cetuximab/Avastin
6/08 discontinue Avastin due to side effects
2/11 3 years NED quit chemo
6/12 back in brain lungs spine and cervix folfiri/cetux
6/12 srt brain mets x2
4/13 cone biopsy pos. for MCRC
10/14 sbrt to hilar lymph node
10/15 Left lower lung lobe collapse due to radiation pneumonitis
4/16 160 rds of FOLFIRI/Ce
7 half marathons since dx while on chemo (and counting hopefully)

Pita
Posts: 637
Joined: Wed Feb 10, 2016 3:48 pm
Location: So Calif

Re: Radiation for lungs???

Postby Pita » Sat May 28, 2016 10:20 pm

Suzanne, I am so sorry for what you have gone through :( I do appreciate you taking the time to tell me your story, hubby and I have read about what radiation can do both good and bad. We have read most on the cancer sites but it makes it so believable when someone tells you their story. I'm feeling good about postponing the decision both of my docs have made for me and will seek alternatives. The main thing that influenced my decision is that I had a partial lung collapse during the biopsy and of course the advice others have given me on this post of mine.
The best to you and others, let's beat this nasty disease.
Linda oxo
70yo Fem DX: 1/21/2016 RC Stage IV-Nodules lungs
MSS-Kras Wild-Lynch Synd Neg-Lung Biopsy 1/27/16-Port 2/19/16
MRI 7/7/16 Endometrial polyp found, watching LAR 7/19/16, No Ileostomy, Stage ypT3 N1
CT 11/7/16: Most mets stable,1 shrunk,1 new??
CEA Tests: 1/21/16=20, 12/22/16=5.3, 1/20/17=4.8, 2/15/17=6.2
9/20/16-1/24/17 Folfuri & Avastin
#10/10 Done
PET/CT 2/10/16-1/31/17=Some shrunk & growth to 2, Avastin failing ??? :evil:
2/21/17 Folfuri & Avastin

User avatar
Rob in PA
Posts: 1995
Joined: Wed Dec 09, 2009 9:16 pm
Location: Pennsylvania

Re: Radiation for lungs???

Postby Rob in PA » Sat May 28, 2016 11:32 pm

Pita wrote:Well Rob thanks for that great saying, think it might become a Colon Club regular. :lol: I prefer being on this side of the dirt :D

Thank you all so much for your responses, it has really given me a lot to think about. I have cancelled the radiation on my lungs for now until we pursue other avenues and opinions really soon!

Thanks. It is easy treatment butt carries consequences
dx 11/07 crc IIIb @ 39
Xelox/Rad/ temp colostomy
LAR/J-pouch/ temp ileo
Folfox-8
Failed reversal
2/09 liver mets; liver resect/ileo reversal
Folfiri/Avastin - 12
2/11 5 lung mets
Folfiri/Avastin 2011
SBRT 3/12
Lung met 5/13/ said NO to more chemo
SBRT 8/13
2 lung mets 5/14, VATS 8/14, NED


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