Lung Treatment Options- VATS more than once?

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Hapa
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Lung Treatment Options- VATS more than once?

Postby Hapa » Fri Aug 05, 2016 11:51 am

DH had VATS in 3/23/15. He wasn't able to do chemo because of other health issues (which have now resolved). Recent Pet showed tumor returned to incision line of the previous lung surgery. Just talked with Lung Surgeon & he said DH not candidate for VATS because it would be difficult. IF he did surgery, it would have to be a larger incision (not VATS). I believe the surgeon because he is one of two that do VATS in our area & is highly experienced. The radiology oncologist said SBRT with follow up chemo. I asked him about SBRT, ablation, cyberknife etc. He said they are all the same. (made me feel a little dismissed). I guess I am hoping for any alternative to radiation.

While reading peoples treatments- I see that several people have had VATS multiple times. Perhaps in different areas? Really disappointing that surgeon thinks radiation would be best option. The tumor board will meet next week to talk about it.

My question to the people who have had lung treatments- Is there a difference between Cyber knife,nano knife, & SBRT? Of course, any input would be great.

Things are complicated even more because we leave on a 10 day visit to Family on the opposite side of the country. As usual, it's hurry up & wait

Thanks
DH Stage 3 RC

Sams wife
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Re: Lung Treatment Options- VATS more than once?

Postby Sams wife » Sat Aug 06, 2016 6:24 am

I am not positive at all but I think if you do RFA (ablation?) you can do normal radiation after. If you do radiation first, you cant go back & do RFA. Radiation leaves scar tissue. I need to get researching this stuff too, soon! Good luck. Hope someone else can explain better. And I hope I'm halfway right, anyways :)
Husband dx 1/13/15 St.2 CEA 7.1
Chemo/25rad 2/15 till 4/24/15
5FU/leucovorin
Surgery 6/8/2015 Stage IIa T3N0MX microscopic cancer left
Watching 4 lung spots
0/5 lymph nodes. Lap. APR
25% less 5FU/leucovorin 7/14/2015 x 26 CEA 3.4
25% more 5fu 9/2015
9/16/15 CEA 7.7
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3/16 New lung spot 4x4 mm
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BrownBagger
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Re: Lung Treatment Options- VATS more than once?

Postby BrownBagger » Sat Aug 06, 2016 1:41 pm

If RFA is possible, it can be done multiple times. The technical term for that is "whack-a-mole." I've had two thoracotomies--one on each lung, one VATS and 3 RFA. Never any radiation (just pelvic and plenty of that). I've also had two bronchospies to address a tumor in front of the opening to my left lung (my problem lung). My thoracic surgeon said that if it comes back again, we can treat it with targeted radiation, administered with a bronchoscope.

I'd be really hesitant to get SRBT done if I had any other choice. My onc explained to me early on that radiation tends to make tumors less responsive to chemo. So if it doesn't work, you're kind of out of options if it's not operable.
Eric, 58
Dx: 3/09, Stage 4 RC
Recurrences: (ongoing, lung, bronchial cavity, ribs)
Major Ops: 6/ RFA: 3 /bronchoscopies: 8
Pelvic radiation: 5 wks. Bronchial radiation—brachytheray: 3 treatments
Chemo Rounds (career):136
Current Chemo Cocktail: Xeloda & Erbitux & Irinotecan biweekly
Current Cocktail; On the Wagon (mostly)
Bicycle miles post-dx 10,477
Motto: Live your life like it's going to be a long one, because it just might, and then you'll be glad you did.

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mypinkheaven
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Re: Lung Treatment Options- VATS more than once?

Postby mypinkheaven » Sat Aug 06, 2016 2:06 pm

BrownBagger wrote:If RFA is possible, it can be done multiple times. The technical term for that is "whack-a-mole." I've had two thoracotomies--one on each lung, one VATS and 3 RFA.

I'd be really hesitant to get SRBT done if I had any other choice. My onc explained to me early on that radiation tends to make tumors less responsive to chemo. So if it doesn't work, you're kind of out of options if it's not operable.


You've answered my question why people avoid SRBT.

Were your procedures decided by the location or size of the tumors?

I spoke to my #2 oncologist last week and asked her about surgical options (depending on what my CT scan shows on 8/22). She said: "Oh, that's such a big operation." Is it possible she doesn't know about VATS or RFA? I'm seeing #3 oncologist next Friday. . . . .
MSS, KRAS Wild NRAS Mutated
9/2012 CRC IIB Lft Colectomy 0 lymph nodes 0 Chemo
10/2013 CT clear
11/15 CEA 2.7 to 4.6
11/15 Spread to uterus. Hysterectomy
2/16 Pelvic radiation 25, brachytherapy 3
4/16 - 6/16 Xeloda
6/16 CT Several lung nodules 5 mm
8/16 CT Nodules still present. Most stable. Some growth
11/16 Transfer to UCSD Moores
12/16 Folfox + Avastin failed
2/17 Folfiri + Erbitux
8/17 5FU+Erbitux No 5FU bolus
7/18 Spread to vagina
6/18 Folfiri + Avastin + Trametinib
6/18 CEA dropping

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BrownBagger
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Location: Central NYS

Re: Lung Treatment Options- VATS more than once?

Postby BrownBagger » Sat Aug 06, 2016 3:44 pm

mypinkheaven wrote:Were your procedures decided by the location or size of the tumors?


I honestly don't know. I've gotten this far by doing what my doctors recommend, so I just do what they say. I do think location has something to do with it--I know it does when deciding whether VATS or a full thoracotomy is necessary. For deep tumors, the latter is usually required. But I think the RFA technology is improving rapidly, to the point where surgery may not be as common. The only issue I'm aware of with RFA is that it's statistically not quite as effective as surgery. But, on the other hand, it's much less invasive, so you can get it done much more frequently if necessary.

As far as the surgery being tough, yes, it is. My biggest lung op was a double--thoracotomy and lobectomy on the left side; VATS on the right. I think I was back on my bike for my usual 23-mile hilly ride in six weeks. Back at work after two. So, not all that bad.
Eric, 58
Dx: 3/09, Stage 4 RC
Recurrences: (ongoing, lung, bronchial cavity, ribs)
Major Ops: 6/ RFA: 3 /bronchoscopies: 8
Pelvic radiation: 5 wks. Bronchial radiation—brachytheray: 3 treatments
Chemo Rounds (career):136
Current Chemo Cocktail: Xeloda & Erbitux & Irinotecan biweekly
Current Cocktail; On the Wagon (mostly)
Bicycle miles post-dx 10,477
Motto: Live your life like it's going to be a long one, because it just might, and then you'll be glad you did.

Ajane
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Re: Lung Treatment Options- VATS more than once?

Postby Ajane » Sat Aug 06, 2016 11:42 pm

Eric, I continue to stand in awe of you! You're one tough cookie.
7/13, T2, G3, Ultra-low. CEA 5.7 KRAS Wild, MSS
8-9/13 6 wks Xeloda/radiation
12/13 TEM pCR NED
5/15 CEA 4.6 PET 1.5 cm met, UL Lobectomy
6-10/15: Rounds 1-2 Xelox+Avastin; 3-8 Folfox+Avastin
10/15-4/16: 12 rounds Avastin
9/2016 CEA 4.2, 12 mm AP node
11/2016 CEA 4.3. PET/CT. 16mm AP nodal met removed
4 wks chemorad
2/2017 NED CEA 2.4
Carafate to tx esophageal ulcers caused by rad
Avastin maintenance postponed

2 Corinthians 12:9


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