Radiation for Lung Met

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James65
Posts: 377
Joined: Thu Mar 06, 2008 9:41 am
Location: Exeter, NH
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Radiation for Lung Met

Postby James65 » Thu Dec 07, 2017 1:16 pm

Hi All,
Just received my fourth cancer diagnosis with another met in my upper left lobe (lung). It seems to be just the one, but follows a resection a little over a year ago to remove a met in the same upper left lobe.

My oncologist said the best bet would be radiation and I'm wondering what others have experienced with this treatment. I did chemo/radiation with the primary rectal tumor, which was painful and caused some bad side effects, so wondering what to expect.

Thanks and best to everyone,
James
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.

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Atoq
Posts: 264
Joined: Wed Oct 25, 2017 9:31 am

Re: Radiation for Lung Met

Postby Atoq » Thu Dec 07, 2017 2:04 pm

I am sorry for your new metastasis, I am also going to check one in the lungs next week. I cannot help you with information about radiation, but I wanted to wish you good luck and a quick recovery. I would guess the skin on the chest is more tough than in the pelvis.

Best recovery

Claudia
45 year old, mother of 2
Dx rectal cancer October 2017
At least T3N2aMX (suspect metastasis to one lung 8 mm)
Lynch negative
Neoadjuvant chemoradiotherapy Xeloda + 25x2 Gy
05.12.17 laparotomic surgery for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle biopsy of lung, updated to stage IV
07.05.18 CAT scan, lung metastasis 11 mm
04.06.18 ileostomy reversal
26.06.18 wedge VATS surgery

James65
Posts: 377
Joined: Thu Mar 06, 2008 9:41 am
Location: Exeter, NH
Contact:

Re: Radiation for Lung Met

Postby James65 » Thu Dec 07, 2017 2:39 pm

Hi Claudia,
Thanks for the thoughts. Much appreciated.

I hope yours turns out to be okay, too. My last met was 8mm in the lung and that turned out to be the easiest one to treat that I've been through.

Best,
James
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.

Ana123
Posts: 41
Joined: Fri Jun 13, 2014 5:23 pm

Re: Radiation for Lung Met

Postby Ana123 » Sun Dec 31, 2017 4:13 am

Is it SBRT that is being offered? My father's experience was that it killed the met for about six months, but seems to have missed something as the met grew again. We also did not have chemo afterwards. There are others on this forum for whom SBRT worked, and it also seems to have worked despite no chemo afterwards.

As for the procedure, it was targeted and he took it over five days. He said it was like going in for an x-ray. He had no side effects.

My father just had the same lung met treated with RFA and we will meet the oncologist next week to discuss chemo. What we learnt through this process through the radiation oncologist and online studies is that although SBRT has an 80% local control rate, the 20% failure rate is usually for CRC mets. Whereas with RFA, whereas it has a 90% local control rate, the 10% failure rate is usually for lung cancer. Obviously nothing set in stone since these are fairly new treatment modalities, but worth bearing in mind.

The other thing to bear in mind is that SBRT substantially affects the anatomy of the lungs and affects the kinds of treatments you can have down the line. For example, whereas my father's met was on the left upper lobe and far away from any vital organs or structures, the SBRT shrunk his lung and the intervention radiologist who did the RFA said that the met was now much closer to the heart and aorta, substantially increasing the risk of the procedure. So unlike SBRT, RFA doesn't affect the structure of organs and can be safely repeated on the same tumor. The risks of repeating SBRT are much higher and the radiation oncologist absolutely refused to do it.

I hope this helps. Good luck with it.
Daughter of 73 year old father
CABG 4/2014
Colectomy 5/2014
T4N1M0
Folfox 6-12/2014
Lung Met 2/2017. SBRT. No chemotherapy.
Met growth 12/2017. RFA.
Chemotherapy?

James65
Posts: 377
Joined: Thu Mar 06, 2008 9:41 am
Location: Exeter, NH
Contact:

Re: Radiation for Lung Met

Postby James65 » Sun Dec 31, 2017 11:41 am

Ana123,
Thanks so much for all of this info. I didn't know there is a SBRT and RFA. Do you know what the difference is? Did your father have side effects for RFA?

My node is upper left near the middle as well.

Best to you,
James
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.

Ana123
Posts: 41
Joined: Fri Jun 13, 2014 5:23 pm

Re: Radiation for Lung Met

Postby Ana123 » Sun Dec 31, 2017 12:35 pm

SBRT is targeted radiation done by a radiation oncologist. It is very different to the radiation that targets the entire body. You can find more about it here: http://www.cancerresearchuk.org/about-c ... erapy-sbrt

RFA is a minimally invasive procedure done by an intervention radiologist under CT guidance. Similar to a lung biopsy if you have had one (they did this for my father to determine that his met was colon cancer and not a new lung cancer, before deciding on intervention). They gave my father general anaesthesia. The radiologist then inserted a needle into his chest and once in the met he delivered heat to kill it. The needle they used is designed to also allow radiologists to get a 4cm margin. You can find more about it here: http://www.cancerresearchuk.org/about-c ... y-ablation

My father did not have side effects from the RFA. He left the hospital four hours after the procedure.

They decided these treatments in my father's case as he isn't a good candidate for surgery, and are trying least invasive options. An interdisciplinary team of a radiation oncologist, intervention radiologist, surgical oncologist and the oncologist should be deciding on the best course of action in your case.
Daughter of 73 year old father
CABG 4/2014
Colectomy 5/2014
T4N1M0
Folfox 6-12/2014
Lung Met 2/2017. SBRT. No chemotherapy.
Met growth 12/2017. RFA.
Chemotherapy?

James65
Posts: 377
Joined: Thu Mar 06, 2008 9:41 am
Location: Exeter, NH
Contact:

Re: Radiation for Lung Met

Postby James65 » Sun Dec 31, 2017 3:52 pm

Ana,
Thank you so much.

Best in the New Year,
James
Diagnosed with stage III rectal tumor (though probably late stage II) January 2006.
Chemo/Radiation
Full APR Surgery
Folfox Chemo
So far NED.
Oops. Liver tumor diagnosed 10/13 after elevated CEA. Liver resection for 5cm tumor 12/6/13. So far so good.
Oops again, one tumor in each lung diagnosed 8/8/16. One too small to deal with and the other resected in late September. Wait and watch for now.


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