Vats for lung nodules

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Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Vats for lung nodules

Postby Markdale » Thu Jul 22, 2021 6:04 pm

Hello all. In about a month I will have A VATS SURGERY to cut out a few metastasis. I would like to know if people here have had the surgery and how long it took to recover and if you hey have noticed any loss of lung function.

Mark
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

Brearmstrong
Posts: 112
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: Vats for lung nodules

Postby Brearmstrong » Thu Jul 22, 2021 6:50 pm

I just had vats surgery two weeks ago. One small met but was in an area in between my upper and middle lobe so they had to take more tissue than hoped. It’s my 5 major surgery and I was thinking it was going to be much easier than the abdominal ones but to be honest, recovery has been just as long, if not longer. Perhaps I am just getting tired of losing parts of me :-). But surgeon did explain to me today on my follow up that the nerves here are the largest in your body and it can be painful. I also had a collapsed lung from the biopsy two weeks prior and had no symptoms so my breathing post surgery has been fine. If it helps, buy an o2 meter and monitor your levels at home. It can give you some piece of mind! Best of luck!
50 F diag 1/17
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Nov 17 PET p aortic nodes Stage IV
Folfori w/avastin
May 18 surgery on nodes xeloda 2yr
Aug 18-May 20 NED
July 20 hysterectomy
July 21 vats right lung
Clinical trial- failed liver Mets biopsy shows now poorly differentiated carcinoma.
HAI pump at MSK may 2022
Nov met to pancreas- causing pain
Radiation ablation to pancreas Dec 22
New lung Mets watch and wait

DCook54
Posts: 31
Joined: Sat Sep 05, 2020 10:12 pm

Re: Vats for lung nodules

Postby DCook54 » Thu Jul 22, 2021 8:42 pm

In July 2020, I had vats in both lungs 48 hours apart. Recovery from the incisions took several weeks, but recovering lung capacity is a different story. It took several months. For me, the most painful part was the chest tube from the 2nd surgery. I agree about the O2 meter, and a recliner is very helpful in recovery from this surgery. My surgeon recommended that I walk 30 min twice a day as well. I will be having a nodule removed from my left lung on August 5, and I am not looking forward to it, but it sure beats the alternatives!!! Good luck!!
54 yo f
Stage IV colon- mets to lungs
KRAS G12V
Dec 2019- partial colect adenocarcinoma
0/31 LN
Jan 2020-PET NED
Jan 2020- Staged at I
July 2020-Ct-nodules both lungs
July 2020-VATS both lungs pos crc mets Stage IV
Aug 2020 began 1/6 cycles Folfox
Nov 20 Comp 6 Folfox
Dec 20 Colonoscopy/CTs clean
Dec 20 NED
April 21 Stable scans. 4 mm lung nodule to watch
Aug 21 VATS 2 nodules cancer
Sept 21-present Xeloda Main.
Nov 22 clear scans = 15 months NED
Dec 22 pleural effusion neg for cancer

NedPlease
Posts: 550
Joined: Fri Mar 23, 2012 3:56 pm

Re: Vats for lung nodules

Postby NedPlease » Thu Sep 02, 2021 9:52 pm

Hi,

I infrequently check in these days but I had VATS eleven years ago so details are vague (finally) but it was a successful surgery and NED since. No lung issues and recovery was easier than liver/colon resection.

Stage Four and still here.

Good luck,
Ned
F-54- St 4- Ascend Colon, 2 Liver mets, Poorly dif, Mutant
6/10- Folfox
9/10- R Liver Resect/Colon/Gall/Appendix
11/10-3/11- Folfox
11/11- R Lung, 1 met, VATS
3/12- 9/12- Xeloda
2/12- 6/18 Clear Scans
6/19- first time no scan
Today- NED

User avatar
Atoq
Posts: 412
Joined: Wed Oct 25, 2017 9:31 am

Re: Vats for lung nodules

Postby Atoq » Mon Sep 06, 2021 10:26 am

I had VATS surgery in one lung and the recovery was very smooth and quick. I did not notice any change in lung capacity, and I would notice it because I am runner :D

All the best

Claudia
1972, 2 kids
Dx rectal cancer 10.2017
T3N2aMX (met left lung 8 mm)
Lynch neg
CEA 1.8
Neoadjuvant chemoradio Xeloda + 25x2 Gy
05.12.17 laparotomic surg. for blockage, colostomy
25.01.18 laparotomic lar, hysterectomy, ileostomy
05.03.18 core needle lung biopsy
07.05.18 CAT scan, lung met 11 mm
04.06.18 ileo reversal
26.06.18 wedge VATS
24.08.18, 31.02.19 CAT scan
12.09.18, 06.02.19 scope, CEA 1.6
19.11.18 scope
20.08.19 CAT, eco
13.09.19 scope, CEA 1.2
18.03.20 CAT, eco, scope, NED
29.11.20 CAT, NED
2023 NED

Bpaint
Posts: 68
Joined: Sun Oct 11, 2020 8:54 pm

Re: Vats for lung nodules

Postby Bpaint » Tue Sep 07, 2021 11:53 am

I see from a different post that you already had a different surgery. Good luck with recovery.
husband (age 41 at dx):
8/20 CRC Stage 4. Mets to lungs, liver, distant lymph nodes
MSS, KRAS wild
CEA 713 at dx
Folfox (12 rounds)
Liver, colon and node resection 4/21
New lung mets, Vectibix monotherapy started 6/21
Stop Vectibix lungs stable about 6 months; all other areas stable
Start Folfiri + avastin 1/22
Stop Folfiri (lungs stable 6 mos); start Vectibix 7/22
Stop Vectibix 12/22 (lungs stable 5 mos this time)
SBRT on lung Mets scheduled for 1/22, will restart Folfiri

Markdale
Posts: 107
Joined: Wed Dec 02, 2020 4:45 pm

Re: Vats for lung nodules

Postby Markdale » Tue Sep 07, 2021 5:46 pm

Thank you. They went straight for a thoracotomy rather than than the vats. I had the surgery a week ago. The worst part was when the drain tube was in, but after they took it out the pain has been manageable with nsaids and paracetamol. I havnt noticed much change in lung function but I havnt been running or walking up more than a flight of stairs. I’ve been walking an hour twice a day to try to make sure my lung expands properly (I’m not sure if it’s helpful but can’t hurt).
09/20:Diagnosed after colonoscopy for bleeding.
MRI and ct scan confirmed tumor at rectosigmoid junction aswell as lung nodules in RLL (1X1.2cm) and RUL (3X.5cm)
10/20: LAR tumour t3n2m1 4/24 lymph nodes.
11/20: pet scan confirmed Mets
11/20: folfoxiri - 10/6/21. 12 rounds in total
1/1/21 thoracotomy 1 met removed
2/2022 sabr to 2 lung nodule
09/22 PET scan progression of sabr’d nodules
10/22 phase 1 trial bispecific antibody
9/23 added pd1 blocker
12/23 bilateral VATS all visible (7) lesions removed

User avatar
Thedruid
Posts: 24
Joined: Tue Aug 21, 2018 1:49 pm
Facebook Username: theDruid

Re: Vats for lung nodules

Postby Thedruid » Fri Sep 10, 2021 1:48 pm

Brearmstrong wrote:I just had vats surgery two weeks ago. One small met but was in an area in between my upper and middle lobe so they had to take more tissue than hoped. It’s my 5 major surgery and I was thinking it was going to be much easier than the abdominal ones but to be honest, recovery has been just as long, if not longer. Perhaps I am just getting tired of losing parts of me :-). But surgeon did explain to me today on my follow up that the nerves here are the largest in your body and it can be painful. I also had a collapsed lung from the biopsy two weeks prior and had no symptoms so my breathing post surgery has been fine. If it helps, buy an o2 meter and monitor your levels at home. It can give you some piece of mind! Best of luck!


Hello, Bearmstrong,

I can see on your signature you had some para aortic lymph nodes as one of the recurrences, right ? I made a PET-CT today and I got some quick feedback from the doctor I am on the same boat. 2 para aortic lymph nodes impacted + one small met in the lung (6mm).

How was your lymph node surgery ? Was you able to remove them in a VATS surgery as well ? Did you also had only a few nodes impacted ?

Thanks !
_____________________________________
Diagnosed 07/16/18, age 43
Colon Resection 03/08/18,
Stage 3B, T3N2aMO
Lymph-vascular invasion confirmed
6/16 lymph nodes
Port installed in 08/25/18
FOLFOX 08/18 - 2/2019
Liver met in 01/20. Stage 4. RadioAblation in 02/20
4 PALN + 01 nodule in the left lung found in 09/2021
Lymphadenectomy removed 04 PALN in 11/2021
Folfox (again) 11/21 - 05/22
Removed single lung met in 11/22
2 new "suspicious" nodules of 4mm in both lungs.. no growth until 04/23

Brearmstrong
Posts: 112
Joined: Sun Mar 26, 2017 3:24 pm
Location: CT

Re: Vats for lung nodules

Postby Brearmstrong » Fri Sep 10, 2021 7:08 pm

I had 8 para aortic nodes removed laparoscopically despite a dangerous location. 5 ended up positive. Was then NED for two years before back on ovary. Another years NED and now spread to lung and removed by vats. Currently pursuing a clinical trial as I won’t do more chemo. Has never done much for me, unfortunately but fortunately, surgery has still been options for me so far.

brenda
50 F diag 1/17
Muc Adeno 4cm
mod diff G2 T4aN2
nodes 8/50
CEA 4.6 after surgery <.05
KRAS G12D MSS
FOLFOX Apr-sep 17
Nov 17 PET p aortic nodes Stage IV
Folfori w/avastin
May 18 surgery on nodes xeloda 2yr
Aug 18-May 20 NED
July 20 hysterectomy
July 21 vats right lung
Clinical trial- failed liver Mets biopsy shows now poorly differentiated carcinoma.
HAI pump at MSK may 2022
Nov met to pancreas- causing pain
Radiation ablation to pancreas Dec 22
New lung Mets watch and wait

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: Vats for lung nodules

Postby catstaff » Sat Sep 11, 2021 9:46 am

Did you go to a major cancer center for surgeries? Here they have not been willing to treat my husband's retroperitoneal lymph node mets with anything but chemotherapy. They did do radiation on the ones present when he was initially diagnosed, and that seems to have been completely successful, but now they say there are too many for radiation, plus some are likely in the old field. Two other mets are not resectable but I am sure radiation would work for him. I would like to get as many removed or destroyed as possible.

He is also KRAS G12D though his primary was rectal, so left-sided. He did have a partial response to folfiri+bev at least.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

User avatar
Thedruid
Posts: 24
Joined: Tue Aug 21, 2018 1:49 pm
Facebook Username: theDruid

Re: Vats for lung nodules

Postby Thedruid » Sun Sep 12, 2021 7:08 pm

Hello, Brearmstrong

Thanks for your quick answer. In my case I had a "suspicious" lung nodule + 2 para aortic lymphnodes found in a CT a month ago. Last Friday I did a PET and unoficially the doctor said at least the 2 lymphnodes lit during the exam. I will get my results on this Thursday and then begin my journey to see how to treat this. I beliebve my Onc will suggest surgery or surgery + radiation.

I prefer surgery, since if it can be done with a clear ressection margin I can stay more 1-3 years without another recurrence.

How was your recovery of the para aortic removal surgery, Brearmstrong ? Was it somewhat smooth ?

Thanks!
_____________________________________
Diagnosed 07/16/18, age 43
Colon Resection 03/08/18,
Stage 3B, T3N2aMO
Lymph-vascular invasion confirmed
6/16 lymph nodes
Port installed in 08/25/18
FOLFOX 08/18 - 2/2019
Liver met in 01/20. Stage 4. RadioAblation in 02/20
4 PALN + 01 nodule in the left lung found in 09/2021
Lymphadenectomy removed 04 PALN in 11/2021
Folfox (again) 11/21 - 05/22
Removed single lung met in 11/22
2 new "suspicious" nodules of 4mm in both lungs.. no growth until 04/23

Beza1422
Posts: 17
Joined: Wed Apr 21, 2021 2:45 am

Re: Vats for lung nodules

Postby Beza1422 » Mon Sep 13, 2021 11:13 pm

Hey Catstaff, we are also experiencing this same problem. My mom’s cancer is “contained” to a retroperitoneal lymph node that’s causing issues with hydronephrosis. It is growing while on chemo and we have not been offered any other options and need to do something as it is progressing. They won’t explore bracytherapy for this area and I am concerned with the risks of surgery.


catstaff wrote:Did you go to a major cancer center for surgeries? Here they have not been willing to treat my husband's retroperitoneal lymph node mets with anything but chemotherapy. They did do radiation on the ones present when he was initially diagnosed, and that seems to have been completely successful, but now they say there are too many for radiation, plus some are likely in the old field. Two other mets are not resectable but I am sure radiation would work for him. I would like to get as many removed or destroyed as possible.

He is also KRAS G12D though his primary was rectal, so left-sided. He did have a partial response to folfiri+bev at least.
DX 2/19: Mid-rectum adenocarcinoma, moderately differentiated
KRAS G12D ( p.Gly12ASP), MSS
4/19-5/19: Neoadjuvant Xeloda and Radiation
7/19: Low anterior Resection with end colostomy
4/21: CEA 74, two hyper metabolic left supraclavicular lymph nodes confirming adenocarcinoma at biopsy, focal activity at pelvic lymph nodes and a 0.9 cm lesion in mesentary/small bowel

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: Vats for lung nodules

Postby catstaff » Tue Sep 14, 2021 9:19 am

Knock on wood (very much), it seems to have been mooted for us for now, because yesterday's CT showed the lymph-node mets resolved. Seemingly the L5 is the last met standing. That definitely doesn't mean they can't come back when he goes onto "maintenance" since there's certainly no guarantee that every single cancer cell was killed in those nodes. So I may become interested again in the future.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

MadMed
Posts: 216
Joined: Sun May 02, 2021 5:52 pm
Location: Massachusetts

Re: Vats for lung nodules

Postby MadMed » Tue Sep 14, 2021 11:22 am

Wow, great news, knock on wood. Glad to see some positive news from you catstaff, you keep pushing DH towards complete NED!
52M DX: RC lower rectum, guessing now 2cm from AV 4/27/2021
T3N0M0 adenocarcinoma with signet ring cell features
Tumor size 30mm
Tumor grade: G3
Baseline CEA 1.0
MSI status: MSS pMMR
Started Folfox 5/12/2021
Switched to FOLFIRINOX from session 2. 8 rounds total.
CT+MRI tumor contained shrunk 80%, no spread to other organs.
CRT started xeloda + 28 days Radiation 9/27-11/04
NED as of 4/06 CT/MRI/sigmoidoscopy
On W&W 04/06/2022

catstaff
Posts: 177
Joined: Wed Mar 03, 2021 11:37 am

Re: Vats for lung nodules

Postby catstaff » Tue Sep 14, 2021 12:26 pm

Thank you, IsmailMehdi, but I am not sure what they'll be willing to do about the L5 met. It is small (11mm), didn't grow during the chemo and the onc thinks it may have shrunk a bit, with lytic tumor being replaced by sclerotic bone around the outer boundary. The conundrum is that because it's small and asymptomatic they will likely not want to do anything about it, yet because it's small the odds of a successful and relatively low-risk treatment with something like SBRT are probably good. I am pretty sure that it's the source of all or at least most of the residual over-normal CEA. His CEA dropped in a near-perfect exponential decay from 40 to 8.6 over 5 treatments. We had to start partially over after he missed a cycle and it's been going down much more slowly (8, 7.6, 7.3, now 6.8 ). Bone mets are hard to kill but the onc seems to want to try to keep grinding it (and him) down with the treatments as long as possible. Maybe if he goes on maintenance after another cycle or two they'll consider other options if it seems to start to grow a bit.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-


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