Lung cancer advice needed

Thanks Steve for your reply. The surgeon I saw did say he expected a curative outcome with surgery and that I should make full recovery and be able to return to my current level of activity within a few months. He too is a renowned surgeon and I'm sure he wouldn't have advised surgery if it was not right for me. 

As you say it is the fear of the unknown and I will try to speak to my consultant after Xmas just to ask a few more questions which might help to put my mind at rest. Like you I have also tried to gain as much info as I can before making a final decision. 

Please keep us up to date with how your surgery goes.

Best wishes

Pepper 12,

Hi Pepper

I had a slow growing mass which was larger than yours and I chose not to have surgery as a first line treatment, opting for SBRT instead. This is often the choice of treatment when surgery is not possible or when the patient declines surgery.

In my case it wasn't totally effective and I ended up having a lobectomy earlier this year, 18 months after a biopsy had confirmed it to be adenocarcinoma.  It was still low grade when it was finally removed.  It was also smaller than suggested by imaging (I had scar tissue from the radiotherapy and it's not always easy to tell what's scarring and what's cancer on the CTs).

Definitely have a talk with your team, both the surgeon and the radiation oncologist.  Everyone's cancer is different and the available options depend on your own specific circumstances.

"Watchful waiting" can be a valid course of action with indolent cancer.  I considered it with mine but opted for a biopsy ASAP.

One question I asked before deciding to have SBRT as a first line treatment was whether surgery would still be an option if it didn't work.  In my case, the answer was yes.

I had just been through 6 months of chemo for lymphoma when my lung cancer was diagnosed and I was still immunocompromised, which definitely influenced my choice (covid was new and everywhere at the time, too).

Thanks for that Lolie. SABRT wasn't really discussed with me as the respiratory consultant and thoracic surgeon both thought a biopsy might give a false negative because of the type of nodule I have and their view was having a wedge resection which would be better which could then be biopsied. SABRT was never offered as an option so I have never seen a radiologist oncologist, but I don't suppose it can be offered without a definite cancer diagnosis can it? Do you know why SABRT didn't work for you and were there any side effects from SARBT and how many treatments of it did you have before they knew it wasn't working? 

I suppose my main worry is that that if I leave it too long making a decision it might spread and I wouldn't be able to have surgery or it might end up being a bigger op than is currently planned - the surgeon was going for a wedge resection on my upper left lung rather than a full lobotomy.

It's a difficult decision to make but maybe it might become clearer when I have asked a few questions next week - I have a phone number for the consultant's nurse so I might give her a ring. 

Sorry to hear you're still experiencing pain from your op one year on, which is what worries me, and I hope this soon improves for you soon.

Once again thank you for your helpful reply. 

SBRT has about a 90% success rate, similar to surgery.  I had 4 sessions over a period of 2 weeks.  Because it causes inflammation, it can be a while before they can tell whether or not it's worked.  It was about a year after mine when they biopsied mine again and referred me to a surgeon (and then covid cause a further 6 month delay in me getting surgery).  

I didn't really have much pain for the first 3 months after surgery, more a tightness like wearing a bra many sizes too small.  Once I started gardening again I injured my intercostal muscles and I've aggravated that injury on a number of occasions.  The pain is manageable now with OTC meds, although I do try to avoid aggravating it again.

Glad to hear that your pain is now under control - be careful not to damage those muscles again

As I say I don't think SBRT will be an option before a biopsy diagnosis as they don't know what cancer they are dealing with, if any. To be honest a biopsy scares me nearly as much as the surgery but I am a bit of a wimp I can see another sleepless night thinking about it. 

Have a nice Christmas. 

Have 

I had a lobectomy in july this year by VATS ,for a 19mm nodule ,though afterwards i was in pain for a few weeks ,it was difficult to lift my arm ,and lay on the side where i had surgery ,but after the 8th week things did start to improve ,i was told that this was the best option for me ,even afterwards when i was told that only 20% of the nodule was cancerous ,it was now gone with a good surrounding margin also removed ,it is now 5 months down the line ,i have no pain ,movement is now normal ,so even though you have a fit and healthy lifestyle ,maybe delaying surgery  may not be the best idea ,its better to have this surgery while you are fit and healthy ,as you have a better chance of recovery that is what my surgeon told me ,it might only be 3 months out of your training 

Hi Christie,

Thank you, all the information I'm getting here is really useful. Glad to know you're much better now. 5 months to reach recovery sounds pretty good to me, mentally I'm prepared for longer so if I match your timescale I'll be well chuffed.

Pretty much anyone who has been serious with their weight training has at one time or another had a training injury, it goes with the territory. I'm hoping my surgery will be like just another training injury, something that hurts but will eventually heal up if I'm not stupid with it.

I got offered the lower right lobectomy early in the first week of January but I figured the team operating might still be hung over from New Year so I'm going in a week later. Not long now, my bag's already packed.

kind regards,
Steve

Don't say that Steve, I've been offered 4/1 for my wedge resection which I have accepted - hopefully any hangovers will be gone by then. Feeling scared but have decided it has to be done.

Good luck with your op and let us know how it goes. 

Pepper 12

Hi Pepper,

Oops, sorry, my bad. The date I turned down was the 3rd - I'm sure they'll be in best condition by the 4th. Wednesday - they'll be nicely warmed up and in the groove by then. I'm scared too, it's only natural. I'm even more scared of cancer though so I'll be glad when it's been done.

kind regards
Steve