I may refuse surgery.

Hi Mark,

How much lung can be saved? That depends on extent of spread, they remove margins to make sure it's all out but try to keep the collateral damage to an absolute minimum. A lung isn't a simple bag of air, the right lung has 3 lobes and the left lung has 2 lobes - typically they remove just one lobe.

Other treatments? Radiotherapy can be just as effective as an alternative. Which is best is a call only the oncologist can make. If surgery is on offer that means they are aiming for cure and normal lifespan survival.

Refusing surgery if that's on offer is crazy talk. It's their job, it's what they do, believe them and be guided by them.

Minimal invasive is the surgeon's preference - keyhole, either video-assisted or robot-assisted. It's all high-tech these days.

Exercise? Checking my 2023 diary for a real-world example:
 - Tuesday 10th January Lower Right Lobectomy (no weight training for 6 weeks)
 - Friday 13th January back home in 3rd floor flat (walked up the stairs)
 - Wednesday 1st February 30 mins on exercise bike, 70W non-stop 110bpm average
 - Saturday 18th February did down+up stairs (12 steps) 14 times, not maxed out
 - Tuesday 21st March Did 33 mins weight training
When you've had a chunk of lung removed then at first normal activity (walking, stairs, etc) is hard exercise. Just keep building up the duration and resistance, same as in the gym until you're back on the weights.

Long-term impact? Day-to-day: none - I can jog up the stairs, carry my shopping home from the supermarket, etc. Weight training: I get out of breath more easily now and need a longer rest between sets. I rest when my pulse rate hits 130 (I'm aged 72.)

Hope you find this useful, and best wishes for your recovery. Regular hard exercise is way the best prep for surgery, so you've nailed that.

kind regards
Steve

Hi Steve, Thank you for your reply, Its amazing how well you have recovered, Im fine with a partial removal but a full removal panics me mainly because my DR said the cancer is central and near the bronchi so if the cancer is in that im not sure where i stand, I had radio therapy for my tonsil cancer and responded well to it, i was classed as in remission but of course the new cancer may be associated or primary.

Extent Of Spread ... The CT scan shows no spread in the lung or lower organs but a node was mentioned.

I have my appt on the 6th does anyone know how long it will take for surgery / treatment from that date.

Thank you.

Hello,maybe you are suitable for a microwave ablation.Ask the doctors,if it’s not spread they just send little tube from the mouth and burn it.

I also searching information from all over the place,as my husband had an infection and now they think it’s a lung cancer,early stage.They offered him surgery,even the segment has reduced in size,they also don’t know what it is,but it’s better to remove it.

Please don’t rash to refuse a surgery,you just do it if you want to stay alive.and I read many articles that people even with one lungs doing well playing tennis,golf.

Depression can be treated with the medication,but cancer must be removed.Wishing you all the best and long and happy life.

Hi I will not offer advice just tell you my story . May 25 told it was cancer in my right lung . I like you was thinking of not going through with surgery suddenly my friends and family all became experts .I had a melt down telling them you are all cancer specialists now telling me to have this operation I’m not having it . Left alone to decide I had the operation in August 25 . Woke up in recovery feeling ok the top part of my right lung removed. Back on the ward I was out of bed a hour later sat in the bedside chair in my own pjs . Next day I was walking to and from the toilet feeling ok . Physio discharged me on day 3 all they did was watch me walk up and down the ward . Day 4 I was allowed home . Over the next 10 days I was in some discomfort from the area the drain was in it was uncomfortable to lay down I got very constipated from the pain killers . I am now over a year post op and I have had 2 scans both clear of cancer . I can walk on the flat for miles going up stairs I get short of breath and the same for inclines. I have a tread mill at home and I go to the gym . It was the best thing for me I am now on yearly scans hope this helps you 

Thankyou for the replies, my issue is the location of the cancer, its centred and close to the airways, im not sure if i can have part of my lung removed which i would be ok with.

I definately do not want the entire lung removed, any issues then and your stage 4 instantly.

I just can not undertand why other treatments are not offered before a major operation, im still not sure what they will offer me but i will take their advice of course.

Has anyone else had cancer in the middle of their lungs, ive read its the most common place but there is little else on treatments of that area.

Also has everyone here had minimal invasive surgery for their lung surgery?

Hello Mark, I'm sorry you find yourself here and in this position.

I was 57 when diagnosed, the cancer was in my right lung and in an awkward position so the whole right lung had to be removed. The right lung has 3 lobes and the left 2, so the effect on breathing can be worse if the right is removed rather than the left. The good news is I've have survived 11.5 years so far with no further lung problems since.

I'm not a medical expert but to answer your questions as far as I know:

Can part of lung be saved? Depends on tumour size and position, the surgeon will only remove what's necessary to ensure best results, could be part but could be full removal if that's necessary and they'll not know for sure until they're "in" and can see the true extent.

Other treatments rather than surgery? Yes there are such as radiotherapy, chemotherapy etc. but the general concensus in the medical world is that surgery is the gold standard if the patient can have it.

If you refuse surgery there's no way you should be denied other treatments, it's entirely your choice but you won't be left high and dry. 

Less invasive surgery option is, I think, dealt with in your first question.

I hear what you say about depression and exercise. I guess you can take antidepressants but do think your exercise route beats drugs any day. I didn't have this problem but what I can say is that, after surgery, it obviously takes time to recover and you have to take it easy at first - you'll be advised by a physio what to do and if you don't follow this your body will soon tell you to take it easier. 

I'm not into the exercise routine you follow but I did want to recover as well and quickly as I could and my path was to challenge myself each day to push further until I reached my new fitness level I was happy with. You sound like you'd be well up to the challenge and perhaps your programme to regain maximum fitness would be enough of a challenge to continue warding off depression, it certainly helped me to accept the new normal.

There's no doubt I have not regained the same fitness I had before but you can still have tough targets to aim for during and after reovery - just don't overdo it at first.

I hope you can reach the right decision for yourself. If there's anythig more you'd like to ask I'll do my best to answer. 

All the best,

Derek.

Thank you and im so glad you have recovered and are doing so well

When you say awkward, do you remember where the mass was.

Heres my CT scan results in part, if anyone can better understand them i would appreciate it.

Lungs, Plueura: 47mm soft tissue mass in LUL -measurment on image 166/ series 9, The mass is continuous with the left hilum and narrowing branches of the left main bronchus, imaging suggests at least T2 b Disease. The central airways are patent. no pleural effusion.

Cardiovascular All normal

Lymph nodes: left hilar lymphadenopathy. additionally 12-13mm subcarinal node.

I'm afraid I can't remember exactly, other than it was somewhere central which meant a lobectomy wasn't feasible. My stage was T2AN0M0 prior to surgery but revised to T2AN1M0 after as one lymph node close to the tumour was found to have cancer cells during forensic examination of the lung.

I'm sorry but don't know enough to understand the medical words in the scan result but "cardiovascular all normal" and "no pleural effusion" look good.