Thank you all and your advice needed

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impactzone
impactzone Member Posts: 551 Member
edited March 2014 in Colorectal Cancer #1
Thanks all... You know how hard it is. I tru;y appreciate your kind words and help getting me back up. Failure was the wrong word choice...more like letting down others... and I know its not true but that is the feeling. I'm better, your words helped A LOT and getting fighting mad again... For those that know the story.."Eddie Went"

Here is my next dilemma: (which was the same dilemma 1.5 years ago)
I talked to the surgeon today and have a long appt with him next Thursday at Stanford:
He says this:

"the nodule is on the opposite side from the previous surgery AND you have a whole lung on the right, going in earlier would be a very reasonable approach. I don’t see any other lung nodules and I would try to get the right lower lobe out thoracoscopically. The only caveat here is that, with one lobe out on the left, we may not be able to collapse the right lung fully—an event that would mean that the resection would need to be done as an open thoracotomy rather than thoracoscopically. I very much doubt that you would need to have the whole lower lobe out—most likely, you would need a segmentectomy (about a quarter of the lobe); a wedge resection is unlikely to be possible as the nodule is not truly on the edge of the lobe."

For me, I am an aggressive person, and want to do all I can to try to defeat this disease. I have had clean scans since 11/07. This nodule showing up concerns the onc and he may opt for chemo after this surgery but again there is nothing to track or see. My onc recommended waiting 2 months and doing another CT scan to see if growth occurred and then look at options. My worry is that at 2 months I may have lost options.

It seems to me I have 2 choices:

1) Wait and see - the surgeon said this : "waiting an extra couple of months would be very unlikely to be harmful."
2) Get surgery done now: the big advantage here is that surgery is possible right now, I'm healthy and if it has to be done waiting could not allow this option.
3) Chemo right now doesn't seem to be an option as CEA hasn't risen, and if the spot disappears is it the chemo or was it not anything in the first place.

As people who have faced these decisions what would you opt for and what questions would you have?

Respectfully,
Chip

Comments

  • CherylHutch
    CherylHutch Member Posts: 1,375
    #2
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    Some questions
    Hey Chip,

    1) I may have missed it but is there a reason they can't do a needle biopsy to see if in fact it is cancer or not?

    2) I would definitely ask your onc if there is a radiologist in the area who can do the RFA (Lung Ablation) procedure. Since you only have the one lesion, you are a primary candidate for this procedure right now.

    3) I would be very surprised if your onc would suggest chemo right now without knowing if the lesion is benign or not... that would be horrible if they were pumping you full of chemo and then you find out it's a benign lesion... again, potential for a needle biopsy?

    4) Lung surgery is pretty invasive as you know, having gone through it before, which is why I would suggest finding out if the RFA is possible and then asking if you were to wait the 2 months or so that your onc is suggestion, what is that doing to your options of having surgery 2-3 months from now. IF (worst case scenerio) the lesion was to grow quickly and in 2 months it's now not possible for surgery, then what would the options be... chemo to shrink it and then do the surgery? Or are you playing Russian Roulette. I would want to know EXACTLY what the pros and cons are of waiting.

    The other thing that I guess they want to take into consideration is.. is this the only lesion that can be seen but there are others "seeded" that can't be seen... hence by waiting that might give them time to grow so they can see what they are dealing with and then what the options/treatment plan would be if there are more. In that case, having the invasive surgery to go after one may not be in your best interests because the surgery will knock the wind out of your sails for a bit... and you might need your energy to go through chemo if that is the treatment that would be recommended.

    So, I'd take a deep breath... and over the weekend write down all the questions that pop into your head, no matter how small or big.

    Huggggs,

    Cheryl
  • impactzone
    impactzone Member Posts: 551 Member
    #3
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    CherylHutch said:

    Some questions
    Hey Chip,

    1) I may have missed it but is there a reason they can't do a needle biopsy to see if in fact it is cancer or not?

    2) I would definitely ask your onc if there is a radiologist in the area who can do the RFA (Lung Ablation) procedure. Since you only have the one lesion, you are a primary candidate for this procedure right now.

    3) I would be very surprised if your onc would suggest chemo right now without knowing if the lesion is benign or not... that would be horrible if they were pumping you full of chemo and then you find out it's a benign lesion... again, potential for a needle biopsy?

    4) Lung surgery is pretty invasive as you know, having gone through it before, which is why I would suggest finding out if the RFA is possible and then asking if you were to wait the 2 months or so that your onc is suggestion, what is that doing to your options of having surgery 2-3 months from now. IF (worst case scenerio) the lesion was to grow quickly and in 2 months it's now not possible for surgery, then what would the options be... chemo to shrink it and then do the surgery? Or are you playing Russian Roulette. I would want to know EXACTLY what the pros and cons are of waiting.

    The other thing that I guess they want to take into consideration is.. is this the only lesion that can be seen but there are others "seeded" that can't be seen... hence by waiting that might give them time to grow so they can see what they are dealing with and then what the options/treatment plan would be if there are more. In that case, having the invasive surgery to go after one may not be in your best interests because the surgery will knock the wind out of your sails for a bit... and you might need your energy to go through chemo if that is the treatment that would be recommended.

    So, I'd take a deep breath... and over the weekend write down all the questions that pop into your head, no matter how small or big.

    Huggggs,

    Cheryl

    Thanks again for your
    Thanks again for your post.
    RFA is what I was hoping for. The location of this met seems to initially preclude this. They do this routinely at Stanford but I have to defer to the surgeon. I was also hoping for thoroscopic surgery (less invasive) but in an open surgery they can palpate the lung and fell any other areas.These are areas I will ask.

    Too small for needle biosopy and its location (deep in lung) seems to preclude but I will ask.

    Your comments are right on regarding chemo and seeds.
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #4
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    RFA
    I had that done once and it was a piece of cake, I was in and out with just an overnight stay. If you could do that, it's the way to go. On the other hand, if there is more going on, waiting 2 months could be in your best interest. I have had 3 major lung ops (+ 1 RFA) and a lung op is not even an option now. The more you have, the less you can have due to scarring as you know.
    I hope you can go with the RFA and be done with it once and all.
    -p
  • kimby
    kimby Member Posts: 797
    #5
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    Chip
    Ok, my situation is different (aren't they all) but it does effect my opinion. When they found the mets to my liver there was also a spot on my lung that was diagnosed as a met. Since going after the liver mets it is now determined that the spot on the lung is not cancer at all, most likely scare tissue. That was determined a couple of monthss in by observation, so your med onc is not making an unresonable suggestion. If you wait, the spot is most likely to either stay the same or grow slightly, but not likely to multiply in that length of time unless there are already small undetectable tumors there. If there are other small ones, now would not be the time for surgery anyway.

    From my perspective (I'm not a doc nor do I play one on TV) either waiting the 2 mos or so (the hardest choice for sure) or RFA seem the best options. I would meet with the sugeon next week, see a radiation onc for an opinion and see the med onc again. Get ALL of your options before you make a decision, you may come up with options you haven't thought of.

    Good luck and prayers,

    Kimby
  • tootsie1
    tootsie1 Member Posts: 5,044 Member
    #6
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    Hard decision
    Chip,

    I have not experienced any of this (Stage 1 diagnosis), so I can't offer anything valuable as an opinion on it. I do relate to your worry about what might happen if you wait.

    I'll be praying that you will find the answer you need after talking further with the doctors.

    *hugs*
    Gail
  • Annabelle41415
    Annabelle41415 Member Posts: 6,742 Member
    #7
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    Chip
    I'm sorry for your dilemma and the frustration you have. I just want you to know that you are in my prayers. I find so much strength in your journey and the courage that you possess. You are truly an amazing person to be going through what you are and still keeping a good attitude and an aggressive strategy for your healing. You are an inspiration to me.

    Keep the faith and be strong.

    God Bless! Kim
  • vinny3
    vinny3 Member Posts: 928 Member
    #8
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    Difficult decision
    Chip,

    That's some tough choices. I assume they have carefully compared all your scans. I had them several times describe nodules in my lungs and make recommendations until I made sure they compared the scans and noted that, in reality, there was no change. Assuming there is a true nodule I would ask the surgeon what he/she would do if he/she were the patient. If there was a pretty good chance they could do it with the scope that would seem to be the best option. If there were any other way to get some tissue to confirm whether or not it is actually a met that would be good. Would a PET scan be in order or is the area too small?

    We will pray for help in your decision and that it is not a met.

    ****

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