Stage IV need advise tonight

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nicotianna
nicotianna Member Posts: 209

Hi Pals - I have a hilar node in my RUL & a nodule in the RUL.  The thoracic surgeon said he can remove both.  I am on the OR schedule.  My oncologist says that she recommends my geting chemo rather than surgery at this time  The regimen would be 2 rounds of 5FU & cisplatin ea. 28 das. apart.  Then do a PET.  See the response.  Then decide on whether surgery is an option.  What do you guys & gals think?

Nic 

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Comments

  • lp1964
    lp1964 Member Posts: 1,239 Member
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    Dear Friend,

    I don't have any experience with Stage 4 Cancer, but from what i hear from other patients is that if surgery is possible that should be done forst and follow it up with chemo.

    Consider post your question on the colorectal forum, there are many more people there with similar situations.

    Whatever you decide wish you the best of luck,

    Laz

  • mp327
    mp327 Member Posts: 4,440 Member
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    nicotianna

    I'm so sorry you find yourself in this position--I'm sure this is a difficult decision to have to make.  I will tell you that this happens so often--each doctor recommending what they are most familiar with.  However, I will also tell you that if it were me, I would be having the surgery, then consider getting chemo as some extra insurance that the tumors are gone and won't return.  In my mind, getting the tumors removed is the only sure way to know that they are gone.

    On another site that I'm on, there is a woman who has had tumors show up in her lungs a couple of times and both times, she has had them "plucked" out, to use her word.  I believe that afterwards, she has had both radiation and chemo.  To date, she is doing well--a stage 4 survivor who is living a full life.  Her treatment has all taken place at MD Anderson in Houston.

    Please keep us posted on what you decide.  You will be in my thoughts and prayers.

    Martha

  • nicotianna
    nicotianna Member Posts: 209
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    lp1964 said:

    Dear Friend,

    I don't have any experience with Stage 4 Cancer, but from what i hear from other patients is that if surgery is possible that should be done forst and follow it up with chemo.

    Consider post your question on the colorectal forum, there are many more people there with similar situations.

    Whatever you decide wish you the best of luck,

    Laz

    surgery vs chemo

    Thanks Laz!

    Will keep you posted.

    Nic

  • nicotianna
    nicotianna Member Posts: 209
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    mp327 said:

    nicotianna

    I'm so sorry you find yourself in this position--I'm sure this is a difficult decision to have to make.  I will tell you that this happens so often--each doctor recommending what they are most familiar with.  However, I will also tell you that if it were me, I would be having the surgery, then consider getting chemo as some extra insurance that the tumors are gone and won't return.  In my mind, getting the tumors removed is the only sure way to know that they are gone.

    On another site that I'm on, there is a woman who has had tumors show up in her lungs a couple of times and both times, she has had them "plucked" out, to use her word.  I believe that afterwards, she has had both radiation and chemo.  To date, she is doing well--a stage 4 survivor who is living a full life.  Her treatment has all taken place at MD Anderson in Houston.

    Please keep us posted on what you decide.  You will be in my thoughts and prayers.

    Martha

    surgery vs chemo

    Thanks Martha!

    I will keep you posted.

    Nic

  • sandysp
    sandysp Member Posts: 868 Member
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    did you get the biopsy?

    I am following you and am very interested. Did you get the biopsy?

    My Oncologist said I needed to get a biopsy. I was thinking at the same time whatever is there I would have him remove it while under. But haven't had my interview yet.

    I thought you weren't going to have to have chemo. I am so dissapointed for you.

    This is what my scan on July 28th read:  

     Interval increase in right 
    infrahilar confluent area of focal consolidation now spanning 
    approximately 2.6 x 2.5 cm previously 2.8 x 1.3 cm and is somewhat changed 
    in configuration when compared to more remote studies dating back to June 
    29, 2011. More superiorly within the right lower lobe are focal areas of 
    groundglass opacity which appear to be new. Perifissural subcentimeter 
    nodule along the left major fissure in the left upper lobe stable.

    It also says the thoracic hiliar node is unchanged in another section.

    Anyway, what is happening with you is really touching me here. I am right behind you. Anyone who has a distant organ metastases is stage 4. I have already sort of accepted that this is what is going on but of course are hoping not.

    Let us know. But I am with Martha - I don't want to wake up with whatever is there still in me after the biopsy.

    Sincerely,

    Sandy

  • nicotianna
    nicotianna Member Posts: 209
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    sandysp said:

    did you get the biopsy?

    I am following you and am very interested. Did you get the biopsy?

    My Oncologist said I needed to get a biopsy. I was thinking at the same time whatever is there I would have him remove it while under. But haven't had my interview yet.

    I thought you weren't going to have to have chemo. I am so dissapointed for you.

    This is what my scan on July 28th read:  

     Interval increase in right 
    infrahilar confluent area of focal consolidation now spanning 
    approximately 2.6 x 2.5 cm previously 2.8 x 1.3 cm and is somewhat changed 
    in configuration when compared to more remote studies dating back to June 
    29, 2011. More superiorly within the right lower lobe are focal areas of 
    groundglass opacity which appear to be new. Perifissural subcentimeter 
    nodule along the left major fissure in the left upper lobe stable.

    It also says the thoracic hiliar node is unchanged in another section.

    Anyway, what is happening with you is really touching me here. I am right behind you. Anyone who has a distant organ metastases is stage 4. I have already sort of accepted that this is what is going on but of course are hoping not.

    Let us know. But I am with Martha - I don't want to wake up with whatever is there still in me after the biopsy.

    Sincerely,

    Sandy

    surgery is the plan

    Sandy - Your oncologist is right!  You need a biopsy or at least a pc. of tissue to make a plan.  Theoretically, I am not stage IV until we know it's a met.  Getting chemo not knowing what is going on is not a good idea.  No one thought I should get chemo except my oncologist & her peer (I think).  So, I am having surgery tomorrow.

    Your report does not seem bad to me.

    Thanks for your interest.

    Probably will not feel too good 'til Sat w/f/u:)

    Nic

  • mp327
    mp327 Member Posts: 4,440 Member
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    surgery is the plan

    Sandy - Your oncologist is right!  You need a biopsy or at least a pc. of tissue to make a plan.  Theoretically, I am not stage IV until we know it's a met.  Getting chemo not knowing what is going on is not a good idea.  No one thought I should get chemo except my oncologist & her peer (I think).  So, I am having surgery tomorrow.

    Your report does not seem bad to me.

    Thanks for your interest.

    Probably will not feel too good 'til Sat w/f/u:)

    Nic

    nicotianna

    I don't know if you will see this message before you go in for your surgery, but I want to wish you all the very best and let you know that I will be thinking of you.  You will be in my prayers tonight.  Please let us know how things went when you are up to it.  Hugs!

  • pializ
    pializ Member Posts: 508 Member
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    mp327 said:

    nicotianna

    I don't know if you will see this message before you go in for your surgery, but I want to wish you all the very best and let you know that I will be thinking of you.  You will be in my prayers tonight.  Please let us know how things went when you are up to it.  Hugs!

    biopsy

    I hope all goes well for you today. Sending you hugs 

    Liz

  • knolltop
    knolltop Member Posts: 56
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    Nic

    Here it is the 21st of August and I just read your post.    You had surgery and I'm praying all went well for you.

    I, too, would chose surgery.    When my cancer met to Liver....I had two rounds of chemo and then resection and two more rounds of chemo.

    Knowing it is out is the best choice for me.   I'm still playing the waiting game...next scan end of September.   Pulmonologist found a spot on left lung now that radiologist didn't pick up.  Still to small to biospy.

    Heal well and let us know how you are doing when you are up to it.

    Blessings and prayers.

    tory

  • sandysp
    sandysp Member Posts: 868 Member
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    surgery is the plan

    Sandy - Your oncologist is right!  You need a biopsy or at least a pc. of tissue to make a plan.  Theoretically, I am not stage IV until we know it's a met.  Getting chemo not knowing what is going on is not a good idea.  No one thought I should get chemo except my oncologist & her peer (I think).  So, I am having surgery tomorrow.

    Your report does not seem bad to me.

    Thanks for your interest.

    Probably will not feel too good 'til Sat w/f/u:)

    Nic

    How are you?

    How did the surgery go? 

    I hope you are feeling better. 

    I feel so close to you right now.

    Thanks for saying my CT scan didn't sound so bad. I smiled at that. I guess we just won't know unless we biopsy it and that is what my oncologist thinks we should do.

    So no wonder I am feeling close to you.

    I read that your throat is really sore afterwards since they go down with the bronchoscopy. Did they have to cut you open at all or were they able to work from the bronchoscopy? 

    My report may not look so bad, but the bad part, I found out is that because it is located so close to my heart, it's going to be a tricky procedure. I feel if I go through all that they should remove the whole thing while I am under sedation so I won't ever have to see it on the report again. It's been there for three years!

    Well, have a speedy recovery. We all need to hear from you soon.

    fondly,

    Sandy

  • nicotianna
    nicotianna Member Posts: 209
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    knolltop said:

    Nic

    Here it is the 21st of August and I just read your post.    You had surgery and I'm praying all went well for you.

    I, too, would chose surgery.    When my cancer met to Liver....I had two rounds of chemo and then resection and two more rounds of chemo.

    Knowing it is out is the best choice for me.   I'm still playing the waiting game...next scan end of September.   Pulmonologist found a spot on left lung now that radiologist didn't pick up.  Still to small to biospy.

    Heal well and let us know how you are doing when you are up to it.

    Blessings and prayers.

    tory

    spots on lung

    Tory - I hope the spots are nothing special.  I do have an area in the LUL that has always had some activity but apparently is inflammation.  Hope this is the case for you.

    I am doing remarkably well!  I do have support from family & friends.  I am living alone in my house w/my dog. Need to put on wt.  Have become quite skinny.

    Thinking about you & hoping the docs figure out what's going on in your lungs.

    Nic

  • nicotianna
    nicotianna Member Posts: 209
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    pializ said:

    biopsy

    I hope all goes well for you today. Sending you hugs 

    Liz

    more than a biopsy

    Thanks Liz!  I had a segment of my lung plus about 5 nodes removed.  The path report is pending.  I am doing well!  Will post the results as soon as I hear.

    Nic

  • nicotianna
    nicotianna Member Posts: 209
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    sandysp said:

    How are you?

    How did the surgery go? 

    I hope you are feeling better. 

    I feel so close to you right now.

    Thanks for saying my CT scan didn't sound so bad. I smiled at that. I guess we just won't know unless we biopsy it and that is what my oncologist thinks we should do.

    So no wonder I am feeling close to you.

    I read that your throat is really sore afterwards since they go down with the bronchoscopy. Did they have to cut you open at all or were they able to work from the bronchoscopy? 

    My report may not look so bad, but the bad part, I found out is that because it is located so close to my heart, it's going to be a tricky procedure. I feel if I go through all that they should remove the whole thing while I am under sedation so I won't ever have to see it on the report again. It's been there for three years!

    Well, have a speedy recovery. We all need to hear from you soon.

    fondly,

    Sandy

    S/P RUL VATS apical & posterior segmentectomy & lymphadenectomy

    Hi Sandy - My surgery was minimally invasive.  About 5 nodes were removed in addition to the lung segment.  I did not have a bronchoscopy but had general anesthesia.  So I had a tube in my throat during surgery to protect my airway & provide ventilation.  I had very mild throat discomfort post-op due to this.  I have ~ a 2" incision & maybe 2 other tiny ones for the chest tube & maybe the vdeo equipment (not sure).  Anyway, the chest tube came out on the 2nd post-op day just before I was dc'd (8/22).  This did not hurt, & actually, I was more comfortable w/it out.

    The nodes were close to important vessels such as the pulmonary artery.  I need Gray's Anatomy to actually know the situation.  Probably can find it on line.  Because of the proximity to the important vessels the surgeon has to be good.  They wanted to prevent my going into atrial fibrillation which could happen because of the close proximity to the heart & blood vessels.  Post-op I received metropolol (a beta blocker) to prevent a fib.  I will be taking this for a couple weeks.  No big deal.

    They gave me something IV (apparently) in the surgical waiting area & I woke up in the recovery room.  I never felt or saw a thing in the OR.

    I am waiting for the path report.  I think it will be a met (metastasis):(

    Thanks for your good wishes!  I am hoping your surgeon is confident that he can do it for you if this is indicated.

    Nic 

  • sandysp
    sandysp Member Posts: 868 Member
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    S/P RUL VATS apical & posterior segmentectomy & lymphadenectomy

    Hi Sandy - My surgery was minimally invasive.  About 5 nodes were removed in addition to the lung segment.  I did not have a bronchoscopy but had general anesthesia.  So I had a tube in my throat during surgery to protect my airway & provide ventilation.  I had very mild throat discomfort post-op due to this.  I have ~ a 2" incision & maybe 2 other tiny ones for the chest tube & maybe the vdeo equipment (not sure).  Anyway, the chest tube came out on the 2nd post-op day just before I was dc'd (8/22).  This did not hurt, & actually, I was more comfortable w/it out.

    The nodes were close to important vessels such as the pulmonary artery.  I need Gray's Anatomy to actually know the situation.  Probably can find it on line.  Because of the proximity to the important vessels the surgeon has to be good.  They wanted to prevent my going into atrial fibrillation which could happen because of the close proximity to the heart & blood vessels.  Post-op I received metropolol (a beta blocker) to prevent a fib.  I will be taking this for a couple weeks.  No big deal.

    They gave me something IV (apparently) in the surgical waiting area & I woke up in the recovery room.  I never felt or saw a thing in the OR.

    I am waiting for the path report.  I think it will be a met (metastasis):(

    Thanks for your good wishes!  I am hoping your surgeon is confident that he can do it for you if this is indicated.

    Nic 

    Hoping not a met

    Thanks for explaining your procedure to me, Nic. 

    Are you a medical professional yourself? You seem very confident using a lot of terms and abbreviations that I am not sure I follow. I've always been impressed by your level of communication. This was pretty clear to me though and I am so grateful you shared it. The proximity of your "thingamagiggy" sounds similar to mine. Gray's Anatomy would be handy about now:-)

    But that you are doing fine and taking care of yourself means the world to me. I have not known what to expect after the 8th or after the surgery (biopsy or whatever) but if yours went this well, I feel much more confident mine will too.

    Thanks again for sharing and God bless you for your courage. I am praying it's not a met, but if it is, it is. This life thing is all about one day at a time and sometimes we enjoy our days more knowing they are numbered as everyone's certainly are. I am finding that anyway. And it helps not to be in pain any more like I was for YEARS before my initial diagnosis. I am truly grateful for that and very happy you are not in pain either.

    Enjoy your summer.

    Sincerely,

    Sandy

  • sandysp
    sandysp Member Posts: 868 Member
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    spots on lung

    Tory - I hope the spots are nothing special.  I do have an area in the LUL that has always had some activity but apparently is inflammation.  Hope this is the case for you.

    I am doing remarkably well!  I do have support from family & friends.  I am living alone in my house w/my dog. Need to put on wt.  Have become quite skinny.

    Thinking about you & hoping the docs figure out what's going on in your lungs.

    Nic

    Left Upper Lobe?

    LOL usually means "lots of laughs, I think:-)

    Fondly,

    Sandy

  • nicotianna
    nicotianna Member Posts: 209
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    sandysp said:

    Hoping not a met

    Thanks for explaining your procedure to me, Nic. 

    Are you a medical professional yourself? You seem very confident using a lot of terms and abbreviations that I am not sure I follow. I've always been impressed by your level of communication. This was pretty clear to me though and I am so grateful you shared it. The proximity of your "thingamagiggy" sounds similar to mine. Gray's Anatomy would be handy about now:-)

    But that you are doing fine and taking care of yourself means the world to me. I have not known what to expect after the 8th or after the surgery (biopsy or whatever) but if yours went this well, I feel much more confident mine will too.

    Thanks again for sharing and God bless you for your courage. I am praying it's not a met, but if it is, it is. This life thing is all about one day at a time and sometimes we enjoy our days more knowing they are numbered as everyone's certainly are. I am finding that anyway. And it helps not to be in pain any more like I was for YEARS before my initial diagnosis. I am truly grateful for that and very happy you are not in pain either.

    Enjoy your summer.

    Sincerely,

    Sandy

    abbreviations

    Hi Sandy - I am an RN w/a masters in nursing.  My focus was neuro.  Forgive the abbreviations.  Ask me the confusing ones.  I have learned so much on this web site & found excellent resources from it.

    s/p = status post

    RUL = rt upper lobe

    LUL = lt upper lobe;  lol = lots of luck (not medical jagon:))

    met = metastasis

    I did find a diagrahm on line from Gray's anatomy of the nodes & vessels near the lungs & heart.  I googled it.

    Thanks for your encouragement & kind words.  I am wishing that your biopsy is negative for ca.

    Nic

  • knolltop
    knolltop Member Posts: 56
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    spots on lung

    Tory - I hope the spots are nothing special.  I do have an area in the LUL that has always had some activity but apparently is inflammation.  Hope this is the case for you.

    I am doing remarkably well!  I do have support from family & friends.  I am living alone in my house w/my dog. Need to put on wt.  Have become quite skinny.

    Thinking about you & hoping the docs figure out what's going on in your lungs.

    Nic

    Nic

    I hope too that these area are of no concern....just would like to know either way.

    I'm happy that you are doing so well and have good support.   I smile because I am so overweight and need to lose 30 pounds....I'll send 10 pounds your way.

    I'm about 135 in my picture with hubby.    Was just diagnoise with hypothyroidism...on meds and hoping I can now lose some weight.

    Rest up.

    Blessings,

    tory

  • sandysp
    sandysp Member Posts: 868 Member
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    abbreviations

    Hi Sandy - I am an RN w/a masters in nursing.  My focus was neuro.  Forgive the abbreviations.  Ask me the confusing ones.  I have learned so much on this web site & found excellent resources from it.

    s/p = status post

    RUL = rt upper lobe

    LUL = lt upper lobe;  lol = lots of luck (not medical jagon:))

    met = metastasis

    I did find a diagrahm on line from Gray's anatomy of the nodes & vessels near the lungs & heart.  I googled it.

    Thanks for your encouragement & kind words.  I am wishing that your biopsy is negative for ca.

    Nic

    That was really helpful

    Being as smart as you are and well informed probably doesn't make things any easier right now.

    I can't believe I didn't even get LOL right if it WASN'T a medical abbreviation. All these years I thought it was about laughing!

    I will look at the anatomy of the lungs and heart too so I can be prepared to ask the doctor exactly where this thing is. I wish the other Pulmonologist had never told me that it was so close to the heart she didn't know anyone who would biopsy it (but I think she was referring to a "needle" biopsy). Surely if they can do heart surgery it could be done by somebody. My husband has offered to do it in his garage:-) He really wanted to put the titanium screw that was placed in my head for my hearing implant, but I said no to that also. (I guess I shouldn't say lol here) but hope this brings a chuckle.

    Hopefully you get more than a few chuckles out of my ignorance. Sometimes it is bliss but other times, definitely not. Where are you getting your cancer treatments? It sounds like were in good hands for the procedure.

    All the best,

    Sandy

  • tercure
    tercure Member Posts: 15
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    sandysp said:

    Left Upper Lobe?

    LOL usually means "lots of laughs, I think:-)

    Fondly,

    Sandy

    LOL

    Hi Sandy,

    I've always heard LOL stands for "Laughing Out Loud," hope it helps!

    All my best to you.

  • 7243
    7243 Member Posts: 249 Member
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    abbreviations

    Hi Sandy - I am an RN w/a masters in nursing.  My focus was neuro.  Forgive the abbreviations.  Ask me the confusing ones.  I have learned so much on this web site & found excellent resources from it.

    s/p = status post

    RUL = rt upper lobe

    LUL = lt upper lobe;  lol = lots of luck (not medical jagon:))

    met = metastasis

    I did find a diagrahm on line from Gray's anatomy of the nodes & vessels near the lungs & heart.  I googled it.

    Thanks for your encouragement & kind words.  I am wishing that your biopsy is negative for ca.

    Nic

    Hoping for the best!!

    Thinking of u today ... I hope u get a good report !  Xo