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What non-invasive surgery can be used to remove a few lung mets?

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

Hello semi family! Hope you all had a terrific turkey day. I have not ate so much in quite some time.... and my bowels know it! LOL.... Anyway, I have come to a point in my treatment where I feel it may be time to consider an alternative to chemo. I had a PET/CT last wednesday and get results Dec. 1st. 3 weeks ago I was in hospital and had several MRI's and CT scans. Results showed only 1 met in lungs but they did not do the very top of lungs so something may be lurking there... but I only had 1 there in the past. Not that that means anything. If I do only have a few mets left in lungs I need to know what my options are for getting rid of them. I have a feeling my onc will say "you have had such great progress on chemo that we should just continue with that" I don't want to! I am so burnt out on chemo. I would like to give my body a break... if even for a little while. I think if I could find a way to rid those last few mets I could get off chemo. Of course I realize there is ALWAYS the possibilty of it returning. As a matter of fact, the 2 opinions I got on my cancer they both said I would NEVER be rid of the beast. What do they know...they ain't God.

SO.... if anyone has any history of treatment on lung mets... or knowledge on the subject... my ears are open. As always... thank you all so much.

Jennie

PhillieG's picture
PhillieG
Posts: 4912
Joined: May 2005

I had a RFA (Radio Frequency Ablation) done a few years ago and I am having it done again in a few weeks. It's a very easy procedure there they stick a needle into the tumor, guided by the surgeon during a CT scan. The needle stays in for 30 minutes or so and it heats up and fries the tumor. I walked out the next day with only a bandaid over the needle mark. Piece of cake. Opps, more food ;-)

I've heard of a cyberknife but I think this may be better since it gets just the tumor and with a moving target (a breathing lung) there may be less collateral damage.

I am back on chemo but I was able to go to just Erbitux every other month and every other week of the month that I had chemo. i.e. I had 6 weeks off between the two treatments. I did that for 10 months but now it's every other week with Erbitux and CPT11 and I will continue that until I don't to clean up after the RFA.
Hope this helps.
-phil

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

Hi,

I know there are others who have had lung treatments and/or surgeries on their lungs, wheras I haven't. I have, however, looked into cyberknife and stereotactic radiation and considered having it done at one time, but found I was not a candidate for it. I feel in the same place you do- sick of chemo & have been told I'm not a surgical candidate or a candidate for cyberknife or other radiation treatments right now because of the number of nodules and their size (too small). So, whether you could be considered a candidate for any of those procedures would have to be evaluated by someone who does cyberknife and/or stereotactic radiation & it would depend upon the size, number, and location of your tumors. Your oncologist is not the one who should make the call as to whether you're a candidate for it or not- he/she probably does not know as much as the people who actually do these procedures. I'd get a referral to someone who does cyberknife and stereotactic radiation and have them evaluate you. The plus of cyberknife and/or stereotactical radiation vs. traditional radiation is that there are less sessions (usually between 3 and 5 total) because they can deliver a much higher radiation dose at one time without zapping the nearby healthy tissue.
I would think it would not at all be a bad idea to get your most recent scan and take it into someone who does cyberknife for an evaluation. A lot of the main cancer hospitals don't do the cyberknife there, but you'll find that there are separate cyberknife centers. Some of the hospitals do something similar called stereotactic radiation, which is also a precise radiation, but without implanting gold beads first like with cyberknife. With stereotactic radiation, you would have to hold your breath and try hard not to move during the radiation. Cyberknife allows the precise radiation to go exactly to the needed spot (it's drawn to the implanted gold bead- called a "fidducial").

I know that RFA is another possible treatment & that a few people on the board have had it done successfully. I really don't know enough about it to comment on it, though.

I wish you all the best in searching for other possibilities- don't give up!!

Lisa

idlehunters's picture
idlehunters
Posts: 1792
Joined: Apr 2009

Lisa..
phil...thanks for your input....BUT... until I read what Lisa read about having to remain perfectly still I didn't realize that was necessary. It just hit me that at any given time I can have a seizure which obviously involves quite a bit of involuntary movement. Especially at this stage in my life as I am withdrawing from all anti-epileptic meds I have taken for 30 years to start new meds that do not interfere with liver functions. I have at least 6 more weeks of this before I will be considered stable on new meds. I guess the point I am trying to make is I will have to get over this "bump in the road" before I can tackle anything else.... which means I will HAVE to have more chemo til then... sucks! Phil...does RFA require u to be still? I am assuming since you got a needle stuck in you.... do they put you out for this?

Jennie

CyberKnifeLI
Posts: 2
Joined: Dec 2009

Jennie,

We successfully treat lung cancers with Cyberknife Radiosurgery and I have included some information below from our website that may help you to better understand the procedure. I hope this helps.

The challenge that doctors face with tumors in the lung is that those tumors move as the patient breathes. Radiosurgery devices, such as the CyberKnife Robotic Radiosurgery System, offer patients a new option for the treatment of lung cancer. Unlike traditional radiation therapy, the CyberKnife System precisely identifies the tumor location as the patient breathes normally during treatment and can be used, in some cases, to treat lung tumors non-invasively.

Lung cancer treatment with the CyberKnife System involves a team approach, in which several specialists participate.

As part of the diagnosis, doctors will identify the location and size of the lung tumor. Depending on these results, some patients may not require the implantation of fiducial markers. The CyberKnife System will use only the identifying characteristics of the tumor itself to clearly visualize the tumor within the chest and track the tumor as the patient breathes normally.

Some tumors may require the placement of fiducials within the lung to help the CyberKnife System pinpoint the tumor's exact location. In that case, the patient will be scheduled for a short outpatient procedure beforehand in which three to five tiny gold seeds -- called fiducial markers -- are inserted into the tumor or surrounding lung tissue. These markers may be placed by putting a small needle through the chest, guided by CT scan or an ultrasound. Alternatively, a camera might be passed through the patient's mouth and into the airways or into the esophagus to allow access to the tumor. If fiducials are required, the patient must wait approximately one week before CyberKnife treatment planning can begin to ensure that fiducial movement has stabilized.

Before CyberKnife treatments can begin, patients will be fitted for a special body cradle. The cradle is made of a soft material that molds to the patient's body and is designed to make treatment more comfortable and to ensure body position is the same for each treatment session. The patient also will be fitted with a special vest, which is worn during CyberKnife treatment and enables the robot to correlate chest motion and breathing patterns with the tumor position. The data generated with the vest allows the CyberKnife robot to precisely follow the tumor's motion as it delivers each beam of radiation, ensuring safe and accurate radiation delivery.

While lying in the cradle, a CT scan will be performed to locate the patient's tumor. This CT data will be used by the CyberKnife team to determine the exact size, shape and location of the tumor. A MRI or PET scan also may be necessary to fully visualize the tumor and nearby anatomy. Once the imaging is done, the patient will remove his or her vest and it will be stored with the custom-fit body cradle for use in CyberKnife treatment.

A treatment plan will be specifically designed by a medical physicist in conjunction with the patient's doctors. Patients will not need to be present at this time. During treatment planning, the CT, MRI and/or PET scan data will be downloaded into the CyberKnife System's treatment planning software. The medical team will determine the size of the area to be targeted by radiation and the radiation dose, as well as identifying critical structures - such as the spinal cord or vital organs - where radiation should be minimized.

At this time, the CyberKnife System will be able to calculate the optimal radiation delivery plan to treat the lung tumor(s). Each patient's unique treatment plan will take full advantage of the CyberKnife System's extreme maneuverability, allowing for a safe and accurate lung cancer treatment. After the treatment plan is developed, the patient will return to CyberKnife of Long Island for treatment. The treatment is usually delivered in one to five sessions.

For most patients, the CyberKnife treatment is a completely pain-free experience. They may dress comfortably in street clothes and the CyberKnife center may allow the patient to bring music to listen to during the treatment. The patient also may want to bring something to read or listen to during any waiting time, and be accompanied by a friend or family member to provide support before and after treatment.

When it is time for treatment, the patient will be asked to put on their vest and lie on their custom body cradle. The radiation therapist will ensure the vest is properly adjusted and that the patient is positioned correctly on the treatment couch.

As treatment begins, the location of the lung tumor will be tracked and detected continually as the patient breathes normally. The medical team will be watching every step of the way as the CyberKnife tracks the patient's lung tumor as it moves, and safely and precisely delivers radiation to it.

The CyberKnife System's computer-controlled robot will move around the patient's body to various locations from which it will deliver radiation. At each position, the robot will stop. Then, special software will determine precisely where the radiation should be delivered by correlating breathing motion with the tumor. Nothing will be required of the patient during treatment, except to relax and lie as still as possible.

Once treatment is complete, most patients quickly return to their daily routines with little interruption to their normal activities. If treatment is being delivered in stages, the patient will need to return for additional treatments over the next several days as determined by their doctors. After CyberKnife treatments, most patients experience minimal side effects, which typically go away within the first week or two after treatment. Doctors will discuss all possible side effects prior to treatment. In addition, doctors may prescribe medication to control any side effects, should they occur.

After completing CyberKnife radiosurgery treatment, it is important for patients to schedule and attend any follow-up appointments. The patient should be aware that his or her tumor will not suddenly disappear. Response to lung cancer treatment varies from patient to patient. Clinical experience thus far has shown most patients respond very well to CyberKnife treatments. Doctors will monitor the outcome in the months and years following a patient's treatment, often using CT scans or PET-CT scans.

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