Pneumonectomy AFTER Chemo/Radiation

pasqualina

Can anyone shed light on this?? My father was diagnosed over 4 years ago with Stage IIIb NSCLC. His quality of life is very good. CT scans have been negative until this month. He has a local recurrence, centrally located, left lung confirmed by PET scan. His case was presented to tumor board at the hospital (Karmanos Cancer Institute) and they suggest removal of the entire lung. His PFT's were good in that the right lung can support him and his heart is strong. My issue is the complications associated with the entire removal of a lung. recurrence in the other lung etc. I was looking into other options such as OMNIbeam, cryotherapy, etc. Has anyone chosen pneumonectomy or stereotactic surgery or both?? What is quality of life like??
Thanks!
Lina

cabbott

Lung removal
In my case, they only removed the lobe where my tumor was located (1 cm. spot, stage 1). They used a surgery technique called a VATS procedure. VATS stands for video-assisted thoracic surgery. It is like laproscopic surgery where the three incisions are used to put a camera, light and instruments in so that the surgeon can operate without making a big incision. I was worried how long it would take me to recover since I had heard from folks who had had the standard procedure where the surgeon used a 10 1/2 inch incision and removed rib(s) to work. They were still recovering 1 1/2 to 2 years later. After my VATS procedure, I was weak as a kitten the first day or two in the hospital but believe it or not I was up and walking and jogging (slowly!) around the track with my son about a week and a half later. Unfortunately I had to go back in and have a second modified VATS procedure done then. The 3 incisions could have fit under a bandaid the first time around, but one of the three incisions was a 4 incher the second time around and recovery took about 3 months that time before I was well enough to hit the gym to walk the treadmill and ride a bike. At 6 months I felt pretty much back to normal. Now, in spite of missing a third of my right lung, I feel stronger than ever. Surgery for me was back in 2006.

I don't know why the board felt removing the entire lung would be better than removing just the involved lobe. That would be a good question to ask them. Perhaps that would eliminate the need for further surgery and just maybe they are spotting signs throughout the lobe that reoccurance is likely if they aren't aggressive enough. I know my second surgery was a double whammy for my quality of life. The nurses said that just being exposed to all the drugs they give you for anesthesia alone are a drag on quality of life. Avoiding a necessary second operation is definately a consideration, especially if it is likely to be needed.

Even if the entire lobe is removed, his recovery time can be minimized and his quality of life maximized by searching out a thoracic surgeon that is experienced in the VATS procedure. My doctor could have removed an entire lung through three one inch incisions so they told me if it had been necessary. ( They hadn't finished the job they went in to do on me the first time around because they thought I had stage 4 breast cancer where chemo is treatment rather than surgery. Boy were they surprised by the path report!)Shortness of breath would be likely until the other lung took over completely if you had a complete lung removed, but many folks live quite well with only one lung. You have to aggressively protect the health of that one lung obviously and get your flu shot, stay away from coughing kids, and stay in on smoggy days. One of my friends knew of a mountain climber who was born with only one lung. It didn't stop him from being active. That said, I remember being depressed and short of breath early in my recovery and the nurse practically yelling at me to stop panicking and get myself under control. That was easier for her to say than me to do when I couldn't catch my breath and wanted to cry. Fortunately things are better for me now.

I know I haven't had the experience of getting a whole lung removed, but I hope the information about the VATS procedure helps some.

C. Abbott

pasqualina

Thank you C. Abbott.
A
Thank you C. Abbott.

A lobectomy is not an option for my father. I wish it was. Neither is the VATS procedure. My father has had full chemo and radiation (60 gy) 4 years ago which in the words on the surgeon make his lungs cement, sticky, and unpredictable. VATS would be too risky. They would approach him from the front ( like heart bypass surgery)cutting down on discomfort. His tumor is centrally located between the two lobes and his PFT's show 96% of his breathing is coming from the other lung. My father is unusual in that he's had local recurrence and is actually a candidate 4 years after he was deemed inoperable. I need to know there is someone out there in similar shoes who is doing well. I'm glad you're doing well though and hope you continue to do so. I appreciate your experience too. A lobectomy is a big deal and glad to hear you're ok.
Lina

beach nana

Quality of life after Pneumonectomy
I had a pneumonectomy in November, 2006... My entire left lung was removed after having 2 months of chemo and radiation to shrink it from 9 cm to 4 cm. I was 58 years old. After removal I had 3 months of very strong chemo (the worst part of the whole ordeal). I had PET scans every 6 months for the first 2 years -- now once a year. I was very active prior to cancer -- I now have shortness of breath often and get very tired. I still work full time in an office. I try to get to the gym 3 times during the week -- I take a yoga class which is a life saver -- I also ride my bicycle on weekends. I've changed my diet to vegan. I will never have the stamina I once had -- I get depressed at times because I'm tired all the time -- but I keep perservering -- If I stop exercising I might as well let the cancer take me. I have two grandkids, ages 5 and 2-- I want to see them as teenagers.