Recently diagnosed. What treatment?

Watercolor
Watercolor Member Posts: 47 Member
in Lung Cancer #1

Nodule happened to show on an MRI doctor ordered. CT scan, PT scan, interventional radiology biopsy done = upper right lobe cancer. Not metastatic, 1.a - 1.b. I've seen oncologist, radiation oncologist, thoracic surgeon. Luckily I live near a big hospital complex which includes a cancer center. 'Bout time for me to decide — what treatment? I have good insurance — Medicare and BCBSIL supplemental Plan F. I didn't get Plan D / drugs. Should have. (I'm 78, NO family, never smoked.) 'Bout time for me to decide — what treatment? Chemo / systemic drugs ($$) and thoracic surgery scare me. Radiation is OK. (I had DCIS 22 years ago. Lumpectomy, radiation, tamoxifen. No problems with anything.) Has anyone had radiation only for lung cancer? Good results?

Comments

  • eDivebuddy
    eDivebuddy Member Posts: 90 Member
    #2

    I'm so sorry you're going through this. Cancer is no longer the death sentence it once was. What cancer center are you near?

    There’s a significant difference between stage 1A and 1B, and the distinction is not ambiguous. Understanding the stage precisely is crucial for making informed decisions about your treatment.

    After stage 0, there are four substages within stage 1: IA1, IA2, IA3, and IB.

    Tumors that are ≤1 cm are classified as stage IA1.

    Tumors >1 cm to ≤2 cm: stage IA2.

    Tumors >2 cm to ≤3 cm: stage IA3.

    Tumors >3 cm to ≤4 cm: stage IB.

    Since you're asking about radiation-only treatment, it's important to note that the stage of your cancer plays a significant role in determining whether radiation alone is an effective option. For stage IA1, IA2, or even IA3, stereotactic body radiation therapy (SBRT) can offer excellent local control, often comparable to surgery for patients who are medically inoperable or choose not to undergo surgery. For stage IB, the outcomes with radiation-only may still be good but are slightly less favorable due to the larger tumor size.

    It’s great that you’re near a cancer center and have access to specialized care. Radiation oncologists at comprehensive cancer centers often have extensive experience with SBRT and can provide detailed information about its success rates for your specific case.

    Given your experience with DCIS and your comfort with radiation, SBRT might be a suitable option if surgery and systemic treatments are less appealing. Be sure to ask your radiation oncologist about:

    Local control rates and overall survival specific to your stage.

    Potential side effects of SBRT, especially if the tumor is near critical structures like the bronchus or chest wall.

    Whether they recommend systemic therapies (especially for stage IB and above) in conjunction with radiation, even for early-stage disease.

  • Watercolor
    Watercolor Member Posts: 47 Member
    edited January 23 #3

    I'm not very knowledgable about all this and even specifically my tumor. Thoracic surgeon said I'm clinically 1.a, 1.b. Early. Not metastatic. Don't like the idea of "my tumor". I'm seeing radiation oncologist for a second consult this coming Wednesday — weather allowing. I'm in the 'burbs west of Chicago. Hoping radiation only can do what's necessary to KILL this thing. Rad onc gave me good printed info about various types of radiation and procedures and services that go with it at first consult with her.

    I'm five miles from the Nancy W. Knowles Cancer Center which is part of the big Edward-Elmhurst hospital complex. https://www.eehealth.org/locations/elmhurst/nancy-w-knowles-cancer-center/

    There used to be an ACS regional office only couple miles from me. That's been gone for a while.

  • eDivebuddy
    eDivebuddy Member Posts: 90 Member
    #4

    lived 23 years not too far from you  in Bartlett, so I’m a little familiar with your area. 

    I’m a bit frustrated by the thoracic surgeon’s apparent uncertainty between stage 1A and 1B, especially since this distinction is so critical for determining the best treatment path. Stage 1A might often be treated adequately with segmentectomy or SBRT, while stage 1B nearly always calls for a lobectomy as the preferred surgical option. Understanding this difference is essential for making informed decisions.

    I’d also like to highlight that SBRT outcomes are significantly better for stage 1A than for 1B, further emphasizing the importance of accurate staging for both surgical and radiation planning.

    Beyond surgery and radiation, there’s also the question of systemic treatments. For stage 1A, systemic treatments are typically not recommended outside of research settings. For stage 1B, however, systemic treatments are frequently part of the standard of care.

    Personally, I wouldn’t feel comfortable making decisions without a precise understanding of my stage and how it affects all treatment options. The entire premise of informed consent relies on having this clarity.

    You’re fortunate to have access to two of the greatest cancer research centers in the world: Northwestern Medicine and The University of Chicago Medicine. I’d recommend considering a telehealth second opinion with one of them to get a clearer picture of your options. If needed, Medicare will also cover a third opinion if the second opinion differs.

    Here are some resources to explore:

    Northwestern Medicine Cancer Second Opinion
    https://www.nm.org/conditions-and-care-areas/cancer-care/cancer-second-opinion
    University of Chicago Medicine Cancer Second Opinion
    https://www.uchicagomedicine.org/cancer/patient-care/second-opinion

    NCCN Member Institutions
    https://www.nccn.org/home/member-institutions/

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