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What is typical treatment for a Lung Met?

pluckey's picture
Posts: 484
Joined: Jul 2009

Hi All

I haven't been active here in quite a while as I went about my "normal post cancer" life.


A spot on my lung that we've been watching since the summer doubled in size to 1.3 cm on my scan last week.

My onc said she would recommend a 12-course round of Folfox (oxiliplatin, right) and 5FU after resextion.
For ONE stinking tumor? Is that normal?

I have appt with Thoracic surgeon Tuesday (I am in Chicago and treated at Loyola) and then will get 2nd opinion at MSKK in NYC.

I'm not having issues with getting the tumore cut out..but WHY a full-on chemo regiment for one tumor?

Is it because of my history? Stage 4, 9 mets to liver, colostomy, very very sick and diseased when diagnosed. My Onc told me I "defied all the odds" by surviving and thriving.

Is this Lung Met **** like whack-amole? One pops up, cut it out, do chemo. Wait for the next one? How much cutting can one do in lungs?


Any insight appreciated!


PhillieG's picture
Posts: 4912
Joined: May 2005

Sorry to hear about your lung met. I don't think there is a typical treatment for lung mets. I have had those are my main issue for six out of my eight years with cancer and it's still my issue. I have had 3 wedge resections done when we first started deling with them, roughy on a year. Each time I went back on Erbitux and Irinotecan. I never did FOLFOX except for my initial chemo after diagnosis and before my initial surgery for the colon and liver.
When I had the wedge resections, there were small clusters of tumors for one and also they were in a place where the resection made sense. I believe they were near the outer lung area, not deep inside.

After the three wedge resections, partly due to a lot of scar tissue, and partly because it was just one or two tumors they did RFAs on me. That's a Radio Frequrncy Ablation where they insert a needle into the tumor during a CT Scan, then heat the needle which dissolves the tumor. I do not hink they can do this if you have multiple tumors that are scattered about. If you hav a mall cluster they may be able to do the RFA. The GREAT thing with the RFA was that the recovery time is very fast and out of the four that I've had one, the last three times I went home the same day. The first time I had it done I stayed overnight only or observation. I had no problems with the procedure at all. I did feel a little sore afterwards but it was minimal. As with the resection, I went back on Erbitux and Irinotecan.

I seem to grow a spot a year and I can, in theory, keep doing the RFAs indefinitely. I am REALLY glad to hear you are going to Sloan. I've been fortunate to have all of my operations/procedures done there. That was also where I got my second opinion from.
As their commercials say "Where you get treated first makes all the difference". I truely beleive that to be true...

Good luck with everything Peggy. Keep us posted please.

Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

Have lung mets also (5) but getting Avastin & Irinotecan with no folfox this time around.

pepebcn's picture
Posts: 6352
Joined: Aug 2010

experience on that, you may PM her.Also Dr. Phil is a book of wisdom talking about Lung mets,hahaha. Both of them are the most experienced in the matter. Hugs Peggy.

pluckey's picture
Posts: 484
Joined: Jul 2009

Thanks Phil..I am having trouble emailing you from here so I'll jsut ask some more questions.

so, you did chemo first, then colon and liver resections?

OK, I did colon resection, chemo, liver resection. About 1.5 Years after liver resection (Martch 2010) was when they started getting concerend on this one spot.

So, have you been getting chemo the entire time- in between each procedure for removal of tumor?
So you've had 3 lung mets, at 3 separate times?
Are you working or is the chemo too much?



PhillieG's picture
Posts: 4912
Joined: May 2005

I just sent you an email.

geotina's picture
Posts: 2123
Joined: Oct 2009

Jennie (idlehunters) is getting cyberknife for her lung met(s). I don't know if she is also doing chemo at this time. Send her a pm and she can fill you in on cyberknife. If you search her name her discussion posts on the topic will come up but a pm can give you more specifics.

Take care, sorry for that darn met - Tina

Sundanceh's picture
Posts: 4408
Joined: Jun 2009

If I can be of any help, call me Peg:)

I've done the lung with the DaVinci and an open procedure...radiation/chemo etc. etc.


idlehunters's picture
Posts: 1792
Joined: Apr 2009

PM or call me Peggy if you want to talk. I am getting quite a bit of Cyberknife experience as Pepe and Tina know.....but as Craig just posted he too has had numerous lung met experiences. You know we are here if you need us! Take care Peg


tootsie1's picture
Posts: 5065
Joined: Feb 2008

No experience with it, but I just want to wish you the best!


Posts: 15
Joined: Jan 2012

A friend of mine who has lung cancer is also undergoing cyberknife treatment. The doctors have said that his prognosis looks good. Cyber knife is non-invasive, and the recovery period is very quick. You remain an outpatient and can resume normal activities soon after treatment. The best thing about it is that the radiation beams they use target only the malignant cells and preserve healthy tissue. It’s worth getting the opinion of radiation oncologist. Wish you the very best for your treatment.

Kenny H.'s picture
Kenny H.
Posts: 503
Joined: Aug 2010

My surgeon is against cyber knife. Said open surgery is best guaranteed method for me. Maybe becuase I have several nodules dunno. Doing one lung at a time & Im ready for anything but more chemo.

dmj101's picture
Posts: 527
Joined: Nov 2011

typical treatment... no such thing it would seem.. but your question comes at the same time I have been asking the same thing...

I had a stage 2-3 rectal cancer with a resection that ended with me having a colostomy.
I made it thru FolFox initially.. Now I am on FolFiri and Vectibix as I am presenting with multiple Lung Mets. we aren't talking about surgery at all yet. So I have to say I don't know there is a standard protocol. I assume they do surgery when the met is near the airway.. Mine are not I am assuming.
I am thriving too and this is found.. what stupid luck.. I switched onc's a my previous was not treating this too aggressively and I felt she was waiting for it to manifest further before doing anything reall.. so I found someone who would as I just feel attacking when I feel good should have better response than when I feel like crap. I don't know that others feel that way.. but I do.. I have age and health on my side presently and faith.. so I that is my story and I am sticking to it..

I hope you find the solution best for you..
Check out a site titles.. is my cancer different.. i think it will give you the courage to ask the questions you need to ask.. just knowing someone else is thinking gave me courage.. You may also find some good info at MY Crazy Sexy Life.com and the Colon Cancer Alliance..
The folks here too are great and very sharing.. I have learned alot here too. and to laugh..

Take care and be peaceful.


barbebarb's picture
Posts: 464
Joined: Oct 2011

M reading all these posts and my doc''s said take it all out! This was their Multi-disciplinary approach. I hope this was the right start. They didn't mention other procedures...
I feel very fortunate but realize reoccurence will be on my mind always.
The VATS hasn't been a walk in the park recovery and I found the thorocotomy/wedging was easier.
It seems that colon cancer lung mets hold steady more than actual lung type cancers? Please correct me if this may not be true.
Location of the tumors makes a big difference.

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