SBRT

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sledhead
sledhead Member Posts: 11

I have conslulted with a local radiation oncologist regarding a 5.9cm x 3.5cm lesion on my right adrenal. He assured me that he could treat the area with a 60-70% local control rate. If there is a reccurance in the same lesion can it be followed up with more sbrt, rfa or cryo? Also, my oncologist at the U of C stated that the radiation guys there didn't want to treat it at all with sbrt but would consider rfa. I am not sure why they would think that as control rates with rfa are not better than those with sbrt. I am having a consult with an IR at the U of C in a couple of days. Any thoughts?

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  • todd121
    todd121 Member Posts: 1,448 Member
    edited July 2016 #2
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    Adrenal Tumor

    I had an adrenal tumor just last year. I was at City of Hope. There was never any discussion of anything other than surgery for me. My tumor was smaller than yours and probably wholly contained in the adrenal gland.

    I've gone to some talks on SBRT and read several accounts here and talked to other patients. I've never heard of them using SBRT for a soft tissue tumor like this. On a few rare occasions I've heard of them using SBRT for inoperable tumors in the lungs. Usually it's been used in places hard to operate such as in the brain, or near the spine or on bones like ribs and such. If surgery is an option, it seems that's what the first choice is.

    Are you sure it's RCC? Did they do a biopsy or how do you know?

    I'd make sure I was getting a consult with a medical oncologist who is an RCC expert (IF that's what you have, you didn't actually say that you have RCC...).

    With RCC, while recurrence in the same area may be of concern, I think the bigger concern is recurrence somewhere else in the body. But maybe that's something you would ask a medical oncologist with expertise in RCC.

    Is it possible this is not kidney cancer at all? I have a friend with a benign adrenal tumor and they've been watching his for years without doing anything.

    Regards,

    Todd

  • todd121
    todd121 Member Posts: 1,448 Member
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    todd121 said:

    Adrenal Tumor

    I had an adrenal tumor just last year. I was at City of Hope. There was never any discussion of anything other than surgery for me. My tumor was smaller than yours and probably wholly contained in the adrenal gland.

    I've gone to some talks on SBRT and read several accounts here and talked to other patients. I've never heard of them using SBRT for a soft tissue tumor like this. On a few rare occasions I've heard of them using SBRT for inoperable tumors in the lungs. Usually it's been used in places hard to operate such as in the brain, or near the spine or on bones like ribs and such. If surgery is an option, it seems that's what the first choice is.

    Are you sure it's RCC? Did they do a biopsy or how do you know?

    I'd make sure I was getting a consult with a medical oncologist who is an RCC expert (IF that's what you have, you didn't actually say that you have RCC...).

    With RCC, while recurrence in the same area may be of concern, I think the bigger concern is recurrence somewhere else in the body. But maybe that's something you would ask a medical oncologist with expertise in RCC.

    Is it possible this is not kidney cancer at all? I have a friend with a benign adrenal tumor and they've been watching his for years without doing anything.

    Regards,

    Todd

    Apologies

    I looked at your profile after I responded and see you've had RCC. But did they biopsy it? Are you not a candidate for surgery? Why would they not just do the surgery? It was a much easier surgery than the nephrectomy. Is that your last adrenal? Or is it on the same side?

    Wishing you well,

    Todd

  • sledhead
    sledhead Member Posts: 11
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    Todd, thaks for the reply the

    Todd, thaks for the reply the lesion is on the right side which is the same side as my nephroctemy. The radiation oncologist says that is favorable because the kidney will not be affected by the radiation. They have not biopsied it but are calling it rcc. My left adrenal is uneffected & is healthy. I don't think they are considering sugery as a first option at this point because I have a liver lesion and a few small lung mets. Radiosurgery is less invasive and a good option for me as long as the control rate is acceptable. The local radiologist oncologist is telling me 60-70% at will treat but the experts in Chicago will not treat because I believe that they are not comfortable with those numbers. 

  • todd121
    todd121 Member Posts: 1,448 Member
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    sledhead said:

    Todd, thaks for the reply the

    Todd, thaks for the reply the lesion is on the right side which is the same side as my nephroctemy. The radiation oncologist says that is favorable because the kidney will not be affected by the radiation. They have not biopsied it but are calling it rcc. My left adrenal is uneffected & is healthy. I don't think they are considering sugery as a first option at this point because I have a liver lesion and a few small lung mets. Radiosurgery is less invasive and a good option for me as long as the control rate is acceptable. The local radiologist oncologist is telling me 60-70% at will treat but the experts in Chicago will not treat because I believe that they are not comfortable with those numbers. 

    60-70%?

    Thanks for the explanation. I'm always interested in learning something new. I didn't understand your statement "...is telling me 60-70% at will treat...". What does that mean?

    The surgery was much easier than the nephrectomy, but I did take 6 weeks off work (same as my nephrectomy). My healing time was slower mainly because I seemed to have developed an allergy to the damn glue they use now instead of sutures.

    BTW, if it's on the same side as your nephrectomy, why would the kidney be affected by the radiation? I'm assuming there's no kidney on that side. Or did you have a partial?

    Best of luck. Please post an update on how it went.

    Todd

  • sledhead
    sledhead Member Posts: 11
    edited August 2016 #6
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    Same Side

    Todd,

    The lesion is on the same side as the nephrectomy so there isn't any risk of kidney damage from the SBRT.

    The Radiation Onlcologist told me 60-70% control rate which means that is the probability there will not be recurrance in that area.

    Usually, sbrt carries a better rate (around 90%) but I have been told that I can repeat the procedure with RFA or cryo in the event of recurrance providing that the lesion shrinks to around 3-4cm.