Guillermo Berazadi

I was going to have a 2nd lobectomy in the same lung. My doctor called the evening before surgery and hesitated and apologized saying that after seeing the last MRI he was not sure about my rib problem and surgery as a cure. We decided that he was going to contact Onc radiologist about doing biopsy and do radiation if metastasis. In the morning I was ready for surgery and waited 3 hours in a bed when he was doing another surgery then he talked to us about needle biopsy being very difficult for radiologists, he could do an open biopsy cutting rib piece but was going to produce lots of chronic pain, so biopsies not recommended and radiation better. I assumed that all the suspicious readings from CT, PET and bone scans plus MRI are interpreted as cancer met in the rib, so the surgery was cancelled. Yesterday I went to see the Onc radiologist and asked directly and got confirmation. So we are going to do strong radiation M-F for 6 weeks. They did a CT scan to map the area and tattooed 3 dots in my chest, I will start in 1 or 2 weeks, the radiation is just 5 minutes, so a couple of hours per day round trip. Side effects fatigue, temporary burnings, etc. Easier than surgery and Dr. West in Onctalk agreed with this, he mentioned that surgery with mets is offered but may not work and radiation is a choice. He gives excellent support and frank advise. My Onc said is not palliative care, I am strong and "healthy" and is an aggressive treatment to eradicate the tumours. I don't feel any symptoms, If I didn't ask for a PET scan that detected rib problem, I will be operated now and probably will have a cancer site growing in the rib. Life is a lottery, I feel like with my tumor/s they found the needle in the hay stack, then they burn the hay stack! At least I will keep my old lobe, I am attached to it! Your comments are welcome. Do you know general average life expectancy 2 years after first upper lobectomy stage 2BN1 and now midle lobe 1.8x1.3 cm tumor and almost sure mets in 4th rib?

Thanks for all the information and support. After additional tests PET scan found only a 18 x 13 mm soft tissue nodule (with an SUV of at least 3.5 ?)associated with right major fissure and prior lobectomy suture. Also the right fourth rib is worrisome with a focus (with an SUV up to 2.8 ?), waiting for thorax MRI results, can be benign trauma. Oncologists did not recommend SBRT in my location, can not use strong doses without damaging organs. So on Feb 26th. I will have right middle lobe removed with the traditional larger cut operation. My tested lung capacity surprisingly is the same as before the first lobectomy, lung expanded, and 125% of expected for my body and age! So I'm going to be average after 2 lobectomies... Optimist, hope is a cure and buys me more enjoyable time, feel very well, traveled a lot in the last 2 years and had one daughter married and other finishing university!!! I'm also lucky treated in Toronto, Canada in one of the world 5 major cancer centers with all expenses paid by OHIP Ontario Health Insurance Plan. Good luck to all of you. Carpe Diem

Original Title: Dilemma: choose radiation or second lobe surgery removal. Please comment and advise me.Confirmed: December 21st. is the darkest day of the year, after a CT scan my lung surgeon toll me that lung cancer is back.I hate to give my wife this Xmas present, I will tell my kids in January.I am a tall 69 year old canadian male, never smoked but had NSCLC adenocarcinoma 5.5=cm tumor stage IIB pT2N1 removed with right upper lobe in Jan 2005. Before that had 1 month of Iressa and after surgery had Adjuvant chemo Cisplatin and Vinorelbine for 3 months. Great surgery In Princess Margaret Hospital Cancer Center and fast recuperation, discomfort and failure with chemo. Now have to do Blood work, MRI brain, bone scan, lung biopsy (my request), abdominal ultrasound, pulmonary functions test and see a Radiation Oncologist. If tests are OK I need to make the best choice: a.- Surgery: remove 2nd right lobe and end with 60% lung capacity, my volume was always high and good. Minor concern a few experiences of atrial fibrillation controlled with daily half atenolol, blood pressure low OK. or b.- Radiation: New for me. Does it cure or just reduces size and spreading of cancer tumors? Concern about my esophagus, I had stomach reflux for a few years, controlled with Ranitidine or Zantac. Does radiation burns and damages good areas? Any info or experience with Image Guided Radiotherapy (IGRT) or Stereotactid Body Radiation Therapy (SBRT)?? c.- Other type of Chemo? Thanks for your info and have a good holiday season. Guillermo Berazadi