Don M

Whew indeed, Jim! That is great news. I hope you stick around for much longer than 3 years. It was really nice of you to offer yourself to others for support. There is a guy in my chemo shop who I think has lc. Maybe I will sit next to him next time and strike up a conversation. Don M

Lynda: I hope the radiation gives your dad a good break before chemo. I think he would probably do chemo too if he starts to feeling better. Don M

Jenny: Check out cyberknife surgery. Your dad may be a candidate. Here is a link where you can ask radiation oncologists about your dad's situation. http://www.cyberknifesupport.org/forum/default.aspx?c=4 They are very helpful and answer within 24 hours. Here is a link to the manufacturer's web site where you can enter a state to find the nearest cyberknife center. http://www.accuray.com/SiteLocations/index.aspx I have cut and pasted the loctions in Florida from the above web page: CyberKnife Center of Miami 7867 North Kendall Drive #105 Miami, FL, 33156 USA Phone Main: (800) 204-0455 Phone Alt: (305) 279-2900 NCH Regional Cancer Institute Opening in July, 2004 733 4th Avenue North Naples, FL, 34102 USA CyberKnife Center of Palm Beach 10335 North Military Trail, Suite C West Palm Beach, FL, 33401 USA Phone Main: (561) 799-2828 Phone Alt: (877) 330-3339 Here is a link to a recent newes release about cyberknife in Cancer Compass News: http://www.cancercompass.com/cancer-news/1,11070,00.htm Don M

Carleen: Peggy's post choked me up a little bit. I think of you and Keith evry day. I hope you both find some peace together in this time. Don M

http://www.cancercompass.com/cancer-news/1,11070,00.htm Don M

Hi Lisa and welcome to the lchelp boards. A PET scan will give you more information. Did the bronchscopy test positive for NSCLC? It is fairly reliable for positive results. If the bronchoscopy tested positive for NSCLC, your dad proably does not need any more biopsy other than for lymph nodes. I have been told that a PET scan is very good for detecting cancer in lymph nodes. Perhaps a follow up with a mediastinscopy would be good to confirm the PET scan re lymph nodes. I think a common practice for stage II cancer is to pretreat the tumor with chemo and some radiation then operate then do followup treatment possibly both chemo and radiation. They would not want to radiate too much before the operation so that the surgeon won't have to deal with scar tissued lungs. I am a big fan of targeted radiation. The tumor(s)can be killed or shrunk considerably while minimizing damage to adjacent lung tissue. Check out Cyberknife surgery and image guided rdiation therapy (IGRT). http://www.cyberknifesupport.org/forum/default.aspx?c=4 The cyberknife message board is managed by radioation oncologists who are very helpful and answer within 24 hours. http://www.elekta.com/site_dbase.php?fo ... _id=101495 The above link is an overview of IGRT using the Electa Synergy system. Since it is your first visit with the oncologist, see if you can get someone else to go with you and your dad to sit in as a second set of ears and maybe help take notes. I hope your dad gets the cancer nipped while it is still early. Don M

Hi Donna: I would like to welcome you to the boards also. I hope your dad is able to get back on chemo soon. You may want to look into to having targeted radiation therapy after chemo. Targeted therapy can kill tumors while minimizing damage to adjacent healthy tissue. Cyberknife surgery is one option that can kill tumors, but the nearest facility is in the Netherlands and so insurance could be a problem as well as travel. There is another form of targeted radiation therapy called image guided radiation therapy (IGRT). Your dad may be a candidate for this. I am sure it is available in the UK, as the manufacturer maintains offices in the UK as follows: Worldwide Product Support Center - Oncology Elekta Limited Linac House Fleming Way Crawley West Sussex RH10 9RR UNITED KINGDOM Phone: +44 1293 544 422 Fax: +44 1293 654 321 You could probably give them a phone call and find out what hospitals have the technology in the UK. Here is a link to a BBC new article from 2004 relating to the Electa Synergy system: http://news.bbc.co.uk/go/pr/fr/-/1/hi/h ... 578079.stm They write about the Christie Hospital at Manchester. It was a trial in 2004 and they must be in full service by now. I found another news release from May 16, 2006, that gives more details on the British Government investing in the technology for several hospitals: http://www.elekta.com/site_dbase.php?fo ... id=3560566 Here is a link that gives an overview of IGRT: http://www.elekta.com/site_dbase.php?fo ... e1section6 Your dad has my best wishes in beating this disease. Don M

Hi. I would like to welcome you to the boards too. I know how frustrating and disheartening it is to deal with more cancer. I am kind of out in the boonies myself. I travel 25 miles for my chemo treatment. I just recently completed 6 weeks of image guided radiation therapy at Swedish Caner Institute in Seattle for my third cancer. That is about 160 miles from my house, so I stayed with my son and his family who lives in the area. The intent of the radiation was to kill the tumor while conserving healthy lung tissue. I am doing the chemo as a follow up. Your husband might want to inquire to having a targeted form of radiation if the intent of his upcoming treatment is to radiate what they can see. Using conventional radiation sometimes can cause pneumonitis to occur in healthy lung tissue. There is still a chance of pneumonitis with targeted radiation, but it is greatly reduced. I see that the Mayo Cancer Center in Rochester has a technique called intensity modulated radiation therapy (IMRT). This is a targeted form of radiation similar to what I had, except that it does not have real time imaging capability that IGRT offers. The most advanced IGRT system runs on the Electa Synergy Machine. Varian accelerators also can do IGRT, but they don’t have real time imaging capability while the Electa Synergy accelerators do. Cyberknife is another form of targeted radiosurgery that is the most accurate. There are 2 centers in Missouri that have cyberknife capability: Mercy St. John's Cancer Center 2055 South FremontSpringfield, MO, 65804USA I see that the above center also has image guided radiation therapy, probably using the Varian system. Saint Louis University Cancer Center 3635 Vista at GrandSaint Louis, MO, 63110USA Phone Main: (314) 268-7015 I could not find anything on the web site for St Louis that talks about other forms of targeted radiation therepy, but if they have cyberknife, they must have other methods too. I would prefer cyberknife because it is the most accurate and can usually be completed in 3 treatments per tumor. The treatment includes placement of little metal rods or bee bees around the tumor so the robotics can track it as one breathes. I did not do it for my tumor, because I have just one lung left, and I did not want to assume the risk of a collapsed lung. My treatment using IGRT did not require penetration of my lung, and was nearly as effective. Here are some links for cyberknife: http://www.accuray.com/SiteLocations/index.aspx http://www.cyberknifesupport.org/forum/default.aspx?c=4 The first link is to the manufacturer’s web site. It will take you to a page where you can enter a state and find the cyberknife centers available. I cut and pasted the above centers from that page to this post. The second link takes you to a message board where you can ask radiation oncologists who practice cyberknife surgery questions. They are very helpful and respond within 24 hours. I suspect that the Springfield Center is closer to you. Here is another link to the Electa Synergy website that describes IGRT: http://www.elekta.com/site_dbase.php?fo ... _id=101495 I hope your husband’s treatment goes well, and that he nails the cancer. Don M

I am sorry tina. i hope you MIL can be made comfortable. Your MIL, you and the rest of your family have my prayers. don M

Go for it. Don M

Carleen, I am sorry. Don M

Hi Sharon: that sure is a cute grandbaby you have. I hope you enjoy the summer and that your grief is tempered by fond memories of your dad. Don m

Good luck with your scan Ginnie. The cough could be from your agressive treatment. I hope the scan shows even more shrinkage. Don m

Mary; I hope you get good results with the taxotere and your upcoming radiosurgery. Don M

Hi Mary: I viewed some posts at the cyberknife ask the docs website. They all say the cyberknife is more accurate. One of them says that the accuracy of novalis is 2 mm or worse. Then I browsed some more, and found a site at Moffit that says Novalis can have a submillimeter accuracy. That must be with the halo attached. Cyberknife has a submillimter accuracy. I guess the main difference is that a slight movement won't make a difference in cyberknife, because the robotics can track the movement. With Novalis, immobility is critical. Given that the 2 methods probabaly have similar results as long as you remain immobilized, you might as well go with the docs you know and trust. I am not sure if a cyberknife surgeon would go after a met as smal 1 mm. I am surprised that they would use Novalis on mets that small, but I guess if they can see them, they can zap them. Another thing for you to consider is that the docs you are with now are ready to go and you can get rid of the mets with out further ado and doctor shopping. I should tell you though, that I would do cyberknife. But, I know the docs there. Happy met hunting Don M

Hi Amy, welome. You and your husband have a difficult situation to deal with. It must be so frustrating. I guess all your husband can do is just try to be supportive for his mom. I don't think that means he has to pretend there is nothing wrong. Maybe he could tell his mom that he will support her in whatever she decides to do about her condition. Don M

Hi Jan, welcome to the boards. Don M

Hi Lee, welcome. Wow..4 ribs gone. I guess the docs must have thought you would get along fine without them. I hope the cancer never comes back. don M

Hi and welcome and good luck with your surgery. don M

Hi Jenny and welcome. A recurrence is no fun. Fortunately it is still within your dad's lung and can be dealt with. I have had 2 recurrences and I expect to be NED again. Your dad has my best wishes. Don M

also: http://www.cyberknifesupport.org/forum/default.aspx?c=4 http://www.thedoctorslounge.net/oncolog ... m.php?f=27 Don M

Hi Linda...maybe the mets are causing her confusion? They have cyberknife at Swedish Hospital in the James Tower, near Seattle University. Seattle CyberKnife at Swedish Medical Center 550 17th Avenue, Suite A10 James Tower Life Sciences Building Seattle, WA, 98122 USA Phone Main: (206) 320-7130 Don M

that is great! and what's more, you had a good time and no worry on your trip. Don M

Mary, I am sorry you got the bad news. There are a number of cyberknife centers in Florida where they can kill the tumors easliy in your brain and on your spine. No halo is required. The following link is to a message board staffed by radiation oncologists. One of them is from Florida.. Jerome J. Spunberg, M.D., FACR, FACRO Cyberknife Center Of Palm Beach jspunberg@radiationoncologyinstitute.com (561) 799-2828 Here is the link: http://www.cyberknifesupport.org/forum/default.aspx?c=4 Here is another link to the manufacturer's web site that allows you to find where the centers are located: http://www.accuray.com/SiteLocations/index.aspx I cut and pasted the adresses of the facilities from the above web page here: coming soon! CyberKnife Center at North Florida Radiation Oncology Gainesville, FL, 32605, USA More Info CyberKnife Center of Palm Beach West Palm Beach, FL, 33401, USA More Info CyberKnife Center of Miami Miami, FL, 33156, USA More Info NCH Regional Cancer Institute Naples, FL, 34102, USA More Info

Tina: I hope the tarceva has been working. It seems to me that there would still be other options if there is a spread. There are other chemotherapys available. Avastin, gemzar and in various combinations with each other and with tarceva are some. But, I suppose since your MIL's immune system is already compromised, maybe that is why the oncologist would suggest hospice if the tarceva is not working. I hope it is.