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Saw surgeon today


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Saw cardiothoracic surgeon today; very interesting visit. The surgeon pointed out that although we're calling him stage IV, we don't really know b/c we don't know for sure the other two spots on his lungs are cancer. To recap: Dad has one 2.5 cm nodule R upper lobe, bx-proven NSCLC; one 1cm RUL nodule adjacent to that; one 1 cm L lower lobe nodule; and one 1 cm lymph node near the aorta. The surgeon said that basically, if the lymph node and the LLL lesion are cancer, he's stage IV. But if the LN and LLL lesion are something else, he's a lower stage and potentially curable. The odds he gave us were 80-90% cancer, 10-20% something else.

Because of Dad's good functional status, the surgeon wants to do a mediastinoscopy to get at that lymph node. If it's cancer, the LLL lesion probably is also, and no more staging needs to be done. If the lymph node is negative, he'll do a thorascopic resection of the LLL nodule, and see if it's benign also. One day hospital stay if Dad gets the mediastinoscopy, three days if he needs a thorascopy too.

Since Dad's gotten two doses of chemo, the surgeon wants to wait until this cycle is over, and then re-scan. That way if the new scans show growth in the LN or the LLL lesion, no need for any invasive procedures since they're almost certainly cancer, and Dad is spared some days in the hospital.

I liked his decision tree. The odds are it's stage IV, I'm bracing myself for that.

(deep breaths) Trying to.

But even if it is, I'll be happier with his treatment plan knowing that we're acting on the best possible information, rather than an educated guess.

We see an RFA guy on Monday, God willing. Want to get a take on that possibility as well.

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I am so sorry about your Dad. I pray that the nodules are benign. There is so much they can do to treat this disease today if it is cancer. Qaulity of life is first, at your Dad's age. Usually Doctor's will suggest a less aggressive treatment due to the side effects. If it is cancer, and stage iv, then radiation is not recommended. It can be used pallatively to help stop pain. Chemo is normally given in combinations, but for many older patients the use of one drug is preferred. Many handle it well, if no previous health problems exist. Best of luck, and visit us often.



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Am praying for your Dad that the other nodules aren't cancer. Sometimes an old pneumonia or other infection shows up. I had a medianastinoscopy didn't show any thing in the mediastum, then when I had lung surgery, they did find a malignant node in the chest. I was so disappointed. But I am still feeling okay and it has been nine months since surgery. I was diagnosed at Stage IIIA. I have known several people who lived quite a long time with Stage IV so don't give up hope. I think that there were even some on the site who had treatment in that stage. Prayers and hugs for you and your Dad.


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