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chemo/radiation crossroad


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With a little nudge on my part my medical onc referred me to a radiation onc for evaluation with a view to possible radiation therapy.

The radiation guy has offered me what I gather is the standard course for NSCLC, +/- 7 weeks of daily radiation combined with some type of chemo.

I see my medical onc on Monday to review the bidding and discuss chemo options, etc.

I gather it is a little unusual to give radiation when there is a malignant pleural effusion as in my case.

Offsetting that is the fact that I seem to be in pretty good shape. People who've known me a while say I've never looked better. (Is it possible that I'm such a perverse SOB that cancer agrees with me?) :twisted:

The only adversity is shortness of breath. I'm fine walking on flat ground--can easily do 10 blocks or more. But hills and long stairs can be a challenge. I just have to stop and catch my breath. Maybe take a hit on the inhalers.

I'm inclined to go with the radiation unless I discover some profound reason not to in the coming days. I'm doing further research/reading on it.

I thought maybe some of you around here might have feedback/input on your experience with adjuvant radiation/chemo. I wouled welcome any input.

Thanks and regards to all...

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I can tell you of my Moms experience with the radiation/chemo combo. She did chemo once a week for 6 weeks and radiation every day during that time. Then she had a 3 week break of nothing and went back for 3 more doses of chemo given once every 3 weeks.

Nvere having dealt with anything like this and only going by the stories we had heard, I really expected the chemo to be bad and tried to prepare for that, but it never happened. Sure there were days she was tired,naseated and stuff, but nothing she could not handle. The adiation though i guess got her the worst. And that was something i had never given really any thought and just assumed it was easy. WRONG. Her tumor was located on her trachea. Her esphogus was really burned and for weks she could eat or drink very little. Had to take more pain meds for that than anything else. But they have numerous different meds that do help this. Mom has said that it wasnt has bad as she expected either overall.

I think if you have the opportunity to have both, you should definetly go for it. It worked for mom, she has been NED since her first scan in November.

Best of luck in what ever you chose and keep us posted

Take care,


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Hey BC,

Once again I can't get over the similiarity in our cases. Like you, I feel pretty darned good after the onset of Chemo is over and walk a couple miles each day, on the level no problem, but some shortness of breath when going up hills. I'm 67 and diagnosed 4/7/04, almost a year ago.

As for the radiation, they didn't recommend it due to the PE. In my case, I went to Roswell Park Cancer Institute in Buffalo (3 1/2 hours) as soon as I was Dxd. I sat down with a Surgeon, a Radiation Onc and a Medical ONC and they discussed my case with me. Each time I go back, my Onc Doc reviews my Cat/Pet Scans with the others. After reading your latest on radiation, I plan to pursue the radiation thing again to see what their attitude is now. My last scan in Feb showed that I am no worse off cancer-wise than when I started. The primary tumor is just a little smaller than when I started and no new areas. This Alimta thing is kinda kickin my butt this time, but I guess it is expected since I'm told that it is cumulative.

I meant to ask you before, where are you receiving treatment? I looked at Memorial Sloan Kettering which is down in the City somewhere and about the same distance travel-wise, but I settled on RPCI since they were doing a lot of research on Malignant Pleural Effusions and that is what I was diagnosed with. So far, I have been real happy with the treatment I get out there and their attitutude is terrific. I especially like the fact that all the Docs are in the same office and all they deal with is Lung Cancer.

Don't know if any of this jabber has helped but I just wanted to kinda compare notes since we are both in the same boat. Take care and good luck.


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I did the combo thing. I did really, really well with it. The treaments actually made me feel better. When I was first diagnoised I had pleurisy and pneumonia, and after my bronchoscopy I would cough continuosly and I mean continuosly. At times i could not even carry on a conversation with anyone. I had trouble having the CT's and PET scans done because of my coughing. Just remember everyone is different and everyone handles if differently.

Best Wishes,


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Thanks for the interesting feedback.


I'm being treated at the Brooklyn VA Hospital, which is affiliated with SUNY Downstate Hospital and NYU.

I went to MSKCC last fall for a second opinion. They validated everything the VA said and offered basically the same treatment plan.

I'm sure MSK deserves its global reputation. However I felt and continue to feel that I have better access to my attending oncologist at the VA than would be the case at MSK. I can literally walk into the VA any day of the week without an appointment and see my oncologist or whoever is covering for him if he isn't there.

MSK is a production line. Very efficient. Superb facilities. But you walk in and there can be 100 people in the very nicely furnished waiting room.

I found it both over-and-underwhelming. Yet I would not hesitate to go there again for another opinion if I feel it is warranted at some point.

If you want to know what a huge industry cancer treatment has become go to MSK.

If you want personalized care and you are not the potentate of a Central Asian republic I'd go some other place.

Best personal regards...

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Hi There,

What I can tell you is that following surgery my dad was given only radiation for his laryngeal cancer, it has not come back. Following lung surgery for his lung cancer he initially had just chemo, before chemo was finished they found a new long nodule. They then stopped that line of chemo and did radiation plus a new line of chemo. He just had a great report. Its seems like radiation works well on the cancer in my dad's body and his docs feel that the more you can handle when you are healthy, the better the long term prognosis. Definitely confer with all of your docs but just wanted to let you know our experience.


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Hey BC,

That's fantastic that you have a VA hospital so near that provides cancer care. They sound like they got their stuff all in one sock. I'm also an ex-military guy, 24 years and have a lot of faith in the VA. Around here they are all small clinics that don't do major stuff. Good luck with it.


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Hi BC,

Just to kick in my nickel's worth.

Radiation and chemo are/can be synergetic, and do more together than each separately. It turned my big ole tumor to a DEAD big ole tumor, which the surgery confirmed (and, surgery gave me a prosthetic chest wall, since I was missing 5 ribs worth of bone).

If you want to fight it, hit it with both, is my recommendation. The reason they would not recommend it for malignant pleural effusion is that every surface the fluid touches is potentially "contaminated" or seeded.

If I had to choose one, I'd choose chemo, since it is systemic and so you can't miss a spot, as can happen with radiation.

I like your grit, bc. My family was originally from NYC.

Hang tough, take care,


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