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News not good


Nancy B

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I met with my surgeon this morning. They will have to do a completion pneumonectomy to get to the cancer to determine the type. He said this will be much riskier than the first two surgeries as the cancer is right where the lung attaches to the bronchi. There is a much greater risk of bleeding and airway collapse.

I am so afraid. I am not afraid of more treatment, I just don't want to do more surgery. I just pray that I survive the surgery. He said they discussed me at their tumor board and both lung surgeons looked at each other and just shook their heads.

Guys, I really need you now. My husband is having a real hard time. Our son is in Bowling Green, KY racing, so I just told him more surgery but none of the details. I only found this out acouple of hours ago so haven't completely processed everything yet.

Prayers please,

Nancy B

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Oh Nancy,

This is one of those times I wish I were close and could give you a hug, a shoulder, and an ear, and do something to help in someway.

You have my prayers. You are an incredibly strong spirit and your heart is huge, you aren't done here yet. You CAN get thru this surgery.

And your husband, as terrified as he is for you, because he can't "make it better", will be the best caregiver there is as you recover!!

It won't be easy at all. It is scary for me to even think about, so I can't image your fear...but hang tight to your hope, the love of your family, and all of us. You've much more living to do once this is behind you.

What a story you will tell when it's all over and you are again, cancer-free!

We love you Nancy.

We are always here for you.

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Nancy,

I can't add much to what Katie just said. All I can do is tell you that I understand how you must feel. And like Katie said, your spirit is strong, your physical condition is good - you CAN get through this Nancy - one foot in front of the other.

We're with you, in spirit at least.

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If there is a plan there is hope. I pray all goes well for you during the surgery and that God Helps you and your family throught this difficult time This is so not fair to all of you. There is hope there is a plan. Sending prayers and energy and Hugs for ya'.

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Nancy,

I know how scared you must feel. Give yourself a little time to process and find a spot of calm. It will come to you. You will know what to do when the presentation is right. Two doctors shaking their heads only leaves one with pessimism. Who needs that???

Love and many hugs.

Cindi o'h

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Nancy,

It's not fair that you should have to go through this so many times. But, this is a fight you know how to handle, and I believe you will prevail.

It sounds to me like those surgeons were shaking their heads in disbelief that they have to put you through this again.

Please keep us posted and as always, you will be in my thoughts.

Cindy

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Hi Nancy:

I have been trying to think of alternatives for you. I am not sure I understand the risks, but when you say the air way may collapse, does that include the bronchus? And, I thought the lungs were deflated during surgery anyway and they used a breathing machine to keep you going...not sure. Maybe the biggest risk is bleeding.

Anyway, it sounds like the surgery is more of a crapshoot than a typical thoracotomoy. If it is a big risk, I think why not take a different risk. Just treat the malignancy only with a targeted radiation that will kill it. The risk is, that you would not do a followup chemo and hope it does not comeback, or assume it is secondary NSCLC and do alimta. Alternatively, you could assume it is SCLC and treat it accordingly with chemo. The idea is to transfer the risk of surgery to risk of a recurrence. You may get a recurrence anyway, even if you have surgery. Boy, if I were contemplating a surgery where the surgeons look at each other and shake their heads, I would look for other alternatives. So, here is one possibility.

Cyberknife the malignancy. There is a possibility that placement of the fiducials around the bronchial area could be problematic. Here are some links:

http://www.cyberknifesupport.org/forum/default.aspx?c=4

The above link is to a message board that is run by radiation oncologists. They respond within 24 hours. They are very helpful.

http://www.accuray.com/SiteLocations/index.aspx

The above link takes you to the manufacturer's web page. The page shown, allows you to type in a state to find available cyberknife centers. There are 5 in California.

There is another method of targeted radiation called image guided radiation therapy (IGRT). The most advanced system is run by centers that have the Electa Synergy machine. It does not require the placement of fiducials. It is nearly as accurate as cyberknife and if there is not much breathing motion, can be just as accurate. Most of the motion is at the bottom of the lung, so IGRT could work very well for you. The biggest disadvantage of IGRT is that it requires up to 33 treatments. Cyberknife can usually be done in 3 sessions. Here is a link to a medical center in California that has the Electa Synergy machine. I think it is the only place in California that has the machine.

http://www.ucdmc.ucdavis.edu/cancer/Spe ... racic.html

So, by using one of the above targeted therapys, you can be sure that the current malignancy would be gone. But, you would be unsure about what chemo to use.

One other consideration is that either of the above therapys can be used numerous times, whenever a met pops up, as long as they are not too many.

Whatever you decide, you have my prayers.

Don M

P.S. I had IGRT at Swedish Cancer Institute in Seattle. I have just one lung left, and the risk of pneumothorax was considered too great to have cyberknife or to do a biopsy. So, they killed it whatever it was. It is probably more adenocarcinoma and it is further assumed that it is secondary. So, I am going to start alimta in 10 days or so.

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