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Had my MRI today. Funny little contraption for your head. Hard to lay on the back for that long. The Nurse Practiioner I am seeing called and stated there is nothing up there, so I must be a member of the empty headed club. He did say that my brain was shrinking. First I have ever heard of that. but he said it happens to us old folks anyway. I have a needle biopsy scheduled for the 25th and 26th, because they think I am a higher risk because I have only one lung. The surgeon said I am not a good candidate for a wedge resection because of having only one lung. Then on top of all that I have to get everything ready to move to North Carolina where my wife is being transferred to.


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I think of you often, Ralph. Are they keeping tabs on just that one 8mm nodule?? I am not sure I am totally up to date with all that's been going on. Glad about your head!!!! I think my brain is shrinking as well. Suppose that could be worse, huh?

Sorry about having to uproot and begin anew in another location. Hope all goes well with that without any additional problems.


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Hi Ralph: I am glad to hear you got a clean mri. I got one too after I had my third cancer in my remaining lung, and it came out clear. I had never had one before.

Last March, when I found out about my third cancer, I was looking at cyberknife to kill it. They talked me out of it because preparing for the procedure required penetration of my lung to insert metal markers into the tumor. The penetration could cause a collapsed lung. The collapsed lung in itself would not be bad, except it would be my only lung, and they said that sometimes they cannot reinflate the lung right away. There could be an outside chance that something could go wrong. Maybe it is a 1% chance. So, I took a conservative approach and did not do cyberknife, but did Image Guided Radiation Therapy (IGRT) instead to kill the tumor. IGRT does not involve lung penetration. The intent was to kill the tumor and conserve my healthy lung tissue. I finished radiation in the first week of June. I also did 4 rounds of alimta after radiation. I went to my pulmonologist last week, and had my lung capacity measured. I was at 51% before my treatment and am at 46% now. I suppose that is good lung conservation, but I am disappointed that I lost any. My pulmonogist thought it was no big deal. And I must say that I don’t notice much difference after treatment in how much breath I can get when I exert myself. IGRT does not have the constraint of maximum exposure like conventional radiation does, because it is a focused treatment that targets the tumor only. So, I could do it again if I have to.

I did not have a lung needle biopsy because of the same risk associated with a pneumothorax. I have had 2 lung needle biopsies in the past and both times I had a pneumothorax. I had a second lung to hold me over until the collapsed one could be reinflated. I did have a PET/CT scan that lit up the nodule very high. My docs figured that with my history of lc, and the high intake of the nodule, it was almost certain that it was another malignancy. It did not seem worth the risk of a pneumothorax to go through a lung needle biopsy. And besides, the 2 previous that I had were inconclusive. So I had it treated without a biopsy.

I did have a conversation with an interventional radiologist who does lung needle biopsies. He thinks that the risk of a pneumothorax on a one lunged person can be mitigated. He would have the patient hooked up to a suction pump with the chest tube already in place. That way if any air escapes into the space between the lung and the chest wall, it can be immediately sucked out. That would take care of any immediate pneumothrorax, but some times they occur a day or 2 later. Maybe one would stay in the hospital for a day or 2 hooked up to a chest tube until it was evident that the risk of pneumothorax is passed.

I also have talked with the docs on the cyberknife message board. They say that there is a blood patch technique that some interventional radiologists use to prevent air from leaving the lung through the penetration site after removing the needle. They call it “blood patching”. As I understand it, some blood is taken from the patient and injected directly into the lung, near the site. Then when the needle biopsy penetration is made, the blood is supposed to move up to the hole and congeal and block the hole. I suppose this would prevent a pneumothorax from occuring the next day or day after.

Anyway, good luck with your upcoming biopsy and I hope I did not put a worry bug in your head. Just ask them how they would manage the risk of a pneumothorax.

My third tumor is about 1.4 cm. I will find out in mid December with a PET/CT scan if the treatment was successful.

Don M

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