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Well, Hello there!


georgesalley

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What now? Having managed to more than survive lung cancer; I think I can actually lay claim to be “cured”, so where do I go from here?

The original official diagnosis was for stage IV cancer in April ’06.

The first C-T scan of 3/7 showed a 1.42x1.90 cm mass in the right lung.

The original PET 3/20 reading is as follows: “Hypermetabolic lesion in the right upper lobe of the lung, which corresponds with a 1.5 x 2.3-cm nodule. … There is one hypermetabolic lesion in the right hilium and multiple hypermetabolic lesions in the mediastinum and base of the left neck, consistent with metastatic disease. …. There are several small low-density lesions in the liver, which are not hypermetabolic. “

A 20% increase of the mass in 2 weeks!

A needle biopsy 4/4 showed it to be squamous cell.

Treatment was proscribed as chemotherapy, no mention of surgery or radiation as alternatives.

At the time I knew not enough to question either the diagnosis, or treatment regimen, but I did have some severe reservations regarding published survival statistics. I don’t suppose otherwise I gave the consequences that much thought, other than to just see what would develop.

I had only two goals in mind, participation in the treatment, with the intent of gaining the most results, and learning more about the issue of lung cancer.

The question of whether I really had stage IV was moot because the oncologist, et al, thought, and acted, as if I did. Thus the clinical trail that I was enrolled in was for advanced NSCLC (Carboplatin & Alimta).

I had never had any of the clinical lung cancer symptoms, and physically felt to be in good shape.

The chemo treatment was for 18 weeks, once every 3 weeks, starting 4/24.

Some heartburn, intestinal pain, minor constipation, and fatigue from being anemic. No nausea, no hair loss, put on 10 lbs.

By July the C-T scan showed that the tumor had been reduced to nothing, but by then the chemo had also been working on the blood cells and I needed a transfusion. Last chemo on 8/7.

There was a C-T scan 9/1 which showed no real change from the 7/7, so a PET scan was ordered for 9/18.

When the oncologist stated that the cancer was in remission 9/25 I felt that I had made the 2 year category, and was headed for the 5 year, but didn’t feel the term “cured” was applicable. Thus the decision to seek a second opinion at Duke. My oncologist had no problem with that and set up an appointment.

We made our first visit to the Duke Clinic on Oct 10th. I had copies of the C-T scans and the last PET scan on CD with me.

Because the liver lesions had remained the same throughout the chemo period, on the C-T scans of 4/17, 5/26, 7/7, and 9/1, it was decided that they were not indicative of metastasis.

The first order of new diagnosis was to determine the status of the mediastinal lymph nodes. An appointment was made for a mediastinoscopy on the 24th as an outpatient.

Afterward we returned to Duke the 31st, and the report was negative for any lymph node cancer and a PET scan was scheduled for the 13th.

The results were far more comprehensive than previous scans. In fact I was restaged to IIB!!!

But, there was “something”, “too small to characterize” in the right upper lobe where the tumor had been.

I was scheduled for a lobectomy 11/22 to remove the right upper lobe, the site of the original tumor.

Also I had a brain C-T scan that proved negative.

Met with the thoracic surgeon 12/12 regarding the pathology results of the lobectomy. It was a traditional resection using a rib spreader in order to get all possible lymph nodes.

Everything was negative!! NED The surgeon was astounded that there was no evidence whatsoever of the carcinoma in the lung lobe.

He indicated that he has never seen a carcinoma so completely eliminated by chemo.

All in all, the treatment, beginning with chemotherapy and ending with adjuvant surgery, appears to have been the best for me, I understand that since results and toxic effects from chemo are not all that predictable such treatment might not be a first choice.

So, given that the cancer is now “gone”, and I’m back to reasonably normal regarding life expectancy, has my outlook changed any?

Am I supposed to have some sort of epiphany, make a change of lifestyle, or what?

Actually I have not completely recovered from the lobectomy, having some pain, discomfort, and shortness of breath.

I’ll be 74 on my next birthday, 2/1/07. I was a heavy smoker for 50 years, so the cancer was not totally unexpected. I sorta quit smoking 5 or 6 years ago, but believe me the urge is still there even after all that has transpired. Betty, my wife of over 50 years quit in 1986 and says she too still has the urge.

We sold our Farm in NC Jan ’06, and started building a new house in VA. Hopefully we will be in by Spring. In the meantime we have been living on the site in a 21.5’ RV trailer. Actually that has not been that bad since we lived aboard our sailboat full-time for 6 years ‘96-’02.

So I guess I’ll just mumble along, taking life as it comes. Equanimity has always been my strong suit.

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welcome; thanks for your story and I am glad to see that you have apparently beat the beast.

I try to practice equanimity too. I may equaniminously go down to lc, but maybe not. I was impressed by a zen author who said "just this much". You take whatever situation you are in and go from there. Or, everything that we need to be fully human is right here and now.

Don M

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