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After learning of my new nodules and the proposed treatment I started thinking about a second opinion and if I could get the best treatment in Naples. My first thought was how this place in Naples could be able to satisfy me on knowing if this is the best radiation. Well my dear wife did a little research on this place. It's called 21st Century Oncology. They have over 70 locations throughout the country. This is not what I expected. The doctor that I am to see comes from M D Anderson in Houston.

What I would like to know is there anyone that has any experience or know anything about this group?

Stay positive, :)


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I don't know anything about the group Ernie. I have heard very good things about MD Anderson, it being a Comprehensive Cancer Center and all. I would consider going to MD Anderson or a Comprehensive Cancer Center for a second opinion.

Praying that you get the very best treatment for full recovery.


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Hi Ernie, I am sorry to read about your new nodules.

I don't know anything about the 21st Century group Ernie, but I see that they have IGRT at some locations. Not many hospitals have that capability. I had it at Swedish Medical Center in Seattle just over a year ago. Unfortunately for me, it did not kill my tumor, but I think my situation would be unusual. I think treating your nodules with a targeted radiation would be reasonable. They are small and there are only 2. IGRT will conserve your lung function and get rid of the nodules. You could also use cyberknife, but it is much more expensive, there may be insurance hassles and IGRT would be effective. It has less accuracy than ck, but a few millimeters less accuracy does not make that much difference in the lung.

Still, one thing to consider is that with ck, you would likely have just 3 treatments for each nodule and for the IGRT, there would probably be 33 treatments for each nodule. I suppose they would deliver a dose to each nodule on the same day for the IGRT, but I don’t know for sure. I think that even though you have a history of stage 4 disease, that a ck center would treat your nodules because there are only 2 and they are local. They may tell you that it is not a cure and that they could pop up again in a year or so. But, who knows for sure? It has been over a year and maybe you have a new primary. I have not had new disease in 2 years since my 3rd cancer popped up. Now if I could just kill the stupid thing…

I see from the map that the 21st Century outfit has many locations in Florida. I don't know if the Naples facility has IGRT or not.

Naples also had a ck center:

http://cancer.nchmd.org/index.aspx?sect ... y&id=30343

I hope you quickly get rid of the nodules Ernie.

You could follow up with chemo after the radiation.

Don M

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I'm sorry to hear about the new nodules. Saying a pray for you right now!

I'm not sure how far Naples is from Tampa, but if it's not extremely far, I would recommend Moffit Cancer Center in Tampa, (where Harry goes), for your second opinion.

(We have a spare room if you need it for an overnight stay, and you would be more then welcome to it.)

You've been my greatest inspiration since I found this board. :)


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Do those nodules know who they are messing with????

I don't know anything about the 21st Century Oncology, but I've learned that you will do whatever it takes to get the best and most aggressive treatment possible. So, I'd encourage you to travel wherever you need to in order to satisy yourself that your treatment is the best option.


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Sorry about the news. There is a new drug called HKI-272, it is supposed to work if Tarceva stops.

Not sure of what trials are available but it might be worth doing some research to see if you think it is an option

Take care

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