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Radiation update


SandraL

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I last reported that a new spot had showed up in a lymph node on my latest CT scan (with the rest of my left lung being clear). And of course I still have the mets on my spine and whatever else mess is still going on there from the gradual worsening after my last round of radiation there and the botched bone cement procedure.

I had an appointment with my radiation oncologist today and he recommended against radiation to that lymph node. He said that there was too much risk in damaging and scarring the good lung tissue close to it...precious lung tissue that I might really wish I had later on. And he further said that doing any radiation there would have no impact on whether I have any further spread of the cancer. That is, if the cancer is going to spread to other parts of my body, it will do so regardless of whether or not that spot is radiated. He said he didn't completely understand why that was but that research has shown that to be the case. So, if that particular spot isn't giving me pain that might be relieved, that there was really no need to radiate there. He also confirmed (with some camera tube he put down my nose) that my left vocal cords are not really working. But whatever damage has been done to them is done and radiation wouldn't help with that either.

He did however recommend further radiation to my back, something I didn't expect to hear. I had 2 large blasts of radiation there last May that lessened the pain for a bit and then it gradually started to worsen again. He was away then but said they could have given me more. And that there is less risk there than radiating the lung with more potential benefit. So, I am off for another planning CT scan in prep for some possible radiation treatments there. I also have an appointment with a neurologist next week so I will see what that doctor says as well before I make my final decision re radiation to the back.

Has anybody else heard or been told that radiating in one spot will not impact the further spread of the cancer? I do know that in advanced stages of LC they primarily do radiation for pain relief purposes. But I still think that getting rid of a "spot" would help somewhat in preventing it's spread.

Your thoughts on this would be greatly appreciated as I mull this over during the next week.

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Sandra - as to the radiation question about the one spot in your lung - perhaps you could ask Dr. West at cancergrace.org as he has (I believe) a radiation oncologist now on board. One of the doctors there should have some answers to this. I don't blame you for questioning "do nothing" route as I would feel uncomfortable with that as well (especially only hearing it from one person). I know that radiation is typically used for pain relief; however, sometimes it doesn't hurt to color outside the lines in some cases right?!?! Sorry I'm not much help - I hope others can give you the answers you are looking for my friend.

It would be great if the back pain could be taken care of - does he feel that further radiation to that spot in your back would help? Is it because they did too little last time that it was better and then got worse again? I sure hope that this is doable and will give you some much needed relief from the chronic pain you are in.

There is no doubt about it - this disease sucks big time and I absolutely hate what you are going through.

I hope you had a good time in the mountains and enjoyed the time away.

Take care,

Hugs, Linda

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Thanks for your kind thoughts Linda. Yes, this one is really bugging me. The "do nothing" option isn't that appealing. I have posted my question at cancergrace.org as well and think I will also ask for a second opinion at the clinic. Am going to go slow on this one until I get a few more answers that make sense to me.

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Has anybody else heard or been told that radiating in one spot will not impact the further spread of the cancer? I do know that in advanced stages of LC they primarily do radiation for pain relief purposes. But I still think that getting rid of a "spot" would help somewhat in preventing it's spread.

Hi, Sandra. I saw your question on GRACE and believe the answer will be somewhat along these lines: Once the cancer has spread to one part of the body, the assumption is that it got there through the bloodstream, which means there are almost certainly other cancer cells circulating in the bloodstream which could take hold somewhere at some time in the future. Radiating or surgically removing the one spot in question would have no effect on the circulating cancer cells and therefore would not impact the further spread of the cancer. However, if that one met is causing problems locally such as pain, weakening a load-bearing bone to the point that it might break, interfering with a major blood vessel or airway, etc., then it could and probably should be radiated as a "palliative" measure. You're probably thinking that radiating that spot would remove the possibility of it serving as the source of additional mets, which may be true, but other cells like the ones that settled there are probably still in the bloodstream.

But hearing that your back might be eligible for more radiation — and hopefully pain relief — sounds like good news to me! Aloha,

Ned

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Sandra-

You know that I am no expert on radiation - the radiation I got did not good whatsoever. And I agree with Ned - once cells escape one area then who knows where else they have gone to. BUT - I am wondering about chemo - are you not on any at all right now??? Chemo could help that spot and nip it in the bud before it gets any bigger. I know you were having trouble with side effects from chemos but I am sure there are more out there you could try.

I agree with getting another opinion, especially for your back. You have been suffering from that long enough. And I too hate that "lets do nothing and see" approach - I am WAY too much of a Type A personality for that!!

Hoping you get some answers soon, girlfriend!! Keep us posted.

Hugs - Patti B.

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Sandra,

I agree that the reason for not doing the radiation to the lymph node is that if it is a met, then it is not what it sending the cancer cells out. If that is the case, why jeopardize your lung function? I imagine it it more of a case that the potantial harm outweights the potential benefits.

You might ask your radiologist about the use of Quadramet. I haven't seen it discussed much on this board, but it sure helped my mom with the pain from the mets in her spine.

Susan

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