Old fashion Lobectomy

[Dadsgirl]

 
As of today we FINALLY have all the answers and need to figure out where to go from here. I guess we received the best possible news but still uncertain how to proceed. 
 My father has been diagnosed with stage 1 NSC and has the option to treat with SBRT radiation or have a  Lobectomy (older procudure)  preformed. 

Can anyone chime in on treating with radiation apposed to lobectomy? 

My gut is telling me to advise him to just take it out but his surgeon has advised us how risky the procedure is and it’s scared the hell out of him. 
My father is 75 and in decent health for his age. As of right now, other than a pesky cough and shortness of breath he doesn’t have any other symptoms that are knocking him down. 

Any success stories using SBRT radiation apposed to lobectomy? 

Thank you!

[BridgetO]

Hi again

I answered on your other thread, but I have an additional question for you. Would your dad be able to have a lobectomy by VATS (video assisted thoracic surgery) or would he, for some reason need to have an open surgery? VATs has fewer risks generally and a faster recovery time for most people.

[JoshK]

Definitely not a doctor, but I think the lobectomy followed by chemo would be the safest and aggressive route in terms of destroying the cancer.

Of course, the flip side of those is a major surgery and then potentially followed by chemo might be very taxing on the body. This is definitely a risk.

The flipside is that although any surgery carries inherent risks, a lobectomy, though scary (they're cutting out part of your lung!) is not a particularly risky surgery (like major bypass) and usually does not have much impact on quality of life thereafter. Also, with respect to chemo, that would be more for extra peace of mind to destroy residual disease, but it would be optional. Also, if you do go for it and your dad does react badly, you could stop at any time.

So, those are the two ends of the spectrum. The radiation would be the least risky but also the least aggressive vs. the cancer. Surgery + chemo would be the most risky but also most likely to rid his body of all disease. Which one you choose would depend on how you balance these. My own two cents would be that if your Dad is strong for his age (like my Mom is), might as well go as aggressive as possible...this type of cancer is extremely aggressive, so you want to kick it's *ss as hard and as soon as possible!

Hope that helps.

[Tom Galli]

Dadsgirl,

Here is another view. If I understand your post, your dad was diagnosed with Stage I disease.  That means a small tumor and if it is small, it is an ideal candidate for precision radiation (SBRT).  I've had both.  In my case, a complete pneumonectomy (removal of my right lung) followed by 3 recurrences in my remaining (left) lung.  Precision radiation fried a small  but uncooperative tumor that remained in my lung after 12 infusions of chemo.  There is also an additional benefit of precision radiation that helps prevent recurrence -- the Abscopal Effect.  Here is an explanation.

Stay the course.

Tom

[LexieCat]

I'd just note, with respect to what Josh wrote, the research generally does not recommend adjuvant chemo for Stage 1a.  With Stage 1b, it's equivocal whether it does more good than harm, but with Stage 1a, chemo has been found to cause more harm than good (at least with adenocarcinoma NSCLC).

It does make sense to find out whether there's a medical reason he can't have the VATS procedure.  VATS is a very simple surgery with speedy recovery.  Sometimes there are other factors that make it impossible to use VATS, but you should find out why.