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Am I doing a right thing? I am new this forum


Ted

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Good day everyone!
About a month ago by accident, a 1.5x1.3cm nodule was found in my posterior right upper right lobe.
PET scan demonstrated a peak SUV of 6.5
I was told by 2 different Pulmonologists to skip the biopsy & go directly to the lobectomy, because my COPD test was just fine & I "look" healthy enough for it... so that was their recommendation.
It sounds a little barbaric to me to go under the knife without proper diagnosis.
If this is cancer, then maybe I should go directly to treatment like stereotactic body radiotherapy (SBRT) or stereotactic ablative radiotherapy (SABR).
And if it isn't cancer, then this procedure should just eliminate that nodule anyway.
I do have an appointment with a radiology oncologist on 30 of this month.
Am I doing the right thing, not going ahead with the surgery?
Thank you, everyone, for any help

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Ted,

I'd consult with a medical oncologist and bring the test results you've had to that consultation session. Your pulmonary physicians may in fact be right suggesting a surgical remedy but without a biopsy, the medical oncology community will not be able to determine the type of cancer you have. 

Unfortunately, if you have lung cancer, it is notoriously persistent and recurrence after what is supposed to be curative treatment is common. (Read this for additional insight).  Of course, the tumor or nodule will be biopsied after surgery so a type determination can be made.  But, if you choose SBRT or SABR as an alternate to surgery, no biopsy will be performed and no type determination will be made. You'll need to wait for a recurrence a biopsy to make a type determination. For me, that course of action would be too far down the road.

I wouldn't know if you are doing the right thing or not. I prefer knowing as much about my disease as possible before proceeding to treatment (surgery, precision radiation and etc). But that is my view.

Stay the course.

Tom

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Thank you for your reply, Tom

If it was up to me I probably would go thru with surgery, but my wife is a skeptical kind, who lost 2 best friends 2 cancer one opted to do the surgery & everything else recommended by her doc The other one went the alternative route and outlived the other one by 10 years.... so my wife is the the one who want me to get more opinions before doing  anything as drastic as removing part of my lung.

And that's why I am as confused as anyone can be.

What I really would like to know if anyone did therapy before knowing what they actually had. Since, like I said no one recommended Biopsy.

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Hi Ted,

Surgery is the gold standard for treatment of early lung cancers. In these cases, precision radiation generally used instead only when surgery can't be done for some reason, such as the person can't  tolerate it due to some medical condition.. A biopsy prior to ANY treatment is preferred. In some cases, such as mine, a biopsy pre-surgery couldn't be done because of the location of my nodule. An experienced pulmonologist can tell a lot by the appearance of a nodule; mine was spiculated, which made it suspicious for cancer.  I therefore had a lobectomy without a prior biopsy. If a biopsy had been possible, I would certainly have had one prior to any treatment. If you don't have cancer, you don't need treatment for cancer. Radiation has its own risks and side effects.

I had my lobectomy by VATS (video assisted thoracic surgery) and it was fairly easy as far as surgeries go. My nodule was a non-small-cell lung cancer (NSCLC), stage 1a.  I am 3 years out i with no evidence of disease. 

Bridget O

 

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@Ted I was in the exact situation last year.  I went into surgery not knowing and came out with Stage 1 Lung cancer.  If it wasn’t cancer they would only have taken a wedge with no change in lung capacity.  Since it was cancer they removed the entire lobe.  I have not required any follow up treatment.  My lung capacity is back to normal.  I have a little bit of numbness.  Surgery is the gold standard for treatment.  It does feel barbaric to do it without knowing for sure but I did and I’m glad I did.  

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