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T2aN0M0 Surgery vs SBRT only?


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Hi, my dad (77yrs old, very active, good health condition) recently discovered a 3.8x3.6x3.5 mass in his left lower lung lobe, after series of testings, staging is determined to be T2aN0M0.  His medical team (surgeon, radiology, oncology) believes he is a good candidate for both surgery and radiation (SBRT).  The radiologist even said that SBRT shows similar success rate compare to surgery.  Obviously surgery has a higher risk compare to radiation along, also recover time takes longer.  But we have doubts about the true effectiveness of SBRT, have you or known anyone who had faced similar situation?  What did you/they do? How was it after the treatments?

Much appreciate your inputs!

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Hi Hopeinlife and welcome here. I don't know anyone who has faced a similar situation, exactly, but maybe someone on these forums has and will respond. Usually surgery is considered to be the best first line treatment, where surgery is possible. Sometimes when surgery can't be done , for example because the person's health makes it too risky, SBRT is done as an alternative.  If surgery can be done by VATS (video assisted thorascopic surgery) the recovery is fairly fast. Open surgery usually involves a longer recovery time and more pain.  If your father is uncertain, he might want to consider getting a second opinion. Has he had a biopsy, and if so, what type of cancer was identified? Best of luck to you and your father.

Bridget O

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Surgery and SBRT: I've had both.

Surgery is the gold treatment standard. Why? Nothing is better than a human being putting eyes on a tumor and resecting everything that is disease or could be disease. But SBRT is very effective for those who cannot or should not have surgery.  In my case, it dealt with a stubborn tumor that kept recurring in my remaining lung after my right lung was removed surgically.  One downside to not having surgery is a lack of biopsy to determine the type of lung cancer.  Type determination is important should a recurrence happen that needs to be treated with chemo.

After my SBRT, I've had nearly 16 years of no evidence of disease. So obviously, I'm a fan.

Stay the course.


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Thanks Tom and Bridget!

my dad has done a biopsy for his mass, it is adenocarcinoma lung cancer, non-small cell.  They also did gene mutation matching and PDL1 testing.  He has one mutation, KRAS G12D which has no targeted drugs today.  

Tom, 16 years is very impressive!  My dad is physically fit and he still hikes on a weekly basis, so he probably will recover from the surgery just fine.  However, if SBRT could be an equally effective alternative, why take the risks of surgery at all?  That is our hesitation right now.  

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