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Noela

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I have been battling cancer for 4 years now.  I had a below the knee amputation due to a sarcoma.  As I was recovery from my amputation ---the doctors found that I had an aggressive brain tumor I had to have surgery and went through radiation and chemo after.  While all this was going on, I had regular chest CT scans because the kind of sarcoma goes to the lungs.  A nodule showed up and has been slowly growing ---it is only 18 mm now--that seems small.

The lung tumor board at the Mayo Clinic meet and reviewe my case/ct scan and "The recommendation of the group was that a surgical procedure, possibly a wedge resection would be appropriate given the increasing size of ground-glass opacity with increasing density suggestive of developing lung adenocarcinoma.tumor.:

I am so overwhelmed with having to face another surgery.  I have researched "wedge" surgery -- and am really nervous about this procedure.  It sounds painful, especially when I am allergic to all opiate medicines so pain control is always a challenge for the doctors.

Is the wedge surgery painful?  What is the recovery like?  It would also be helpful if you would suggest any questions I should ask the surgeon when I meet with them?

Thanks,

Noela

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Hi Noela and welcome.You've  really been through a lot! I can understand why another surgery sounds overwhelming.

I had a stage 1 adenocarcinoma of the lung that was discovered in a surveillance CT as a followup from a prior cancer. I had a lobectomy by VATS (video assisted thoracic surgery) and found it to be fairly easy as surgeries go. I asked my surgeon about a wedge resection, which would remove less tissue than a lobectomy, but he said it couldn't be done  because of the location of the tumor. 

Have the docs suggested a biopsy prior to a decision on surgery? That's the most common course of action. Biopsies can often be done by needle or by bronchoscope. I was unable to have either of these types because of the location of the tumor. It was recommended that I have the surgery because of the suspicious appearance of my nodule. 

Surgery by VATS (or the alternative robotic surgery) is generally less painful and has a quicker recovery time than the older type of open surgery (thoracotomy).  I recommend asking the surgeon which kind of surgery he/she is proposing. If they're suggesting open surgery, I would want to know why they don't want to use VATS or robotic and I'd want to be sure they had a specific and really good reason, espcially since you can't use opiates. 

Please keep in touch here. Ask us any questions you may have and let us know how we can support you. That's what we're here for.

Bridget O

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Hi Noela: Sorry to hear about your diagnoses and welcome to our group. It seems like you had your fair chare of surgeries but there is nothing faire about cancer.

You have an advantage that your case was examined by a cancer board at the Mayo Clinic. Personally I have confidence in cancer boards where you the specialists come to a consensus.  I also did some research on wedge resection and it is less invasive than other surgical procedures with a recovery time of less than two weeks. As Bridget wisely suggested, you should explore a surgery by VATS instead of open chest  because it is less painful.

Please post back when you the final decision is made and I wish you good luck and a quick recovery.

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Hi, Noela, and welcome.

First of all, have the docs determined, or do they have a strong opinion, whether this nodule is likely a metastasis from your sarcoma, as opposed to lung cancer? Mets to the lung are treated differently from actual lung cancer--they are treated in accordance with the type of cancer they arose from. (It works the other way, too--a bone met from lung cancer is treated as lung cancer, not bone cancer.) It may be they can't determine that without a biopsy, and maybe that's why they need the wedge surgery.

In the case of lung cancer, anyway, wedge surgery just means less than the whole lobe is removed. If they can remove an entire lobe of the lung using VATS (laparoscopic surgery), there's no reason they can't do it for a wedge resection. In fact, when I had my lobectomy (VATS), they did a wedge resection first to see if the nodule was cancerous, before they removed the entire lobe. VATS is EASY as surgeries go--I was up and around the same day. Most people go home within a day or two and I was out with friends two weeks after surgery.

Again, though, your situation might be different, if this is all arising from your sarcoma, and not lung cancer. 

I think I'd be asking the docs what it is they think is going on and what they think/hope to accomplish with this surgery.

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thanks everyone.  I have been waiting for the surgeon to set up an appointment.  I will check this week to see if I can the apt set.  i found the info on the website that has questions to ask---they look ery helpful.  

You all have been kind and very helpful.  Thank you!

Noela

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