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Questions About Bilobectomy


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I have a question about bilobectomy.  My 79 y.o. husband is awaiting his official biopsy / diagnosis results.  The patient portal reports from the cytologist says his lung mass is preliminary malignant but the lymph nodes were negative or benign.  The MRI/PET scans don't show any other cancer / metastases.  He doesn't have heart issues or diabetes or high blood pressure, but he does have CKD stage 3b (stable).  The original CT scan noted that his lungs show mild fibrosis and emphysema (which is weird because he has absolutely no breathing issues whatsoever - with a blood oxygen of 96).  Generally he would appear reasonably health for someone his age.   That's all good, I know, but I've been researching about treatments and it seems that there may be an issue in that his tumor (5cmx4cmx3cm) spans and is tethered to the fissure between the upper right lobe and the middle right lobe.  Apparently this is not a usual presentation and I'm wondering if anyone here around the same age has had this type of lung tumor presentation and what your team did surgically to remove it, or if they didn't and what they did instead to treat it.  Did you have a bilobectomy?  Did they have to remove the entire lung? I'm trying to get ahead of my homework because the diagnosis treatment plan is coming up soon and my husband emotionally isn't doing well and I will need to help him figure out what he wants to do out of whatever options are presented.

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Your's is a tough question: "did anyone have a bilobectomy?" The term means surgical removal of two lobes of a lung. It can be confusing because the left lung only has 2 lobes while the right has 3. So, it is not a commonly used term.

My right lung was removed in May of 2004 after a diagnosis in February. I had a very large tumor that completely filled the main stem bronchus but thankfully no other signs of disease. I had pre-surgical chemo radiation to shrink the tumor and allow the surgeon to make a complete resection. I was 54 at the time of surgery and my surgery was an open thoracotomy. While the lung was successfully removed, pre surgical chemo radiation affected suture healing that resulted in two subsequent thoracic surgeries and four stent procedures to correct. I had about a year's worth of surgery. My treatment plan was to have post surgical chemotherapy to address stray cells in my blood and lymphatic systems but follow-on surgical procedures canceled chemotherapy. Thus, I emerged from surgical mayhem into recurrence mayhem with three tumors found in my left (only) lung. Admittedly, mine is a rare case but surgical complications must be weighed for anyone regardless of age.

I've known survivors who've had thoracotomies in their late 70s and early 80s. You may want to read the string of posts by member Minh. She had a difficult surgical case. Here is her dialogue.

Each of us is different and predicting one's outcome based on another's experience is problematic. I know waiting is maddening but I think your best course is to learn the results of the biopsy before deciding on a treatment plan. There may be Targeted Therapy or Immunotherapy treatments, perhaps in concert with radiotherapy that might be effective but less invasive.

Stay the course.


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