Update: no surgery

Hi everybody!

Last time I posted on my case: Stage III A Squamous, inoperable tumor in my upper right lung wrapped around bronchus and blocking air flow, but how my surgeon was sending me to Toronto to get a second opinion by a top lung surgeon on whether the lung could be totally removed. (I had finished chemo and 33 radiation sessions by last Oct. and have had no treatment since, even though my tumor is now probably 7 cm or more.) No mets.

So, yesterday the new surgeon told me removing my lung was out of the question as the procedure would kill me. However, he said I was a candidate for brachytherapy (also known as internal radiation therapy) where "seeds" of radiation are directly placed in or near the tumor to shrink or kill it. That's all he told me, as he has to let my cancer team know what his opinion is, and I have a previously scheduled appointment on July 9 to discuss starting Taxotere with my oncologist.

So, I've searched the group's archives and there is next to nothing here on brachytherapy or internal radiation therapy. Is it that rare of a procedure with lung cancer? Has nobody else received it? I'd be very interested in hearing *any* stories from anyone.

I beginning to think my case must be really... different. I really wish somebody out there could share their experience. (Not that I wish it on anyone!) Beginning to feel lonely here.

Thanks!

Kelly

By cuddles53
Posted June 30, 2009 at 8:05 pm
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Hi Kelly,
I have not heard of it in lung cancer but other countries do different things, so fill us all in on this one, it sounds interesting, hopefully it will be curative for you.
God bless Sandy

By Bertha23
Posted June 30, 2009 at 8:30 pm
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Hi Sandy,

I sure will let everyone know what happens, step by step! The surgeon said I was a "candidate" for it, so I'm really hoping that means I'll get it, because it's the first hopeful thing I've heard in ages. But, as I said, I don't know much about it yet.

One thing I did read said that to get this treatment in lung cancer, the tumor has to be in a place accessible to the surgeon, and mine is, being at the top of the lung blocking an airway. So, maybe it isn't done often in lung cancer because tumors tend to be in places where the surgeon can't reach? (It sounds like they use a bronchoscopy approach, using a wire or whatever threaded through the nose or throat into the lung to place the radioactive "seeds". Like, they don't cut you open to place the seeds.) And, I have read that they do it at the Mayo Clinic, so maybe they do do it in the US, just that maybe it can only be used in certain cases? I'm just guessing, so as I learn more, I'll share as my treatment goes along.

Hope all is well with you, Sandy. I always enjoy reading your thoughtful posts.

Kelly

By beckylynn
Posted June 30, 2009 at 8:53 pm
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Wow Kelly I'm glad they aren't going to do the surgery. One of my co-workers had prostate cancer. He opted to do the radiation seeds instead of the normal treatments. He is doing great. The seeds reduced the cancer and he is currently NED. Now I know it's a different kind of cancer but it's a 'targeted' area they are striving for.

I know he could not hold his newborn grandchild for many months because he was 'active' I guess you could say but it worked and this could be something wonderful for you too.

Keep us posted on what you end up doing.
Becky :)

By antonella
Posted June 30, 2009 at 10:17 pm
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Hi Kelly,
I'm live in Brampton, Canada. I would like to know the name of this famous surgeon in Toronto. I have had cheamo, radiation, lobectomy more chemo and radiation. I'm cancer free but told I have a high chance of recurence, so I'm on the look out for any other options out there just in case. My surgeon was very good his name is Dr. Irshad, He works out of William Osler. There is also another procedure called radiofrequency ablation, might be what you are doing. I hope you get the procedure. Keep us posted on your progress.
Antonella

By Bertha23
Posted June 30, 2009 at 10:33 pm
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Hi Becky,

I'm glad to hear brachytherapy was successful for your co-worker's prostate!

I've been reading more about brachytherapy (also called internal radiation therapy) for lung cancer and it does sound interesting and promising. For those interested, here are some URLs:

Short video on lung cancer brachytherapy by Cancer Centers of America:

http://www.cancercenter.com/video/treatments-technology/radiation-therapy/b rachytherapy

More detailed video:

http://www.cancercenter.com/conventional-cancer-treatment/hdr-brachytherapy .cfm

Articles:

http://www.cancer.org/docroot/ETO/content/ETO_1_7x_internal_radiation_thera py.asp

http://www.ncbi.nlm.nih.gov/pubmed/12499415?ordinalpos=5&itool=EntrezSystem 2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDoc Sum

There is lots of info out there, just took me awhile to find it. I'm just hoping I get approved for it, and will let you all know as things develop.

Kelly

By Bertha23
Posted June 30, 2009 at 10:53 pm
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Hi Antonella,

We're almost neighbours! I have been recommended for brachytherapy, also known as internal radiation therapy, not radiofrequency ablation, which is a different procedure using microwave energy. And, hee hee, I didn't say he was famous - I don't think Canada has *famous* surgeons - but a *top* surgeon. His name is Dr. Shaf Keshavjee.

http://www.surg.med.utoronto.ca/faculty/Keshavjee.html

Dr. Shaf Keshavjee, Chair, Division of Thoracic Surgery; Professor of Surgery; Director Toronto Lung Transplant Program; Director, Thoracic Surgery Research Laboratory; MD, MSc, FRCSC, FACS, Toronto General Hospital, Division of Thoracic Surgery. Areas of Interest: Thoracic Surgery, Lung and heart-lung transplantation, Tracheal surgery, Lung cancer Research: Lung transplantation, lung injury, lung regeneration, gene therapy.

I hope you stay cancer free, Antonella, and never need another surgeon or treatment again!

Kelly

By Bertha23
Posted June 30, 2009 at 10:57 pm
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Hi Merylee,

Thanks for rooting for me! I really hope something good comes of this brachytherapy. Things move so slow here in Canada, at least in my case, that I was beginning to despair. Please everyone, pray for me. I need them.

Kelly

By lucy56
Posted July 1, 2009 at 12:22 am
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Rooting and praying for you. This will work for you, that tumor is history. I know all about the wait time its even slower in the summer. I have a ct on July 03 results July 15. So make a lot of noise tell them your going out of your mind with worry (I know someone who got her family doc to phone the cancer surgeon and move her surgery up when said surgeon told her he was booked right up until his vacations she would have to wait till he got back) So beg cry you can build a firer under them to MOVE on this. You can do this VICTORY for you and all us CANADIANS.Good luck and happy Canada Day

By Bertha23
Posted July 1, 2009 at 8:29 am
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Happy Canada Day to you too, Lucy, and everyone else!

I don't know where you are from in Canada Lucy, but in Ontario it is your right to get copies of all reports. So, if you have a cancer team (I have an onc, radiologist, a surgeon, and a second-opinion surgeon) they send hard copies of any written reports of CT scans etc. to the team. My family doctor is also considered part of that team and these reports are sent to him also. So, I get copies of the reports as soon as they come in from my family doctor, which is often way earlier than my appointment with the cancer team specialist who ordered it.

And you're right about the squeaky wheel getting the grease, but even so, maybe because my case has been difficult, it has taken absolutely ages to get anything done. Finally, things seem to be progressing, but we'll see!

I think I'll forget about lung cancer for the rest of the day and just celebrate Canada! I'm making a red and white cake!

Kelly

By misself
Posted July 1, 2009 at 12:27 pm
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Hi,kelly,I too haven,t heard of this procedure but in nursing school in the md 80's I met some patients who did very well with radiation implants.With all the advances in technology I believe this sounds good.Hugs and prayers both to get you thru the wait and then for success,Andi B Not sure of date for your Canada day but hope its happy.Promise as we are neighboring countries will look it up.

By Bertha23
Posted July 1, 2009 at 2:44 pm
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Hi misself,

Thanks for sharing your experience with radiation implants - I believe it is the same or similar to brachytherapy from what I have read. It does sound hopeful in my case and just being given some hope is a wonderful feeling!

And, to save you from having to look it up good neighbour, Canada Day is today - it is always July 1st, just like your national day of celebration is July 4th. It's very quiet at my place today, but a few of my nephews are coming over later for pizza and cake and then there's a free outdoor concert and fireworks at Little Lake in our downtown tonight, so that should be fun for them. I didn't go to the parade, and doubt I'll go to the concert and fireworks - I find I'm too tired to do things after 9 p.m. I get up with the birds around 5 a.m.

Kelly

By lucy56
Posted July 1, 2009 at 8:52 pm
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Hi Kelly I,m from Burlington Ontario. Our only hospital is very under funded . My cancer team is the same on that sends me for scans makes all appt and gives me my reports only in person. One week + after scan (we have one hospital very under funded and our cancer center is run by it.)Family doc takes 1 week to get in to see her. No reports are given out by any of them until they can go over it with you,there is nothing I can do about it so I,m not going to worry about it, lifts to short. When I get upset about this cancer I read the post on this site, the people here are amazing and I,m not afaid (sorry my spellings not so good spent 5years in the hospital my folks were told I was going to died so no point in having any schooling )As my family doc told me the cancer has been there for 10 years so if I wait 1 week or 1 month for results the treatment will be the same But if I think things are not being done that need to be done NO MORE MISS NICE LADY I fought for my life at the age of five (doc think at that age you don,t under stand what they are talking about I sure did ) So at the age of 39? just kidding 53 I will not go down with out a fight. So give them a little push if the are going to slow this cancer likes to slip in and hit you hard , it waits for no one. My wish and pray for you Kelly is treatment so fast that your cancer gets zapped out of your chest and the tumor didn,t see its death coming .

By MarionW
Posted July 1, 2009 at 10:00 pm
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I am a registered nurse of many years and I recall that we used to implant radiation seeds locally in the tumors years ago. It worked well, I believe. The only thing is that you require special consideration as you are radioactive and need to take precautions. they may have improved all of that since then.

God Bless and hope it works well for you.

By Bertha23
Posted July 1, 2009 at 10:33 pm
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Hi Marion,

You're right about that, from what I've read so far. Also, I think it depends on the type of cancer being treated. With lung cancer, the amount of radiation is very small and confined to a small area, and it doesn't affect other people although they caution against being near pregnant women and small children for a few days after treatment as a precaution, same as I was cautioned when I was on Cisplatin and Vinorelbine because they just don't know if it could affect children or not (traces of bodily fluids in the bathroom, etc.) At that time, after receiving chemo, I wouldn't let my young nieces and nephews visit for four days after receiving chemo, just to be on the safe side.

So, after I learn more from the doctors, I'll sure let the list know all those details.

I did read one web page, about cervical cancer maybe, where the patient was put in a lead line box after... pretty scary stuff, but the lung cancer treatment doesn't sound so bad, so far. Will let you all know as I find out more.

Kelly

By avonmamabg
Posted September 4, 2009 at 3:40 pm
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I've been having brachy therapy here in Indianapolis - the first one was Aug 27 - I'm scheduled again Sept 10 and Sept 24. The pulmonologist inserts a catheter at the bottom of the bronchus (as far as he can go, since the tumor has it compressed) and the radiology oncologist drops radioactive seeds into it for 4 - 6 minutes to try and radiate the tumor through the healthy tissue. It's a touchy procedure because you have to leave it long enough to work, but not so long that healthy tissue is damaged. They told me I would lose 15 - 18% healthy tissue to collateral damage, but this is the best chance they have of shrinking it. I'm also getting Cistoplatin / Etoposide and 5 day per week radiation for 6 weeks. I'm 46, otherwise healthy, and would really like to take a deep breath again. They'll rescan me after the second brachy therapy to see how the tumor is responding. Hopefully it will be shrivelling away!!!!

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