Radiation to the mediastinal lymph nodes

Portal Forums Radiation Oncology Chest Radiation Radiation to the mediastinal lymph nodes

This topic contains 6 replies, has 4 voices, and was last updated by JimC Forum Moderator JimC Forum Moderator 9 months, 2 weeks ago.

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January 31, 2017 at 6:53 am  #1289943    

larryw

Is radiation possible to the lymph nodes in stations 5 and 6 (nodes located on and around the aortic arch).
I have nodal Lung Cancer metastasis to node stations 3, 4L, 5, 6, 7.

January 31, 2017 at 9:18 am  #1289945    
catdander forum moderator
catdander forum moderator

Hi Larry,

Welcome to Grace. I’m very sorry to know you under these circumstances but glad you’re asking questions about your case. I’m not going to try to answer your question but will refer it to a faculty. I hope you do very well moving forward.

Janine

January 31, 2017 at 9:43 am  #1289947    
Dr West
Dr West

Yes, that’s very possible.

Good luck.

-Dr. West

February 1, 2017 at 3:58 am  #1289959    

larryw

Thank you for the prompt responses
After a ct scan in feb 2016 showed 3 tumors in my left lower lobe I had a lobectomy to remove the lobe in May 2016.
Surgeons report showed all margins clean and nodes that were removed were cancer free.
I had a post ct on Jun 27 that showed one enlarged 4L node.
Follow up CT and PET SCAN in Sept showed 4L node had doubled in size and a subcarinal node was enlarged.
My oncologist recommended radiation with light chemo and sent me for a bronchoscopy with EBUS.
The ebus found that all nodes that were accessible were actually cancerous and I was told I was stage 4 and radiation was no longer an option.
Now my oncologist is pushing for the radiation/chemo treatment once again.
I am confused and not sure what to do at this point.
Thanks again for your replies.

February 1, 2017 at 3:50 pm  #1289963    
JimC Forum Moderator
JimC Forum Moderator

Hi larryw,

If the staging is based only upon the original tumors and the enlarged nodes it doesn’t seem as though this is stage IV, in which there is distant rather than merely local spread. In stage IV, local therapy such as surgery or radiation is usually used only to relieve pain or other symptoms, prevent bone fractures, etc. In lower stages, radiation would certainly be an option.

Since this is a significant treatment decision point, you may wish to obtain a second opinion, preferably a dedicated lung cancer specialist at a teaching hospital. Dr. Weiss shared some helpful thoughts on second opinions here: http://cancergrace.org/cancer-101/2011/11/13/an-insiders-guide-to-the-second-opinion/

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

February 4, 2017 at 7:09 am  #1289984    

larryw

Thank you for the reply JimC
I read the article and I am searching for an academic oncologist in Nashville

February 4, 2017 at 8:15 am  #1289985    
JimC Forum Moderator
JimC Forum Moderator

Hi larryw,

Two oncologists who have contributed content to GRACE are in Nashville: Dr. Leora Horn is at Vanderbilt-Ingram Cancer Center and Dr. David Spigel is at Sarah Cannon Research Institute/Tennessee Oncology.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then: http://cancergrace.org/blog/jim-and-lisa

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