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I can tell they don't specialize in LC in my area. The thoracic surgeon does more heart than lung and would not do surgery on me. They say no more radiation, of course they also don't have gamma knife. One center I checked in Boston doesn't do GK on lung tumors. So on to others, any suggestions for GK in the northeast would be appreciated. Then the med onc said they're testing my tissue for mutations even though I've been a lifetime smoker. And he would recommend either Tarceva or Xalkori for tx. Really? on a local recurrence. So I'll be trying to do a consult with Dr. Sugarbaker in Boston for sugery and still looking for GK. So onward I go!!!!
Take care, Judy
Forums
Reply # - June 18, 2013, 08:09 PM
Reply To: OMG Treatment Options
Where do you live, Timbuck2? Would it be inconceivable to go to MDAnderson? My Aunt went there from Ohio, had her surgery there and then after when she needed treatment she set it up locally. I mean they have places to stay. I'd check it out sweetie! You have a Great chance to still be cured so you need to go where your chances are greater! Your in my thoughts and Prayers! Keep us posted! Lorrie
Reply # - June 18, 2013, 08:27 PM
Reply To: OMG Treatment Options
Judy, I know you will explore all the options and come up with a plan the fits you best. I just hate you're in the position at all. :evil:
FYI, you can access all the threads you've started by clicking on your avatar, that gorgeous grand baby. http://cancergrace.org/topic/new-biopsy-with-possible-complications
But I'd stay with this thread or the update on biopsy thread. Your thread, your discussion, your call.
Take care,
Janine
Reply # - June 18, 2013, 09:22 PM
Reply To: OMG Treatment Options
Dr. Sugarbaker is certainly someone who will do surgery in some remarkably challenging situations, and I think the bigger challenge is that he will often do it in situations in which very few people (if any others on the planet) would advise it. Obviously, there are some very thoughtful experts on lung cancer in Boston, and perhaps it would be worth a second opinion on what someone from Dana Farber, Mass General, Beth Israel etc. would recommend, which might be surgery or focal irradiation, or not, rather than asking the most aggressive lung surgeon in the field whether he'll do surgery. There may be a difference between what can be done and what should be done.
Remember the old saw: "Never ask a barber if you need a haircut."
-Dr. West
Reply # - June 19, 2013, 03:12 PM
Reply To: OMG Treatment Options
Dr. West, the reason I wanted a consult with Dr. Sugarbaker is because he will do surgery that involves the pleura, since he deals mostly with meso. My recurrence in the LRL is showing spread in the pleura, but they can't tell if it's tumor or scar tissue. He is affiliated with Dana Farber as well. Dr. Loiselle suggested gamma knife, but I've been told they're not using GK on lung tumors but do use cyber knife. I was also told that Dr. Sugarbaker may refer me to Dana Farber for CK consult. I"m still shocked that they want to treat me here as if I have advanced cancer when it's a local recurrence. Thank you all for your suggestions and support. Take care, Judy
Reply # - June 19, 2013, 04:17 PM
Reply To: OMG Treatment Options
Dr. West's comment on Dr. Sugarbaker was so much like the comment D's radiation onc gave us about the surgeon at UAB, only with the twist being pancoast tumors (grow out the top of the lung and into the chest and sometimes operable). The deal was this surgeon was one of the top 2 or 3 thoracic surgeons known for his work with pancoast tumors not to mention he's just 10 minutes from home. We didn't have to make a decision though because he found the met to the spine that moved D into stage IV and the option was gone after a fascinating meeting with him.
In a odd way I was relieved to not need to have a choice. There's no reason not to see a med onc and radiation onc at one of the research hospitals in the area before settling on a plan. If you've not read this lately it may be helpful as you think through your options. I'm always suprised at the multitude and range of take away info found in each of the Grace faculty posts, http://cancergrace.org/cancer-101/2011/11/13/an-insider%E2%80%99s-guide…
You remain in my thoughts.
Janine
Reply # - June 19, 2013, 08:27 PM
Reply To: OMG Treatment Options
I don't mean to imply that Dr. Sugarbaker isn't qualified -- he's renowned, and he's very skilled, no doubt. I just truly can't say whether his willingness to do surgery that other (qualified expert) thoracic surgeons think is not a good decision is because he's just better able to do it or unwilling to say no to any challenge.
Dr. Cerfolio at UAB is another truly renowned lung surgeon, with exceptionally high volumes (which correlates with plenty of expertise and often superior outcomes).
I can't and wouldn't want to second guess either of them on questions of operability; they live in that world, and I don't. I think the main question I'd want to get to is whether either of them might indicate that surgery is really both feasible and a good idea, or just something they'd be willing to do primarily based on a lack of other appealing options. Surgery is a great solution for the right problem. It's not a great approach to take out of desperation.
-Dr. West
Reply # - June 19, 2013, 09:51 PM
Reply To: OMG Treatment Options
Neither did I mean to imply the rad onc believes Dr. Cerfolio isn't qualified though his willingness to do surgery on the most outlier of candidates makes for a very difficult decision on the part of the patient. That's why I thought it may be helpful to get more input with which to measure pros and cons of available options.
Reply # - June 20, 2013, 05:41 PM
Reply To: OMG Treatment Options
Dr. West, I don't consider the thoracic surgeon that I saw here at home a specialist in the LC field. He does do lung surgery, but it's basic. Though I've been previously treated, I know does not make me not a candidate for surgery since this is a local recurrence. I will go see what he has to say and that still doesn't make it a given for me just because he's renowned. I am weighing my options and still looking for cyber knife in the northeast. Take care, Judy
Reply # - June 22, 2013, 11:28 PM
Reply To: OMG Treatment Options
I apologize in advance if this is a silly question (or if it already has been answered), but isn't gamma knife only used in the setting of brain mets? For whatever reason, I vaguely recall a discussion long ago about targeted radiation via gamma knife being used for the brain, and cyber knife, tomo, etc. being used for other areas of the body. Am I not remembering correctly here?
And...more importantly, good luck Judy!
Laya