I had a 2 cm adenocarcinoma removed via a lobectomy of my right upper lobe. There is other "activity" in the form of multiple solid 3 mm nodules in lower left lobe that did light up in a pet scan. My surgeon was not able to biopsy the left lower lobe when he did a bronchoscopy. I just had my first post-surgical follow up with my surgeon and he remarked that he didn't think I was done with him yet because of this left lower lobe and we've scheduled another CT for early November.
I have searched all over the web and I have found no references to people having a lobe removed from both lungs. I'm just wondering if it's feasible and would the results, from a quality of life stand point, be similar to having an entire lung removed. Any info you can provide or pointers to resources would be appreciated.
Reply # - October 2, 2015, 10:21 PM
Hi bfrasca, I hope you're
Hi bfrasca, I hope you're doing well after surgery. It's not usual that surgery would be done if cancer is in the other lung. While taking more tissue is an issue its also not helpful in getting rid of all the cancer.
So waiting to see what happens to the nodules over time is a good way to help decide if it is even cancer. If it doesn't grow over time it's not likely cancer. Waiting and watching can be very stressful but a very appropriate thing to do.
All the best,
Janine
Reply # - October 2, 2015, 10:21 PM
Hi bfrasca, I hope you're
Hi bfrasca, I hope you're doing well after surgery. It's not usual that surgery would be done if cancer is in the other lung. While taking more tissue is an issue its also not helpful in getting rid of all the cancer.
So waiting to see what happens to the nodules over time is a good way to help decide if it is even cancer. If it doesn't grow over time it's not likely cancer. Waiting and watching can be very stressful but a very appropriate thing to do.
All the best,
Janine
Reply # - October 3, 2015, 07:37 AM
I'm facing possible
I'm facing possible lobectomies in both lungs too. I was recently (9/1/15) diagnosed with adenocarcinoma in situ: two ~2cm nodules, one in each lung. I am so grateful to see your post, bfrasca, because I haven't been able to find much info online about this either.
Reply # - October 3, 2015, 08:38 AM
They will do a pulmonary
They will do a pulmonary function test first to see if it's feasible to have another lobe removed. It's unusual to have a 3mm nodule light up on a PET scan. And it it's adeno in situ, even more unlikely. Have you read the info that Dr. West provides for those with adeno in situ, how many times it's over treated? Surgery isn't always the answer, but you'll have to discuss with your doctor and see what works best for you.
Take care, Judy
Reply # - October 3, 2015, 09:44 AM
Hi Molly,
Hi Molly,
I'm sorry you're having such confusion about what's next. Losing anymore lung tissue than absolutely necessary is important so get all the info before moving forward with any type of treatment. A second opinion may be in order before moving forward with more surgery.
If lung cancer moves to the opposite lung it does so through the blood or lymph system and is unfortunately no longer considered curable, at that point systemic treatment is used instead of local treatment like surgery or radiation. These posts may be helpful. http://cancergrace.org/cancer-101/2011/01/01/cancer-101-faq-i-have-meta…
BAC (aka adeno in situ) http://cancergrace.org/lung/2015/10/02/gcvl_lu-f08_optimal_systemic_bac…
Don't hesitate to ask other questions as they arise.
Janine
Reply # - October 3, 2015, 10:28 AM
Hi Judy,
Hi Judy,
Thanks for your response. I don't know whether the 3 mm nodules in my left lower lobe are adeno in situ or not. What we do know is that there are more than one 3 mm nodules, they're solid, and that area of the lung lights up in a pet scan. We do know that there doesn't appear to be any activity in the surrounding lymph nodes based on samples taken during a bronchoscopy in the region. My doctor finds this scenario "unusual" and was disappointed that he couldn't biopsy the nodules. At this point, no decision has been made about surgery but it is still on the table.
My question isn't whether I should have surgery. My question is about whether it is feasible to remove a lobe from the other lung and what the impact would be on quality of life. This is the kind of info I need to make an informed decision about surgery should that be presented as an option. My surgeon commented to my wife after my first surgery that I have unusually large lungs so this might also be a factor in that decision. (I'm not sure how one gets unusually large lungs but I ran distance when I was young and I have been a singer my entire life. Of course it could simply be genetic.) Thanks, Bob
Reply # - October 3, 2015, 10:41 AM
Thanks for the links, Janine.
Thanks for the links, Janine. I'm going to try to not let your reply about this being not curable upset me since I didn't give you much information. With the testing done so far, the oncologist, the radiologist and the head of surgery in the thoracic oncology department at the reputable hospital where I'm being seen agree that I have two primaries—synchronous multiple primary lung cancer. It's not unheard of, but it's rare. They have all told me that they're going for cure. If it's possible for me to avoid one or both of these surgeries, you bet that's what I'll do. There are still more tests to be done and no decisions have been made. Like Bob, I'm looking for information (and hopefully success stories) about lobectomy in each lung.
Reply # - October 3, 2015, 12:45 PM
I see and hopefully your team
I see and hopefully your team will put together a plan for a cure. Indeed 2 primaries are quite possible so your scans must point to this. I will ask a doctor to reply to your and bfrasca's posts though it will be Monday possibly before we hear back.
I'm the last person to rule out the unusual not to mention the rare, my husband has about 6 reasons why his nsclc should have killed him but hasn't and possibly won't. Good doctors, treatments, care, hope and luck go a long way in our lives today.
All the very best of luck.
Janine
Reply # - October 4, 2015, 06:25 AM
Again, just because they lit
Again, just because they lit up on a PET doesn't mean they're cancer. It's hard to biopsy anything that small and the protocol would be to wait 3 more months and rescan to see if they're growing. It could be infection. Also as far as surgery, the pulmonary function test would have to be done every time to see your lung capacity and then your surgeon and doctors would make a decision as to whether surgery is feasible.
Take care, Judy
Reply # - October 5, 2015, 07:05 AM
Hi bfrasca, yes it is
Hi bfrasca, yes it is technically possible to do lobectomies on both lungs if the remaining lung is healthy and pre-surgery lung testing suggests that the post-surgery lung function will be good enough to maintain a normal, reasonable quality of life. That being said, it is not that common and sometimes is not possible. There are also options for treatment that spare more healthy lung tissue, like wedge resections (just pinching off the piece of lung with the tumor in it) or stereotactic radiation which again just targets the tumor but leaves the rest of the lung (mostly) unharmed. These choices are probably not quite as effective as lobectomy but significantly better than no treatment if lobectomy can't safely be done!
The decision of whether another surgery would be the right choice for you really depends on the individual situation and a careful discussion of the risks and potential benefits. If your doctors become convinced that the other tumors are distinct from the other cancer you had (i.e. another primary cancer and not metastases), then they will evaluate you and decide the possible options and then go over them with you to make a decision.
Reply # - December 17, 2015, 04:14 PM
Just to follow up, I did, in
Just to follow up, I did, in fact, have surgery on the other lung (lower left lobe) exactly three months and one day after I had the lobectomy on the right side. He had hoped to do a segmentectomy on the superior segment of the lower left lobe but ultimately had to do a lobectomy on the left side as well so I am now the proud owner of two mini-lungs. The first time he used the VATS technique but this time he was forced to do a good old fashioned thoracotomy which requires a much longer incision, roughly 8 inches or so. This required a seven day hospital stay as well as one return visit of two days for a minor complication. Today marks two weeks since I had the surgery.
What he discovered was two tumors in the 1.8 cm size range that must have been hiding from the CT scan. These are also adenocarcinoma but not related to the adenocarcinoma in the right lung so I have two primary lung cancers (and one primary bladder cancer but that was removed eight years ago and probably isn't relevant here). The new tumors have been staged as T3N1 as there is some tumor presence in some of the local lymph nodes.
So, although surgery was billed as a total "cure" it isn't really as I'm also looking at chemo and will meet with an oncologist next week. The survival stats are a little more grim as well but I'm relatively young (57) and, although overweight, still in pretty good shape due to regular visits to the gym for many years.
What I hadn't anticipated was requiring oxygen when I went home. I guess I shouldn't have been surprised by this fact and it is clearly necessary. I think the reason I'm rattled is I'm afraid I'm going to need it for the foreseeable future and I really don't like carrying that tank around. I've been a singer most of my life and right now I start huffing and puffing just trying to get my coat on so I'm worried about quality of life.
It has only been two weeks so I'll stop complaining and keep on using my incentive spirometer and doing my walking.
Reply # - December 18, 2015, 09:25 AM
I hope you continue to feel
I hope you continue to feel better and send you much good luck for the future. Thanks so much for posting.
Janine