Hello Doctor West,
First, I'm so grateful for this forum and your site!! It's very helpful.
My momma has a single mass in her lung that was indiluent for 5 years. It has woken up and doubled in size from April 2015 to November 2016 - 1.7cm to 3.4 cm in 7 months. It lights up on a PET as active and fortunately has not spread! She is 72 and has COPD, type 2 diabetes and kidney failure. We decided to not do any treatment and keep an eye on it. She is starting to cough and with it growing we feel it is time to do something. Her radiation oncologist has agreed to do radiation without a biopsy. He is suggesting 5 rounds of Stereotactic Radiotherapy, specifically Varian Rapidarc. What is the difference between this and cyber knife? Is there one you'd recommend over the other? He claims they are very much the same, just a different brand. He also said there would be no side effects and that it is very well tolerated. Although, there is a very small chance to have chest wall pain several weeks later. Also, any chance that this type of radiation can activate the mass to spread? She is scheduled for treatment on Feb 22nd. Would love some insight before then.
Thanks for your time, attention, and wisdom.
With Gratitude,
Sarah
Reply # - February 13, 2016, 09:32 AM
Hi Sarah,
Hi Sarah,
I'm sorry your momma has all these issues. Both are types of stereotactic body radiation but there's no evidence that one is better than another. Using what's available is what's considered the best at the time.
I hope your momma gets what she needs.
Janine
Reply # - February 14, 2016, 04:19 AM
I hate to say this, but there
I hate to say this, but there are side effects from having targeted radiation. Where is this tumor located, lung and lobe? Inside or outside of lobe? This is what will decide side effects. All radiation has to go in and come back out. I had two tumors radiated with SBRT, one each in upper and lower right lobe. The upper lobe was on the inside and they ended up going through the pectoral muscle which now causes me long term side effects due to the scarring. The lower one was on the outside and I only get spasms now and then which is bearable.
She will do doubt have to be on steroids during radiation to keep inflammation down from the radiation. This can cause her glucose to spike and she should be monitored daily. They can use lower dose steroids and this is what I'd ask the rad onc about taking.
My tumors were both under 3cm so it was ok to use SBRT. They are now using it on larger tumors, but not sure of the outcome. Maybe one of the rad doctors here could comment on that Janine.
Wishing your Mom all the best.
Take care, Judy
Reply # - February 14, 2016, 02:57 PM
I would not mind asking our
I would not mind asking our radiation oncology faculty to answer the question about possible painful side effects but like Judy said it's not possible for him to do so without knowing where exactly the radiation is focused. That however may not to possible to pinpoint if it's a general "lobe" site (upper right, lower left, etc). It does sound like your momma's oncologist did suggest the possibility of chest wall pain post treatment. So I imagine that side effect was suggested dependant on where the radiation will be directed.
The answer to the question of whether or not radiation can cause cancer to spread is no. There's no suggestion of radiation causing spread. Radiation is very good at killing the tissue to where it is being focused.
It sounds like you mom is getting the care she needs. I know she's thankful for having her children taking such good care of her.
Much luck,
Janine
Reply # - February 14, 2016, 10:07 PM
Thanks for responding
Thanks for responding everyone! Judy, I appreciate you sharing your experience and advice. Her radiologist said she would not need any steroids with this type of radiation. He seems to think she will only need 3-5 treatments and said it was very well tolerated. I'm just concerned bc I've seen my mother suffer from scar tissue in her small intestines leading to several bowel obstructions from radiation to treat uterine cancer 15 years ago. They never told us that this was a possibility. Her current radiologist is suggesting that this Varian Rapid Arc radiation is very well tolerated with minimal side effects. Just wanting to know if this is true or not. My goal is to increase my mothers quality of life and help her to not suffer anymore.
My momma's tumor is located in her left lung in the upper lobe very close to the outer chest wall. I've tried to upload a photo of her scan, but it won't let me for some reason.
Janine, is Dr West no longer part of this forum? I've been in touch with him in the past here and he was extremely helpful. Is there any way to consult with him? I'm happy to email her scan where it can be received.
I'm very grateful for any help in finding clarity on how to best care for my mother.
Very Best,
Sarah
Reply # - February 15, 2016, 06:07 AM
Hi Sarah,
Hi Sarah,
Side effects from radiation will vary based on the nature of the healthy tissues affected by the radiation. Modern radiation techniques such as Rapid Arc are highly focused in order to minimize the damage to healthy tissue, but it's still inevitable that some of that tissue will be radiated as the beam enters the body on its way to the tumor.
Dr. West remains active on the forum, but as far as uploading your scan for interpretation (by Dr. West or anyone else here), that is beyond the scope of this site. We can provide information which may be helpful in making treatment decisions, but we can't review scans and medical records in detail or make recommendations on what you should do.
If you would like some corroboration that the proposed plan is appropriate, you may want to obtain a second opinion, preferably at a cancer center affiliated with a leading medical school. Dr. Weiss wrote a very thorough post on second opinions which you can read here.
Good luck as your mother moves forward with treatment.
JimC
Forum moderator