aussieguy
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Posts:26
My surgeon has recomended that I undergo post operative radio therapy .. The research I have done seems to indicate that this may have a negative impact on my survival.. The radiologist was a bit conservative about doing it however he was pretty confident that he wouldn't kill me with radio therapy .. He ran through the numbers and said that the risk of local recurrence would drop from a 25% chance to about 10% chance .. And since I am squamous I am wondering why wouldn't I do it ? I still have done time to consider as it would start after my adjuvantchemo which starts next week .. Any thoughts
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Reply # - March 27, 2015, 07:51 AM
Hi aussieguy,
Hi aussieguy,
Welcome to GRACE. Without knowing all the details of your situation the way your doctor does, it can be said that he has described the value of post operative radiation well - it can lower your risk of recurrence by several percentage points. While the specific number can be debated, it can provide a benefit.
Whatever you have read about radiation having a negative effect on your survival, I think that risk may be overstated, and may represent the lower survival rate associated with patients who opt for radiation, simply because their risk of recurrence was higher to begin with.
Good luck with your adjuvant chemo. Let us know if you have further questions.
JimC
Forum moderator
Reply # - March 29, 2015, 02:12 AM
Thanks for your response ..
Thanks for your response .. The risk in survival detriment comes from quite a few studies from the 90's with the latest one coming from 2007 and was only 300 people I believe.. These studies showed a median survival of 35 months versus 90 months .. Randomized studies etc .. However we have better equipment now and ct guided equipment so the assumption is it should be a lot safer.. I guess for me I want to do everything I can to cure myself however I don't want to shorten my life span with treatments.. I can provide some further details if it would be helpfull
Reply # - March 29, 2015, 11:16 AM
Hi aussieguy,
Hi aussieguy,
Welcome to Grace. I don't know that anyone can add to Jim's excellent response but tomorrow I'll see if I can have our radiation oncologist comment. Just note in the interest of having many oncologists share the work of providing answers it may take a little more time than we've seen in the past. In the meantime you can let us know about your individual dx (stage TNM, and surgery etc). As the guidelines suggest, "Though we want a good explanation of what’s happening, please be brief in explaining the relevant history."
Stage III cancers have innumerable individual components that make a standard tx impossible. Everyone is different and so much depends on those differences.
I hope all goes smoothly.
Janine
Reply # - March 29, 2015, 10:57 PM
I have squamous nsclc ..
I have squamous nsclc .. Diagnosed december 2014 operates feb 2015 .. Ended up being a left pnuemonectomy because it looked like to cancer had spread .. Lost a piece of pericadum and I think a bit of the tissue in my mediastinum.. Path report said these tissue sample were clear of cancer .. Surgeon took out a whole bunch of lymph nodes and one from station 5 came back with extensive cancer and apparently it had invaded my recurrent laryngeal nerve aswell , surgeon was confident he removed the cancer completely..9 n1 lymph nodes had fused together and pathologist thought there was extra capsular extension but was certain because they has fused together with fibrosis.. Interestingly these has fused together pretty closely to the tumour and the station five lymph node .. The pet scan actually had me at n0 .. My surgeon told me that a station 5 lymph node in a left upper lobe tumour was considered an n1 node .. That's peobably as much relevant info as I can think of for now ... Happy to answer any questions
Reply # - March 31, 2015, 09:43 AM
Hi guy,
Hi guy,
Just wanted to let you know I've contacted the radiation onc.
FYI, a pet scan will only pick up activity at a certain level of which usually takes at least a cm nodule sometimes larger if the cancer is slow growing. As well it takes about a billion nsclc cells to make a nodule the size of a pin head. That's just one of the problems with knowing exactly what you're dealing with until it's established itself.
Hoping for the best,
Janine
P.S. Let us know if you've not heard back in a couple of days.
Reply # - March 31, 2015, 11:11 AM
Hi -
Hi -
Looking over your story here, it looks like a reasonable plan and good recommendation to proceed with radiation therapy to areas which were pathologically involved with lymph nodes.
You are right that CT guided planning techniques are better, much better, both in improving the effectiveness (hitting the right target), and in terms of lowering risk (inflammation and scarring in the lung primarily), even more so given that you have had a left pneumonectomy (which alters the anatomy and location of lymph node stations).
The comments by our forum moderators are also spot on.
Best of luck to you mate.
Dr Loiselle
Reply # - March 31, 2015, 05:59 PM
Thankyou very much everybody
Thankyou very much everybody it is so much appreciated... I have to complete my adjuvant therapy before they will do radio so it will start in a few months .. They are saying mon-fri for 6 weeks so 30 sessions all up .. I think he said it's only a few minutes everyday and that after my lymph nodes would be clean/sterile , I had basically decided to go ahead with this treatment anyway and you guys have made my decision a little less anxious
Reply # - May 4, 2015, 08:29 PM
Just wondering , what kind of
Just wondering , what kind of side effects can I expect from this sort of radiation?
Reply # - May 5, 2015, 09:57 AM
Hey Guy,
Hey Guy,
Generally there may be burning on the skin where the radiation is pointed. Typical burn solutions are used to mitigate skin burn but there are substances that shouldn't be used on the skin during appointments. Radiation pneumonitis sometimes appears weeks even months after radiation, sometimes it goes away by itself within a few days sometimes steroids are used.
Specifically it will depend on where the radiation is directed as to what possible side effects can happen inside. Esophagitis is one such example that can develop if radiation passes through the esophagus. I see your tumor was near station 5 but still I think that's not enough info to know what your individual problems "might" be. That question is best answered by your radiation oncologist. Don't let the radiation oncologist's nurse go to waste either. He or she can be of so so much help. After almost 6 years I'm still friends with my husband's radiation oncology nurse.
Typically chest radiation is quite easy to take with the biggest headache usually being going to the cancer center 5 days a week for 6 weeks. We have a forum specifically about chest radiation that I'm sure has lots of information that can be helpful. In fact I'm going to move your post there (the address will stay the same).
I hope you're doing alright with chemo.
All best,
Janine