1. < Lung Cancer

Adenocarcinoma - newly diagnosed

Posted by Sandy @pixiedust, Feb 26, 2023

Hello. I am new to this group. Thank you in advance for any guidance and or support you have to offer. I have been diagnosed with adenocarcinoma of the upper right lung. Have had a bronchocoscopy, x-rays, CT and lung biopsy - which determined the diagnosis. I have an appointment this Tuesday for a PET scan to determine staging, and a breathing test will follow. The only symptom I have had is hoarseness in my voice. Otherwise I feel fine. I am simply terrified and still in shock.
Pixiedust

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mayocid1 | @mayocid1 | Apr 19, 2023
In reply to @cmcguire10 "Hi Nancy- I just wanted to let you know that I am 3 1/2 weeks post..." + (show)
@cmcguire10

Hi Nancy- I just wanted to let you know that I am 3 1/2 weeks post op after my LUL segmentectomy and a lingular wedge for adenocarcinoma. My surgeon used the Robotic assisted method. It is easier and faster to recover from. I also read a lot about these surgeries and scared the heck out of me. I thought I was going to be in horrible pain, in bed, etc. I was also afraid of the same thing, not being able to breathe. Neither case was true! They had me up walking the second day, still with chest tube in and catheter! Moving afterward is the key. If your not very mobile now, get moving if possible. Use an inspirometer, lung exerciser. My pulmonologist told me to double what I was walking to exercise my lungs and heart.
But, for a different choice, my Aunt who was 77 at the time, had the SBRT for hers, which was in the lower lung. She said it was so easy! 5 days at 30 minutes a day, and done. She is now 82, and all of her CT and PET scans have been clear since. What my surgeon told me was that if you can have surgery to get it out, you should do it. The reason being, if another one comes up later, you may not be able to have surgery at that time because of lung function or heart condition. Hopefully this will help you.
Best wishes, Cindy

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Thanks Cindy. That is helpful to know.
I was told that the surgeons only removed whole lobe(s).
I’m glad that you are doing well.
It’s also good to hear that the SBRT works well too.
I’m going to have to choose soon.

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mayocid1 | @mayocid1 | Apr 19, 2023
In reply to @lls8000 "Hi @mayocid1, Welcome to Mayo Connect! Getting this type of diagnosis is always such a shock,..." + (show)
@lls8000

Hi @mayocid1, Welcome to Mayo Connect! Getting this type of diagnosis is always such a shock, it's completely normal to need some help in processing the weight of the situation, and then they hit you with big decisions to be made! It is overwhelming.
Surgery and SBRT are both common options, and both can be effective. (SBRT Info: https://www.mayoclinic.org/tests-procedures/sbrt/pyc-20446794)
Personally, I haven't been presented with a decision like this yet. I'll likely face something similar in the future when my cancer returns, and I think I would certainly lean toward SBRT. I don't like the idea of sedation and recovering from a major surgery. I'm currently treated with a targeted therapy, and I'm now considered NED (no evidence of disease). I've seen the power of treatments other than surgery, so I'll be open to SBRT.
It sounds like you've had your share of surgeries, so you likely know what it's like to recover.
We all need to make our own decisions, and both sound like good options for you. How large is your primary tumor? When do you need to make a decision?

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It is 1.5 x 1.1 cm.
They wanted me to make a decision last week.
I’m still doing other tests they want and trying to set up a second opinion. My regular doctors told me I should do this. Not an easy assignment. The other hospital set me up with an appointment with a doc that doesn’t do lung cancer. I’m trying to go through an other area of the hospital and find a correct doctor.

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mayocid1 | @mayocid1 | Apr 19, 2023
In reply to @franciekid "Nancy, I’m 78. Robotic surgery went very well. I have a few small - 1 inch..." + (show)
@franciekid

Nancy, I’m 78. Robotic surgery went very well. I have a few small - 1 inch or so - incisions in my side and one slightly bigger where the chest tube was. I had a segment of my right lung removed - not an entire lobe - and my breathing is fine. I am coughing, which I think is not unusual, and my
ribs in front are tender, but I’m doing well. I walked 5 miles one day last week - 3 weeks after surgery. I had a small nodule, so oncologist and thoracic surgeon agreed surgery was the best course. I start chemo next week. My Stage is 1b, so I was lucky. My best wishes to you.

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Mine is also 1b. They recommend surgery or SBRT my choice. No chemo.
Why do they suggest surgery and chemo for you?
I think I’m going to put them off while I ask more questions.

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cmcguire10 | @cmcguire10 | Apr 19, 2023
In reply to @mayocid1 "It is 1.5 x 1.1 cm. They wanted me to make a decision last week. I’m..." + (show)
@mayocid1

It is 1.5 x 1.1 cm.
They wanted me to make a decision last week.
I’m still doing other tests they want and trying to set up a second opinion. My regular doctors told me I should do this. Not an easy assignment. The other hospital set me up with an appointment with a doc that doesn’t do lung cancer. I’m trying to go through an other area of the hospital and find a correct doctor.

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Have you completed a lung function test and an echocardiogram stress test yet? If they are pushing you to choose, they should have ordered these for you, so that you can be sure that surgery is even an option. One of the reasons my Aunt had SBRT was because her heart could not have handled the surgery on her lungs. I see you “name” is Mayocid1 but I’m assuming you are not being seen by Mayo Clinic?

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cmcguire10 | @cmcguire10 | Apr 19, 2023
In reply to @franciekid "Nancy, I’m 78. Robotic surgery went very well. I have a few small - 1 inch..." + (show)
@franciekid

Nancy, I’m 78. Robotic surgery went very well. I have a few small - 1 inch or so - incisions in my side and one slightly bigger where the chest tube was. I had a segment of my right lung removed - not an entire lobe - and my breathing is fine. I am coughing, which I think is not unusual, and my
ribs in front are tender, but I’m doing well. I walked 5 miles one day last week - 3 weeks after surgery. I had a small nodule, so oncologist and thoracic surgeon agreed surgery was the best course. I start chemo next week. My Stage is 1b, so I was lucky. My best wishes to you.

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Franciekid! Great to hear everything is good for you! You and I must have had our surgeries about a week apart! I am curios like mayocid1, why are your Oncologist and Dr. having you go through Chemo if you had a small nodule and at stage 1? I asked my Surgeon about me needing chemo or anything and she said no because I was at a 1a and they don’t usually need to do chemo or that on stage 1a or 1b. Like I said, just wondering???

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franciekid | @franciekid | Apr 19, 2023
In reply to @cmcguire10 "Franciekid! Great to hear everything is good for you! You and I must have had our..." + (show)
@cmcguire10

Franciekid! Great to hear everything is good for you! You and I must have had our surgeries about a week apart! I am curios like mayocid1, why are your Oncologist and Dr. having you go through Chemo if you had a small nodule and at stage 1? I asked my Surgeon about me needing chemo or anything and she said no because I was at a 1a and they don’t usually need to do chemo or that on stage 1a or 1b. Like I said, just wondering???

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My stage is 1b but I have lymphovascular and pleural invasion, which means some cancer cells could not be removed with surgery. So although prognosis is excellent, the oncologist thinks chemo is warranted. I have EGFR mutation related cancer and will also be taking Tagrisso targeted therapy - one pill a day - for 3 years. She is expecting a cure.

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mistyl | @mistyl | Apr 20, 2023

I was also 1b. I had my right lower lobe removed and had clear margins. not other treatment. Curious about chemo as well....

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cmcguire10 | @cmcguire10 | Apr 20, 2023
In reply to @franciekid "My stage is 1b but I have lymphovascular and pleural invasion, which means some cancer cells..." + (show)
@franciekid

My stage is 1b but I have lymphovascular and pleural invasion, which means some cancer cells could not be removed with surgery. So although prognosis is excellent, the oncologist thinks chemo is warranted. I have EGFR mutation related cancer and will also be taking Tagrisso targeted therapy - one pill a day - for 3 years. She is expecting a cure.

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Thank you for the explanation! I am trying to understand all I can about all the different cases so if something new comes up with me, I might be able to have a better idea of what to expect. I wish you the best of luck and God Bless You!

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bluelagoon | @bluelagoon | Apr 20, 2023
In reply to @mayocid1 "As I understand, I am at 1b. Yes, my surgeon uses the robotic method also. You..." + (show)
@mayocid1

As I understand, I am at 1b.
Yes, my surgeon uses the robotic method also.
You are a still cut open, your ribs are pried apart, lobe removed. Lung may deflate, etc.
I am afraid of trying to recover and being able to breath after the surgery. I have heard of some that didn’t go well.
Did your doctors recommend the SBRT radiation instead of surgery?
I’m 70.
Nancy

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@mayocid1 Hi, Nancy! 5 years ago, I was diagnosed as a 2b. The local surgeon wanted to do a lobectomy and said I would be in the hospital for a week, with the first 2 nights in ICU. That sounded extreme since we had been following since before it was big enough to biopsy, so we sought an opinion at Mayo. A gifted surgeon said with my existing COPD that he did not want to take out that much lung. He recommended removing the wedge with the cancer and the 2 wedges around it. They went in through the back with minimal rib involvement. They had me up walking the first night and out in 4 days. It did spread to one lymph node, so I returned for 4 chemo treatments. And this week I returned for my 5-year check-up, where I remain clear! Yippee!!
The only issue I had with my lung deflating was during the initial biopsy at my local hospital where my lung partially collapsed. Since you are still not comfortable with your choices, would you consider getting another opinion? If travelling to one of the biggies isn't realistic, can you check to see which is the best facility in your area? It wasn't until this happened to me that I saw how dismal the hospital connected to my regular doctor was with lung cancer compared to another nearby hospital. And, how much more expensive it would have cost for the stay they had planned!

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franciekid | @franciekid | Apr 20, 2023
In reply to @cmcguire10 "Thank you for the explanation! I am trying to understand all I can about all the..." + (show)
@cmcguire10

Thank you for the explanation! I am trying to understand all I can about all the different cases so if something new comes up with me, I might be able to have a better idea of what to expect. I wish you the best of luck and God Bless You!

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Thank you. Dana Farber has a forum for people with EGFR cancer. You can check their website for more information.

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