Chemo with prior frequent bladder/kidney infections?

Posted by sharon72 @sharonsturdivan, Sep 12 9:06am

Hello, I am new here and looking for advise regarding chemo/immunotherapy with resection, when you have a history of frequent bladder/kidney infections. Been dianosed with 2B NSCLC (4.5 cm) . Bronchoscope test shows it has not spread. However current lung function is not the greatest due to COPD prior to quitting smoking 10 years ago. Biggest issue for treatment is that the mass itself is lower right lobe AND resting up against the rib cage. Options I am being given are . 1) Lower lobe removal surgery now, with follow up of immunotherapy for a year with the possibility of some chemo. May have to be open surgery and 1 or 2 ribs taken to reach the mass. 2) 3+ rounds of aggressive chemo/immunotherapy, then lobe removal, then immunotherapy for at least a year. The idea being that if they shrink the mass AND it happens to pull away from the rib cage, they won't have to remove the rib, nor do open surgery. I have frequent UTI and have for the past 10 years. I am reading that both chemo/immunotherapy are hard on the kidneys and bladder. I'm struggling with which way to go, because of the chemo/immunotherapy as well as the idea of open surgery and the pain residual it may cause. Anyone have any suggestions or experience with these issues? Thank you in advance for any information you can share. I am feeling alone and very scared!

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Hi Sharon, @sharonsturdivan, welcome. These decisions are tough. I'm facing a surgical decision, unrelated to my lung cancer, and I'm finding that I come up with new questions every day. I try to weed through those looking for the ones that are most important based on where I'm at in this process, and I pass those along to my doctor or nurse. My team has been receptive and are responsive to those. Do you feel that your questions to your doctors have been answered? Have they given you an idea of how well your kidneys may tolerate the chemo and/or immunotherapy, especially an aggressive dose? Cancer meds in general can be hard of our kidneys and liver. My targeted therapy causes my liver and kidney numbers to go up any down. Lots of water helps, but it can only do so much.

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@lls8000

Hi Sharon, @sharonsturdivan, welcome. These decisions are tough. I'm facing a surgical decision, unrelated to my lung cancer, and I'm finding that I come up with new questions every day. I try to weed through those looking for the ones that are most important based on where I'm at in this process, and I pass those along to my doctor or nurse. My team has been receptive and are responsive to those. Do you feel that your questions to your doctors have been answered? Have they given you an idea of how well your kidneys may tolerate the chemo and/or immunotherapy, especially an aggressive dose? Cancer meds in general can be hard of our kidneys and liver. My targeted therapy causes my liver and kidney numbers to go up any down. Lots of water helps, but it can only do so much.

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Thank you for your reply Lisa. No the doctors just say that it won't be an issue. They are pushing chemo very hard. I searched my heart and gut and decided to do the surgery WITHOUT prior chemo. Was told to contact the surgeon to be sure he will do it without chemo, even though he told me he would. Of course he is currently on vacation and I can't talk to him or schedule anything.
I think my struggles in all of this is like some many others here. Doctor's arent receptive to a plan other than theirs and they don't reply to questions/concerns in a timely manner. It sure make all of this harder 🙁

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Hi Sharon,

I just saw that you made a decision. Trust yourself, and know whatever decision you make is the right one.

My surgeon wanted me to have chemo first to shrink my tumors. It did work. They shrunk. I had 4 sessions of chemo. Then waited about 8 weeks and had the lobectomy.

Everyone's treatment is different. yet we all go through the same decision process, isolation, worries, etc.

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Thank you April. I really appreciate you word of encouragement. Surgery is set for Oct 11th. Going to try to do robotic but if the mass is still resting on the rib and won't move, then they will move forward with open surgery. Although I havent had a CT scan in a several weeks, to me it feels like it has moved away from the rib. (pain there was how it was discovered in the first place). Now it feels like it as moved closer to the middle of the lung. I am just hoping that it doesnt mean that it has grown larger rather than moved. 🙁

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@sharonsturdivan

Thank you April. I really appreciate you word of encouragement. Surgery is set for Oct 11th. Going to try to do robotic but if the mass is still resting on the rib and won't move, then they will move forward with open surgery. Although I havent had a CT scan in a several weeks, to me it feels like it has moved away from the rib. (pain there was how it was discovered in the first place). Now it feels like it as moved closer to the middle of the lung. I am just hoping that it doesnt mean that it has grown larger rather than moved. 🙁

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Hi Sharon, keep us posted on how the surgery goes-
I had a lobectomy (lower left lobe), and some lymph nodes removed in October 2023.
You are in good hands- trust your team and yourself- it sounds like you do-

april

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@sharonsturdivan

Thank you April. I really appreciate you word of encouragement. Surgery is set for Oct 11th. Going to try to do robotic but if the mass is still resting on the rib and won't move, then they will move forward with open surgery. Although I havent had a CT scan in a several weeks, to me it feels like it has moved away from the rib. (pain there was how it was discovered in the first place). Now it feels like it as moved closer to the middle of the lung. I am just hoping that it doesnt mean that it has grown larger rather than moved. 🙁

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Sharon72, wishing you strength and good luck with your October surgery today. Had a lobectomy just two months ago. The tough recovery will be ahead of you but focus on each day and be kind to yourself. You will grow stronger each day. Let us know how you are doing when you are feeling up to it.

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I use estradiol cream regularly per my urologist and continued through lung cancer surgery, no chemotherapy started yet, but have used that cream since menopause after a botched bladder sling (corrected later) helped me minimize UTIs significantly.

Applying coconut oil topically along with that daily per my urologist helped me to avoid dryness/itching and I was told it was antibacterial. The cranberry and other stuff on the market didn't help and I also had to use antibiotics at a low dose daily as a preventative that helped for years..

I too am concerned about the effects of chemo on my bladder long term and I haven't begun chem just yet—soon—cisplatin and pemetrexed are being offered. I can't find much research or studies on lung cancer treatment and UTIs except that they can happen, more with chemotherapy (??) so will be talking more with my urologist and primary care physician. It won't stop me from doing chemo probably. I am more afraid of lung cancer recurrence and can probably handle the UTIs as long as I use antibiotics and don't let it get away from me. Never sure though.

Can't do immunotherapy supposedly with a negative marker (which I am not versed in.) More questions than answers, but thought I'd throw my two cents worth in regarding UTI issues you brought up before doing my chemotherapy...or not.This info may or may not be helpful regarding what you are looking for. I always want to be careful sharing what works for me. Let me know if you or anyone else has more info or research on it. Best of luck with your journey and treatment.

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UPDATE: Local Cancer center refused to do any pre-op treatment that did not included chemo, which I refused to have. They sent me straight to surgery with the "hope" I wouldn't need an open surgery to remove 4 cm mass, right lung, up against the rib cage. Which was booked from Oct. 11th.
I got a rapid second opinion from another center ( 4hrs from home). They agreed with the staging, and offered to be immunotherapy without chemo. I went back to the local center to see if they would do immunotherapy without chemo using the same immunotherapy drugs. It took them 1.5 weeks but they ultimately refused. To say the least its been a stressful late few weeks.
I contacted the second cancer center and transferred my care to them. Contacted the surgeon and put surgery on hold. I am waiting now for the local hospital to set an appointment for a port and for insurance approval. Should all happen in the next 2 weeks, then we will drive 4 hrs one way for immunotherapy, bi-weekly for a month.
Hopefully the immunotherapy with shrink the mass away from the ribs to allow for robotic surgery rather than open.
Thank you everyone for your encouragements as I move along this road too. If it wasn't for this site, I'm not sure I would have mentally made it this far. You are all amazing!

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