Can radiation be repeated for lung cancer in same site after exactly 5 years
My Dad has a left lung cancer in lower lobe. First diagnosed in 2016 and treated with a couple of chemotherapies and radiation therapy done in March/April 2017( (55Gy in 22 fractions, Equivalent to 60 Gy). And Since February 2019(the last 3 years) my dad has been using Nitendinab tablets(Europe medicine) and his health has been stable for the last 3 years. Recently CT and PET scan reports showed an increase in tumor size in the same site and the tumor size is 47X43X40 mm (6 months before it was 31x28x35 mm). So he did a liquid Biopsy lung panel test and got KRAS G12A positive. Looks like no targeted therapy available for this mutation. Doctors in one hospital suggested chemotherapy and doctors in another hospital suggested Radiation therapy(IMRT). Not sure which one to choose. Can you please let me know if there is any targeted therapy available? Or which one to go with chemotherapy or Radiation? Also Can the radiation be repeated for lung cancer in the same site? Please advise
I am so sorry your Dad's cancer came back. I am going through the same thing now myself and just had a wedge resection of my lower left lobe. It was also Kras (G12C), but it was caught early and removed by surgery. My first primary was 22 years ago, that turned out to be a completely different mutation, so I am not eligible for any targeted therapy either. I was told I was probably a candidate for surgery or radiation (SBRT) if those nodules start growing. No one can advise you which to choose, but I would get a few opinions from thoracic oncologists at different hospitals as well as radiation oncologists and get all the information you can. I'm not sure how the medical system is in Europe, but more than one opinion is always good when able. Have you navigated around our site and read stories from other members who had radiation? Please let me know if you would like any links to articles or if you have found them on your own. There should be quite a few. Hopefully others will join in this discussion with some suggestions. Wishing you all the best, Alisa, LungCancer.net Team 
Hi
. Sorry to hear your Dad's tumor has grown. The question of whether a tumor can be treated with radiation a second time is complicated. As noted in this page from the National Cancer Institute, there is a limit to how much radiation an area of the body can take: https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy#LDL. Sometimes the an area can be radiated again. A number of variables go into the decision, such as the amount of scarring and, of course, the number of RADs. This is a long way of saying that it is important to ask any radiologist why they think it is o.k. to radiate again. Also, while it is true that there is no targeted therapy for KRAS G12A, I did find this research article about the efficacy of immune checkpoint inhibitors: https://www.sciencedirect.com/science/article/pii/S1556086419300401. This may be worth asking his doctors about. Wishing you and your father the best and please feel free, if you like, to keep us posted or ask additional questions. Richard (LungCancer.net Team) 
Sorry to hear that your dad's cancer has returned. I would say 3 is the charm in seeking guidance on which to go with. You have some very valid points and they should be addressed or addressed with the doctors. It's okay to share your concerns and reservations with the medical team, both processes can be grueling to the body, and having an open conversation about it with the doctors is the first step. I hope everything works out. Wishing to the very best!
