Preparing for Surgery

As a stage IV lung cancer patient, I never thought surgery would be an option for me. In addition to my primary tumor in the right upper lobe of my lung, I had other small nodules in my lungs, a pleural effusion, brain metastases, and bone metastases when I was first diagnosed in 2013. My hopes for the past six plus years have centered on managing my cancer as a chronic disease and praying my medication continues working until a new one is discovered.

Results from my latest PET scan

At my regularly scheduled appointment in January, my oncologist mentioned that this might be a good time for me to get a PET scan. While some people living with cancer get frequent PET scans, my oncologist doesn’t order them routinely. I only had one previous PET scan — when I was first diagnosed.

However, I have not experienced cancer growth anywhere other than progression in my main tumor in 2016, which was resolved with a change in my targeted therapy medication. My oncologist somewhat casually mentioned that if the only spot that lights up in the PET scan is this primary tumor in my right lung, maybe we could consider radiating it.

A lobectomy was now an option

After several insurance denials and appeals, I had a PET scan and that was exactly what happened. The only spot that lit up was my original tumor. There was even a statement on the PET scan that read “no evidence of local or distant metastatic disease.” Naturally, I really liked seeing that! I had another surprise in store when I met with my oncologist: she told me that a lobectomy of my upper right lobe could now be an option for me. This would be considered “local consolidative therapy” and might lead to an improved future prognosis for me.

All thanks to research in treatment advancements

In the recent past, there has been an increased interest among lung cancer researchers in local consolidative therapy (LCT). Studies have been done that seem to indicate improved outcomes for late stage patients with limited areas of residual disease who are treated with surgery and/or radiation. This a good article to read to learn more about one of these studies: Overall Survival With Local Consolidative Therapy in Oligometastatic NSCLC.

Preparing for surgery

Things began to happen very fast at this point. Once I told my oncologist that yes, I would be interested in surgery, I found out that I had several other “tests” to pass before I would definitely qualify. I would need a pulmonary function test, a repeat brain MRI (my last one was more than 30 days prior) and a bronchoscopy procedure under general anesthesia called an EBUS to make sure that I did not have microscopic disease in my lymph nodes. Waiting for the results from the EBUS, my final test, really stressed me out but I finally got an all clear!

Feeling excited and terrified...

I’m writing this the day before my scheduled surgery. I’m excited, terrified and experiencing about a half dozen other mixed emotions! I’ve never had a major surgery before and am not really sure what to expect regarding pain and recovery post-surgery. I’ve spoken to a number of others who have had similar surgeries and have heard comments ranging from “a piece of cake” to “I didn’t drive for 6 weeks because I had so much pain that I stayed on pain pills that long.”

Please stay tuned to read my post-surgery article when I will share information about my recovery!

Editor’s Note: We are extremely saddened to say that on June 23, 2024, Ivy Elkins passed away. Ivy’s advocacy efforts and writing continue to reach many. She will be deeply missed.