Thank you all for your precious opinon !!
I will contact my doctor to reschedule my mri scan.
Seth from South Korea, Dx november 2017
Re: Seth from South Korea, Dx november 2017
Dr. Drewes sent me his opinion about lung syrgery. My lung mets are small, but my lymph nodules are too central for lung laser surgery..ㅠㅠ
My next plan for lung and lymph nodules is brachytherapy plus keytruda. For brachytherapy, I should go to LA!
My next plan for lung and lymph nodules is brachytherapy plus keytruda. For brachytherapy, I should go to LA!
Re: Seth from South Korea, Dx november 2017
Hi Seth
Are you performing Dr.Drewes laser surgery first?
I’m not convinced of the brachetonomy ...
It’s used mainly for folks who have an expected short life expectancy ? That’s not you I believe . : /
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643732/
Asps is very radio resistant/chemo resistant meaning it takes a lot more of the above to kill it.
How many and where exactly are the lymph node / lung tumors located ?
Are you performing Dr.Drewes laser surgery first?
I’m not convinced of the brachetonomy ...
It’s used mainly for folks who have an expected short life expectancy ? That’s not you I believe . : /
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643732/
Asps is very radio resistant/chemo resistant meaning it takes a lot more of the above to kill it.
How many and where exactly are the lymph node / lung tumors located ?
Debbie
Re: Seth from South Korea, Dx november 2017
Yes, i had not any treatment for my lung/lymph nodules.
As I recall, George in this forum had brachytherapy for his lung met. In China, iodine seed is implanted, but in US palladium seed is implanted. I know asps is radio resistant. However, since my skull met reacted to cyberknife, i think there might be hope. Also, Korean ACC patients who took a brachytherapy in US had good result. ACC is a radio and chemo resistant, but slow growing cancer like asps.
My lung mets are few mm, except one met that is 1cm. There are 10-20 mets in my lung.
My lymph nodules exist around both bronchial tubes, and they are 2-4 cm size.
As I recall, George in this forum had brachytherapy for his lung met. In China, iodine seed is implanted, but in US palladium seed is implanted. I know asps is radio resistant. However, since my skull met reacted to cyberknife, i think there might be hope. Also, Korean ACC patients who took a brachytherapy in US had good result. ACC is a radio and chemo resistant, but slow growing cancer like asps.
My lung mets are few mm, except one met that is 1cm. There are 10-20 mets in my lung.
My lymph nodules exist around both bronchial tubes, and they are 2-4 cm size.
Re: Seth from South Korea, Dx november 2017
Hello again Seth
I’m not knowledgeable enough of the max size that this radioactive procedure can be performed, but I would guess that a rather large particle would have to be implanted , on both of the tumors ?
Sending your scans to the doctor to review might not be a bad move?
At least get their opinion ?
Ask how many procedures they have done and the risks of treating tumors this size might be ?
I know you are just trying to get treatment and I know how scary and how there is a need , a sense of urgency to do something . I’m sorry if I’ve discouraged you .
I just want you to be careful and get all the information you can before you jump into a treatment .
Please don’t be discouraged.
I’m not knowledgeable enough of the max size that this radioactive procedure can be performed, but I would guess that a rather large particle would have to be implanted , on both of the tumors ?
Sending your scans to the doctor to review might not be a bad move?
At least get their opinion ?
Ask how many procedures they have done and the risks of treating tumors this size might be ?
I know you are just trying to get treatment and I know how scary and how there is a need , a sense of urgency to do something . I’m sorry if I’ve discouraged you .
I just want you to be careful and get all the information you can before you jump into a treatment .
Please don’t be discouraged.
Debbie
Re: Seth from South Korea, Dx november 2017
I already sent my cy scan to brachytherapy doctor, and he said it’s possible. To large met, he implanting more seed not bigger seed. He said, “optimal” size for brachytherapy is 3cm. He is the most skillful brachytherapy doctor in the world(like dr. Littrup in cryo). For implanting the seed, doctor uses thinner needle than cryo. So, the most dangerous side effect is pneumothorax.
I’m not discouraged! In deciding treatment option, safety is the most important thing. Debbie, i always thank you for your kindness opinion!!
I’m not discouraged! In deciding treatment option, safety is the most important thing. Debbie, i always thank you for your kindness opinion!!
Re: Seth from South Korea, Dx november 2017
Seth, the reason this dr from US said the best size for his procedure is 30 mm is that is used in advanced, palliative situation when other options are not avail. Yes, it is possible but not optimal in your case as it is invasive and damages the lungs - when people have a limited life expectancy it is acceptable, but in ASPS cases the life expectancy is long even in advanced cases so it is not acceptable. Have you consulted Dr.Littrup or Dr.Aoun re. possible cryo for the central 10 mm met/lymph node? Otherwise you can have a CyberKnife radiosurgery for it. Unless you want to start Keytruda and see if you might respond.
George in this forum had brachytherapy, but not for his lung met I think, and it is not one of the recommended treatments for ASPS.
George in this forum had brachytherapy, but not for his lung met I think, and it is not one of the recommended treatments for ASPS.
Olga
Re: Seth from South Korea, Dx november 2017
Korean patients who took brachytherapy in US said side effects of brachytherapy is much less than radiosurgery and most of their implanted mets are treated. This is why I try to take a brachytherapy rather than cyberknife!!Olga wrote:Seth, the reason this dr from US said the best size for his procedure is 30 mm is that is used in advanced, palliative situation when other options are not avail. Yes, it is possible but not optimal in your case as it is invasive and damages the lungs - when people have a limited life expectancy it is acceptable, but in ASPS cases the life expectancy is long even in advanced cases so it is not acceptable. Have you consulted Dr.Littrup or Dr.Aoun re. possible cryo for the central 10 mm met/lymph node? Otherwise you can have a CyberKnife radiosurgery for it. Unless you want to start Keytruda and see if you might respond.
George in this forum had brachytherapy, but not for his lung met I think, and it is not one of the recommended treatments for ASPS.
“The theory is to plantation theI_125 particles with radioactivity into the mets by a probe a little smaller than the one using for Cyroablation. The particles will stay in the mets and radioates continously with half-life of 60 days. Geroge had this treatment in 2009, and it looked very effective. The biggest met (~2cm) at that time shrinked to nothing in the CT scans 3 month and 6 month later.
But it's said this radioactive treatment will cause radiation pneumonia which is more tough than ASAP, although there are so many hospital in China is carrying out this treatment.”
It’s from http://www.cureasps.org/forum/viewtopic.php?f=4&t=752.
I’ve not consulted with dr. Littrup or Aoun. Instead, I’ve consulted with cryo doctor in Korea. He said because of location of nodules(around bronchist tubes), there might be a damage to normal tissues. Because dr. Littrup is the best cryo doctor, so his opinion is more precise.
I should contact with dr. Littrup before make a decision.
Thank you so much Olga!!
Re: Seth from South Korea, Dx november 2017
I think it’s too difficult to contact with dr. Littrup in Korea. I will contact with dr. Aoun first! thank you again Olga.
Re: Seth from South Korea, Dx november 2017
Dr.Aoun and Dr.Littrup worked as one team before, Dr.Littrup was a teacher to Dr.Aoun - long time ago. So when you consult Dr.Aoun, if this case is to difficult to him, you can ask that they discuss your case with Dr.Littrup as well. New cryo probes are pretty thin. When the doctor is very experienced, the danger of the pneumothorax is low.
Re. Radiosurgery being more damaging than brachytherapy by the opinion of the Korean patients. It is not directly comparable - the size and the location and the experience of the doctor - they all affect the outcome.
Re. Radiosurgery being more damaging than brachytherapy by the opinion of the Korean patients. It is not directly comparable - the size and the location and the experience of the doctor - they all affect the outcome.
Olga
Re: Seth from South Korea, Dx november 2017
Hi,
George did had brachytherapy to the lung mets, but the mets were less than 2cm. If your mets are 4cm, that means it need 8 times of the seeds than the 2cm mets! So the radiactive damage is a big concern.
Many Chinese patient have Cyber knife to treat the lung mets, most of them get radiation pneumonia even the met is about 2cm. The bigger the met is, more serious the radiation pneumonia is. Cyber Knife is not a good option for lungs.
Actually, Cyber knife is not a good option for Kidney mets either, because of the damage around the met. Recently I just realize that George's right kidney is atrophy due to the cyberknife he had in 2014. Because another ASPS patient who also had radiosurgery to kidney mets also had kidney atrophy.
Dr. Niu in China does huge case of cryoablation. If you have financial concerns of having cryoablation in US, maybe you can ask him as well.
George did had brachytherapy to the lung mets, but the mets were less than 2cm. If your mets are 4cm, that means it need 8 times of the seeds than the 2cm mets! So the radiactive damage is a big concern.
Many Chinese patient have Cyber knife to treat the lung mets, most of them get radiation pneumonia even the met is about 2cm. The bigger the met is, more serious the radiation pneumonia is. Cyber Knife is not a good option for lungs.
Actually, Cyber knife is not a good option for Kidney mets either, because of the damage around the met. Recently I just realize that George's right kidney is atrophy due to the cyberknife he had in 2014. Because another ASPS patient who also had radiosurgery to kidney mets also had kidney atrophy.
Dr. Niu in China does huge case of cryoablation. If you have financial concerns of having cryoablation in US, maybe you can ask him as well.
Re: Seth from South Korea, Dx november 2017
I sent email to dr. Aoun’s secretary, but she is on a vacation. I will send email again when she comeback.Olga wrote:Dr.Aoun and Dr.Littrup worked as one team before, Dr.Littrup was a teacher to Dr.Aoun - long time ago. So when you consult Dr.Aoun, if this case is to difficult to him, you can ask that they discuss your case with Dr.Littrup as well. New cryo probes are pretty thin. When the doctor is very experienced, the danger of the pneumothorax is low.
Re. Radiosurgery being more damaging than brachytherapy by the opinion of the Korean patients. It is not directly comparable - the size and the location and the experience of the doctor - they all affect the outcome.
I understand your advise. I should discuss about side sffects with brachytherapy doctor and cyberknife doctor. Thank you always Olga.
Re: Seth from South Korea, Dx november 2017
Hi Jorge!! Thank you for sharing George’s experience. It’s really helpful. Did George had side effect when he was treated with brachytherapy?Jorge wrote:Hi,
George did had brachytherapy to the lung mets, but the mets were less than 2cm. If your mets are 4cm, that means it need 8 times of the seeds than the 2cm mets! So the radiactive damage is a big concern.
Many Chinese patient have Cyber knife to treat the lung mets, most of them get radiation pneumonia even the met is about 2cm. The bigger the met is, more serious the radiation pneumonia is. Cyber Knife is not a good option for lungs.
Actually, Cyber knife is not a good option for Kidney mets either, because of the damage around the met. Recently I just realize that George's right kidney is atrophy due to the cyberknife he had in 2014. Because another ASPS patient who also had radiosurgery to kidney mets also had kidney atrophy.
Dr. Niu in China does huge case of cryoablation. If you have financial concerns of having cryoablation in US, maybe you can ask him as well.
Some patients in Korea go to FUDA hospital in China to take a cryo. They said the director of FUDA hospital is president of “World Cryoabalation Academy”. Do you know about FUDA hospital? Thank you again Jorge!!
Re: Seth from South Korea, Dx november 2017
Yes, I know Fuda hospital. George had 2 cryoablation there.
Dr. Niu is director of that hospital. They have rich experience of brachytherapy as well. If you're going to consult him, ask in what degree can the met be ablated--completely or like 70%.
There was a dangerous complication in the course of the procedure because the doctor was lack of experience. One of the met George had brachytherapy was very close to the heart. The pericardium was pierced and filled with blood, which made the heart beat dropped to ~50.
other than this, there was not other side effects as his mets were small.
Dr. Niu is director of that hospital. They have rich experience of brachytherapy as well. If you're going to consult him, ask in what degree can the met be ablated--completely or like 70%.
There was a dangerous complication in the course of the procedure because the doctor was lack of experience. One of the met George had brachytherapy was very close to the heart. The pericardium was pierced and filled with blood, which made the heart beat dropped to ~50.
other than this, there was not other side effects as his mets were small.
Re: Seth from South Korea, Dx november 2017
Seth
How many lymph nodes centralized tumors are there?
http://www.cureasps.org/forum/viewtopic ... 507#p12471
How many lymph nodes centralized tumors are there?
“My lymph nodules exist around both bronchial tubes, and they are 2-4 cm”
http://www.cureasps.org/forum/viewtopic ... 507#p12471
Debbie