[Joan M]

I have had both VATS and lung RFA.

If your oncologist is not interested in these procedures, my only suggestion is that if you are, you should go directly to both a thorasic surgeon (VATS) or an interventional radiologist to get their opinion (IR doc for an RFA, or in the case of the liver, RFA and cryoablation, or freezing the tumor instead of burning it). However, keep in mind that a surgeon wants to do surgery and an IR doc wants to do RFA and in the liver, cryoablation.

When my bc advanced, I was getting Herceptin in a local hospital and consulting at a major, world-renown cancer center in NYC, and the breast oncology service there is dead set against these procedures (my local onc was not. And she is not only an onc, but also has a doctorate in molecular biology in cancer. Perhaps she has another perspective because of that). I went on my own directly to the surgeon and IR docs bypassing the doc I was consulting with. In the 11th hour, the oncologist who I was consulting with however found out that I was having a lung RFA and tried to stop it, saying to the IR doc, "what are you doing? This is not standard of care for metastatic breast cancer." The IR doc told me that he and the onc "agreed" that this is what the patient wants to do. (I had the VATS at another major hospital in NYC, but not at the world-renowned one.) In my own humble opinion, I'm not dead set against any of our options, but feel that each patient should be evaluated on a case-by-case basis until a systemic cure is found.

I eventually switched over to the world-renowned hospital with another onc on the breast service (the consultant is one of the top dogs in that service), but during the year I was worrying so much about not having these options that I switched to the major hospital where I had the VATS. The onc I have there is a top, metastatic doc. And now I don't have to worry and dread discussing these treatment options on my cancer advancing.

On that note, for a lung RFA it's better to be in a major cancer center where the procedure has been done many times. However, major cancer centers are known to be very conservative in treatments (generally following NCCN guidelines) even though they are outstanding in research, have the latest equipment, and employ oncs, docs, and technicians who know how to use that equipment.

If you are interested in RFA send me a PM, and I will ask the IR doc for a referral in your area.

Anna, I do not have any thoughts about the questionable area on the outer edges. However, I would get a copy of that report and then ask your oncologist to explain what that means. And keep asking until you get an answer that you're satisfied with. I get copies of every scan and blood work results, just in case I have any questions.

And ask the Lord for strength because we cancer patients often need that in not only coping with our advanced cancer but dealing with oncs and hospitals. At times it has been extremely distressing for me.

Joan