Chemo Now or Later?

3 months ago, they found 2 nodules in my lung (6mm & 3mm). They were only able to removed the 6mm one since the 3mm was too small. Right now I'm a bit unsure of what to do.

My cardiothoracic surgeon says that since the nodule was removed with clean margins, it would be best to wait 3 months, get a CT, and see what happens then.

My chemo doctor says that we should start on ifosfamide (6 cycles).

I'm split between the two. Part of me wants to do the chemo route, but the last time I was on chemo, I ended up with heart failure & sepsis. I barely made it out alive. At the same time, I don't want to put it off because I'm afraid if I wait too long the chemo drug won't be effective, and the cancer will not be controllable.

Any advice is much appreciated. Thank you so much!

Have you asked about the possibility of RFA on the small met. Where are you located?

Where are you being treated Is it a Sarcoma centre or just a cancer centre?

I have had a 5mm lung met after 3 years NED. with a synovial sarcoma site on the top outside apex of my right lung.

the latest scan yesterday showed the lung met to have got more dense and increased in size but only by 1mm. they want to remove it. NO mention has been made of chemo.
I did not have surgery for the first gremlin as it was wrapped round some vital nerves and blood supply.
So I am not happy that I now have to have it. BUT my oncologist ( specialist in UK) at the Royal Marsden says they do not want to leave it as it may seed. So I can understand your concerns>
Where was your original site and what chemo did you have.
I had one dose of Ifos and Dox but a rare side effect of total liver failure, I don;t do ordinary! so continued with 5 more doses of Doxorubicin only. which worked well. then 32 of radiation.

I think, and understand this is a personal experience that the chemo will certainly work later, my original site was 11cm like an apple, then with a 6 cm wide 'stalk' growing up into my throat. and the chemo got that down to 5cm lump with no stalk at all. so you see what it can do! my original site is still shrinking and is now just over 4cm by 2 cm so radiation carries on working over a long time.

I don;t know if this helps. but please answer the questions.

HUGS

My husband has 2 spots on his lungs from the sarcoma too. He is having his PET scan done right now, and after he get's the results will be starting the new pantzopanib chemo pill. It has been approved by the FDA for synovial sarcoma and it isn't as poisonous as the other stuff we hope. He's been fighting this for 6 years now. If you have insurance check to see if they'll pay for it as it runs $7000 a month, yeah that's with 3 zeros. Check into it ok. Good luck. Linda

I think chemo is worth it, I also have mets and had ifos & doxy chemo and I beleive chemo makes a difference and worth doing. It’s a pretty tough treatment, good luck. This doesn’t stop you doing surgery later if it developes so effectively your able to do both.

How big is the 3mm nodule now? If it is still too small to remove it means it is growing very slowly and it is unlikely the chemo will do anything (ifosfamide is supposed to work better on fast dividing cells). I've been in this situation several times and waited. Once I waited for one year before the tumor was ripe...

@ Shirley- I'm being treated at the Stanford Cancer Center.

@ Elodie- I will be having another CT to determine how large the 3mm nodule is now, and go from there.

Thank you everyone for all of the advice. I really do appreciate the time you guys took to respond back to me. I will definitely take everything you said into consideration as I move forward with my treatment. Wishing you all lots of love and good health.

My husband is now on panzopanib and not sick at all check out this new treatment, it's as pill and you can take it at home. Good luck.