I just had a ct, which showed tumor growth, so we are changing from Yondelis to dacarbazine. The CT also showed a "possibly metastatic" lung nodule, 19mm in size. My oncologist doesn't seem too worried about it. I guess we'll monitor it for growth. How big does the tumor need ti be before they perform surgery or do localized radiation. Hopefully the dacarbazine will just kill it off. Still, I'd rather be prepared for the worst.
A 19mm nodule should be big enough to be removed. But it is common to follow-up with a scan instead of removing right away especially if they are not totally sure it is cancer...
Dacarbazine is not commonly used for synovial sarcoma but a few of our members have tried it. You can find it mentioned in a few discussions. For example:
Well we're running out of chemo options at this point.
How do they typically remove 19mm nodules?
My first lung surgeries were VATS (Video Assisted Thoracic Surgery). In this type of procedure, the surgeon makes 3 small holes under the arm, one for the camera, one for the tools and one for the thoracic tube. The advantage of this type of surgery is that recovery is faster and for my first one, I only stayed one night in the hospital. For my last two lung surgeries, I couldn't get a VATS. The surgeon opened my back (big scar between the ribs) and I stayed around 2 weeks in the hospital because of an air leak. Basically, what determines your stay in the hospital is how soon the chest tube can be removed, which is linked to how soon your lung re- inflates fully. The chest tube allows extra fluid and air to come out in the meantime.
One parameter which has an influence on the surgical method used, is the location of the nodule. The closer the nodule to the outer part of the lung, the less lung tissue has to be cut, the easier it is to remove. If the nodule is too deep inside the lung, a whole lobe may have to be removed and I am not sure if it can be done through a small hole under your arm...