Sustained Chemotherapy

Hallo:
I am a stage IV bc patient with lung mets. I began treatment three years ago for a stage Ia disease but a year few months after my TRAM flap had a serious recurrence which was neglected by my surgeons until it was quite large. A new sugeon removed the mass but, after radiaton and chemotherapy (taxotere) four small spots  appeared in my left lung.

I had another unsuccessful try at chemo (VATH) before having a bit of luck with Xeloda (two spots disappeared). We are still trying the xeloda but , as the two remaining spots did not seem to respond per my last CT scan, I am trying to think ahead. I know that the Italians have had great succeses with lung resection.I am puzzzled that  surgery seems NOT to be an option in the US. After five chemo protocols, I would like to give my body a little rest. I seem to recover quickly from surgery. I have no other evidence of disease.

Do you feel this (resection) should be considered if these two spots remain (and there is no new activity)? I like my oncologist very much but when I suggested talking to a thoracic specialist he suggested a second oncologist's opinion instead (?).

Thank you so much. I am a bit tired of these bloody spots!

[CCF-RN,MSN-JS]

Dear Maman,

There is always the concern with metastasis that the areas that are visible on scans or X-rays are not the only areas of disease. This is the reasoning behind using systemic treatments such as chemotherapy or hormone therapy.  In terms of having the nodules removed from your lung, this is not a standard procedure for treatment of lung metastasis in breast cancer.  A thoracic surgeon could probably tell you if it was technically feasible, but in terms of the overall picture as to the risk vs. benefit, a second oncologist