I am an 81 year hold male ,excellent physical shape, recovering by multidrug metronomic chemo from recurrent metastatic Pancreatic Adenocarcinoma without Whipple.Initial diagnosis in 2003 .
The only residual disease is SUVmax= 6.0 in the left bronchopulmonary (hilar ) lymph node ,CA19- 19 ; 22. confirmed by CT/PET Scan in May ,2008., node size is normal , 9 mm max, therec are no outward symptoms such as pain etc.
Planned treatment by an excellent medical team Fractional Cone beam with Stereotactic method ,unfortunately minimum possibly achievable beam diameter is large ,3 cm , Radiation team has no experience with Hilar node , only with nodes further away .Rad may be concurrent or sequential to same multidrug chemotherapy
QUESTION : Should they add Surgical resection of the node as it was done in a Pancoast tumor presented at the 2004 AATS in Toronto by King and others ,(“ High Dose radiotherapy in trimodality …..etc “.) I am an Engineer but I successfully impersonating an oncologist since five years, I intend to go into full recovery , I consider my case a chronic ,highly treatable illness .
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