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wait and see or radiation?

Leland and I made the trek to Pittsburgh 1.5 weeks ago for my regular appointment, the first since my scan in March showed another 1mm growth on a nodule and my pulmonologist freaked out. First, a resident met with us. (We'd met him once before in the last couple years.) He laid out various scenarios -- wait and see, get radiation done now or in the future -- and then said I could also "wait until symptoms develop." This seemed like an obviously terrible idea. So I said, "Um, by the time I noticed symptoms in Germany, my lungs were full of cancer..." Then he kind of backtracked. He also asked, "So, what do you think you want to do?" as if that little 10-minute talk was sufficient to make a decision. I replied, "Wait to talk to Dr. Villaruz and the radiologist." So that was definitely a less-than-helpful discussion. 

When I mentioned the "wait until symptoms develop" comment to Dr. Villaruz she immediately said, we would notice any changes in the CT scans long before symptoms appear. So I really have no idea was the resident was talking about. 

At any rate, she and the radiologist agreed that there is no urgency because the nodule is small and growth is very slow. The radiologist also showed us another small nodule close to the 13mm one that could be zapped at the same time. The options were to do radiation now or to do a regular scan in July and then do radiation if the nodule has grown more (or even continue scanning and monitoring). We opted to do the scan in July and go from there. 

If the nodule grows and we decide on radiation, then I will have to get various scans to "map" the area and also be fitted into a mold to keep my body in place during the procedure. SBRT (Stereotactic Body Radiation Therapy) is highly precise; the beams are less than a half-millimeter wide. There would be 1-5 treatments (number TBD based on scans), each lasting 15-45 minutes, typically done on consecutive days. The UPMC Altoona Hospital will soon be getting an SBRT machine, so I could have this done 45 minutes from here instead of having to drive 2.75 hours each way. It seems fatigue is the main side effect. 

Now I just need to relay all this to my pulmonologist and make sure he is on the same page with the oncologist and radiologist. I am not dwelling on it -- just trying to get through the semester!

Comments

  1. AnonymousApril 26, 2026 at 4:50 PM

    Dear Esther, I always look forward to your updates. Your ability to remain so positive in the midst of personal and external chaos is truly inspiring. I find myself learning from your interactions with medical personnel and thinking about how we might channel those experiences into improved care for everyone. Just being better active listeners (a nod to the resident interaction).Take good care of yourself, and I wish you a strong finish to the semester. I’m returning to my grading now with a much brighter outlook! :-) Best, Leslie Cordie

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