What happened, in summary

An older man with several previous primary cancers developed a growing nodule in the right lower lung. Bronchoscopy confirmed lung adenocarcinoma. At age 86, he chose stereotactic body radiation therapy rather than surgery and received SBRT to the right-lung tumor in January 2020. Five months later, the treated nodule had become smaller. He later developed mild shortness of breath and imaging changes consistent with radiation pneumonitis, but his oxygen level remained normal and the symptoms improved without steroid treatment. The patient also had a separate nodule in the opposite lung that was followed over time and later became a second primary lung cancer. His earlier thyroid, prostate, esophageal and bladder cancers were managed separately and were not part of this lung-cancer treatment course. At 43 months after the first SBRT, there was no local recurrence from the right-lung cancer. He was still alive, walking independently and continuing regular surveillance.