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Steve - Test Results

Chelsea71
Posts: 1170
Joined: Sep 2012

Went to Montreal today to get the results of a ct scan (AB, pelvis, chest) done last Wed. Steve's issue right now is the liver. The purpose of the scan was to determine if the cancer was stable. If stable or if shrinkage was indicated, the plan would be surgery. A two stage liver resection. If there was growth, then TACE or Theraspheres. Unfortunately, a radiologist had not yet reported on the scan. The main surgeons associate (a surgeon too) attempted to decipher it. It showed some necrosis and some shrinkage. There was a tumor at the junction of the vena cava and hepatic artery that shrunk to the point that it would not interfere with the surgery. The location of that tumor (last scan) was the surgeons main concern. So this is good news. But, there was a tumor that looked odd. It looked maybe a little bit smaller compared to last scan but it looked sort of extended. Like a smear or a smudge in the area beside the tumor. Looked like an ink drop that someone made larger by smudging it with their finger. This extension of the tumor was blurry looking. The concern is that this is tumor growth which would suggest the surgery should not happen. If the tumors are not responding to chemo they feel a resection would be useless as cancer would reappear within a short time frame. Tumor Board meets on Friday and will discuss the case and call with a follow up appointment. This doctor said he didn't see anything additional that had popped up since last scan. I take this with a grain of salt as he is not trained and didn't seem too confident in his abilities while comparing the two scans. We see the Ottawa onc tomorrow. He said to tell her that there was overall minor shrinkage. He started Folfiri with avastin mid Oct. Scan in Jan showed huge shrinkage. Avastin discontinued mid Jan due to that blood clot fiasco. I wonder if the minor response is due to mutation or the fact that the Avastin was d/c? Any ideas? The funny looking tumor I described, has anyone experienced anything similar? I'm hoping it could be something other than new growth. So, things are still
up in the air for now. I thought he might say to go back on chemo for the time being but he said to do nothing for now. Wait until they discuss it and come up with a plan. This worries me too. Worried that
the troublemaker (vena cava/hepatic artery) will grow to the point where it may impede surgery.

Any thoughts are appreciated.

Chelsea

annalexandria's picture
annalexandria
Posts: 2271
Joined: Oct 2011

are his tumors only in the liver?  Or are they elsewhere too?   I just wonder if there are any other options for him.  I noticed that one of the women at the Colon Club has had a HAI pump installed, and that ended up getting her to NED after being told it was surgically impossible.  Have you guys looked into that?  Or could they radiate that one spot if needed to get in shape for surgery?

I don't know too much about liver stuff, but I am a fan of getting to surgery if it is at all possible.

Hopefully, this will turn out to be a false alarm.  I've had a ton of those, and if the person reading the scan wasn't really experienced, that could make a big difference.  Keep us posted!  Hugs coming your way~AA

Chelsea71
Posts: 1170
Joined: Sep 2012

As far as we know the tumors are only in the liver. HAI pump would be costly. It's not offered any where in Canada. In addition to TACE and Theraspheres there is also IGRT. I think IGRT is the targeted radiation that Phil is doing at Sloan for his remaining spot on the lung. This guy was definitely not a radiologist. We should know more next week.

Does anybody know how IGRT (image guided radiation therapy) compares with chemoembolization and y90 etc... Or is it apples and oranges?

AnnLouise's picture
AnnLouise
Posts: 276
Joined: Mar 2013

I did SirSpheres to the liver....internal radiation, twice (three weeks apart)...pet scan three months later in March showed clear liver. I will have a ct scan the 28th and will see if it is still clear. I also did SBRT radiation on the lung (targeted radiation) and should find out how that is doing with the scan. An intraventional radiologist and a radiologist oncologist did these procedures. Hope things go well and any questions, feel free to ask. ~ Ann

Chelsea71
Posts: 1170
Joined: Sep 2012

Hi Ann. Did start off with a liver resection? I seem to recall reading that you did. One of my concerns is that a resection will screw up future treatments such as SIRT and spheres.

Thanks

AnnLouise's picture
AnnLouise
Posts: 276
Joined: Mar 2013

I did have a liver resection in June 2012 and my pet scan in Sept. showed recurrence...nov. and dec. the SirSpheres.~ Ann

jen2012
Posts: 1215
Joined: Aug 2012

Sorry the news was so vague!  Hopefully once the radiologist takes a look it will be good news.  Waiting sucks...

Sundanceh's picture
Sundanceh
Posts: 4306
Joined: Jun 2009

I remembered doing IMRT radiation, but that looks like a different animal.....Intenisty Modulated vs guided. 

I cannot even speculate on the other info, Chels....understand your concern that a temporary delay could set back surgery....but it is probably still prudent to wait for the plan...sounds like surgery is still hinging on their prognosis.

Just hoping right along with you:)

Chelsea71
Posts: 1170
Joined: Sep 2012

Hi Craig,

There is also SBRT. Yes, surgery is still a possibility, at this point. Will know more once the radiologist does his report. The guy we talked to yesterday said the surgery would be a big one. He opened his eyes really wide as he spoke. I have concerns about Steve going through another huge surgery. Maybe he would be better off doing TACE or SIRT first. But, Steve is really wanting surgery. I may factor his opinion into my decision. Lol. Completely joking. (sort of).

Thanks for the support.

Chelsea71
Posts: 1170
Joined: Sep 2012

Hey Jen. Yes, waiting sucks. Montreal is an hours drive. I have to miss work for all these appointments. I had concerns that the app was only two days after the scan. The receptionist assured me that the surgeons can read the scans and we don't need to wait for the radiologists report. Live and learn.

renw's picture
renw
Posts: 282
Joined: Jan 2013

I opted for TACE first, even though statistically the radioactive beads are more effective. But sirt can destroy your liver. I talked to the top radiologist doing this procedure and about 2% of patients he treated did not survive the treatment.

I had my first TACE  two weeks ago and I will have several more. Will report results on my blog. So far even after the first treatment some necrosis has been observed, so will see.

Chelsea71
Posts: 1170
Joined: Sep 2012

Hi Ren. Congratulations on the necrosis. How affected is your liver? Are both sides involved? I understand they can only treat one side at a time. What happens to the side that is not under treatment. Do they do anything to it like cut off the blood supply? Steve's tumors extend across the entire liver. Should we be concerned about progression on the side that's not being treated?

Chelsea

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