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Metastectomy???

srbelle1
Posts: 123
Joined: Jul 2013

does anyone know much about metastectomy? I have been reading recent articles that when dealing with a small amount of mets which can be surgically removed successfully, stage IV survival rates increase drastically.

haven't heard it mentioned here and for all I know, I have been reading quackery; my husband is having his first post-surgery scans followed by our visit to the onc post surgery. Four months ago, he showed two mets to the spine. One was dealt with surgically and the other with cyber radiation. Don't know if the scans will show additional mets but if not, my thought was surgically removing the met that was radiated.

am I nuts?

sarah

Galrim's picture
Galrim
Posts: 278
Joined: Apr 2013

Metastectomy can increase the overall long term surval rates drastically for some patient groups with advanced disease. However, it is unfortunately in most cases not an option due to location, number of mets and a variety of other reasons.

Metastectomy is most often performed on single or sometimes dual mets to the lungs. Succesfull removal in other sites are rare afaik. As for mets to the spine/bones I havent read any specific studies though they are probably out there.

As for the survial rates, stressing this is for lung mets only, the 5 year survival rate increases from 5-10% to 30-35% if complete surgical resection of lung mets is achieved.

So if surgical resection is not an option and its a single met, at least get a second opinion just in case, as possible met removal in complicated locations often are connected to the skill and experience of the surgeon in question. 

/G

dhs1963's picture
dhs1963
Posts: 373
Joined: May 2012

If it is an option, it is the best treatement.  In my case, there was a single lung met.  It was removed.  NED.  Now, it does not mean I am cured.  But I could be cured.   The linked article shows the prognosis with solitary mets after surgery.  Note that it is from 2005, so where it says survival, turn it into recurrance (in the past, new tumors meant no survival, today not so much).

 

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1185571/

 

You will see that it largely depends on grade, but with grades 1-3, with a little lick, you are looking at 3+ years without treatment.  Unfortantely for me (grade 4 -- sarcomitoid, but primary tumor t1b), it is a much worse prognosis.  However, I am 9 months of NED right now (though I do have 5-7 swolen  lymph nodes).

 

Good luck.

 

 

foxhd's picture
foxhd
Posts: 1920
Joined: Oct 2011

I also am thinking that if any mets that are removable remain, I want them removed. My doc didn't share my enthusiasm so we wil wait and see what the scans show. Unfortunately, I think most of my issues will be in the bones. So we will see about radiation. Again. People like Donna have had great results with surgical removal. I don't care how much they chop me up. I know I will heal. Just need to get rid of the crappy cancer.

srbelle1
Posts: 123
Joined: Jul 2013

thank you for responding and making me feel not nuts; my husband's met that received cyber surgery. He had the lumbar one removed surgically with one hell of a recovery.

fox, you mentioned that your mets in the bones might preclude surgery; am I understanding this right and if so, why?

i fully agree with cutting out parts of the body in exchange for life; Having double mastectomies 22 years ago, I viewed their loss as a sacrifice to the gods despite many of my friends telling me how brave I was and how they could not part so easily with body parts. Yes, I was young but trading boobs for life was a no-brainer (pun not intended).

sarah

foxhd's picture
foxhd
Posts: 1920
Joined: Oct 2011

Sarah, I've had mets in several areas of my spine and multiple ribs, and pelvis. Some have responded to treatment. Some have not, and some are new. You just can't cut out a vertebrae and leave nothing in it's place. It's not like yanking out a lymph node or lung lobe. We'll see.

srbelle1
Posts: 123
Joined: Jul 2013

fox, you should be getting results from your treatment soon, right? And, isn't that a cure? So, hoping for great results.

is fusion of vertebrae a possibility?

sarah

a_oaklee
Posts: 169
Joined: Nov 2013

Just an FYI.  My husband did have a complete vertebrae removed and a titanium cage was inserted in it's place.  This was done almost 2 years ago.

srbelle1
Posts: 123
Joined: Jul 2013

the met I am referring to is a smaller one at T11; it was not removed with the lumbar 2-4 because the surgery would have been risky.

since, now, it is just this one, my thought was why not now? Yes, we are fortunate enough to have UCSF and any spinal surgery would be done by the neurosurgeon who did the first and he is the BEST UCSF has.

thanks, Sarah

donna_lee's picture
donna_lee
Posts: 407
Joined: Feb 2009

Guess that's what I've been having, in addition to the Nephrectomy. At the same time, left lobe of liver(hepatectomy);a set of nodes with 2 positive (paracaval lymphadenectoym), and defective gall bladder (colecystectomy).  Then separate recurrences at one and at two years in single nodes.  More particulary, lymphadenectomies.

All the physicians, surgeons, oncologists I've worked with have been of the opinion that if it can be removed safely, cut it out.

In the lumbar spine, I don't know.  Best wishes.

Donna

srbelle1
Posts: 123
Joined: Jul 2013

Donna:

my husband DID have surgery to the lumbar (2-4) before the nephrectomy and they fused it with hardware with the hope that the bone will grow around it; they think it might be one year.

the other met (assuming no further mets are found with scans tomorrow) was in T-11 and much smaller. He had cyber radiation already so I am jumping ahead and already thinking it didn't get destroyed. Fighting the stress and negativity brought on by my fear of the scans; today, I was thinking better not to know...Thankfully, he is not like that although I am the one who spends too much time reading about this disease.

i fired his primary today; my husband went along with that, trusting my judgment. This jerk could not explain his lab results and never sent them to the oncologist. I spent hours looking up each test. 

I am way beyond topic, just releasing the stress of tomorrow's scans and Monday's appointment. So far, this disease has hit hardest on my birthday, our anniversary and since my husband's birthday is Sunday and thanksgiving is coming up, along with our granddaughter's 1st birthday, i am projecting....

sorry all, sarah

donna_lee's picture
donna_lee
Posts: 407
Joined: Feb 2009

My first surgery was in late June of '06 and six weeks later my second granddaughter was born.  When I held her I told her I was going to be at her wedding, and she couldn't get married for a long time.  So far, so good.

Congrats on firing a Dr.  In this day and age, it is often hard to do; but sometimes must be done.  And just think, now you know how to read lab results, so something else positive came out of your actions.

Carry on.  You support your husband, and we're here to listen.

Donna

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