RFA to tumor scars in the liver ?

sdp
sdp Member Posts: 181
Dear all,

I had my resection of primary colon tumor and liver mets and also RFA to two small tumors in July- Aug of 2012.
The CT-PET scan in Nov 2012 has three very small spots light up and the radiologist couldn't size them as they were very small and the remark was three foci showed FDG uptake with underlying calcifications. The locationnof the foci was where the tumors were resected and not where RFA was done.

After that I was on maintenance chemo of erbitux solo for 12 rounds and the opinion of the oncologist was that we take the wait and watch approach and finish the erbitux solo maintenance first, and then do the scans. and take a call on further treatment based on the CT-PET done after completion of the maintenance chemo.

The maintenance erbitux got over 2 weeks ago. In a week or so I will be getting the CT-PET done. I am based in India And had my resection and RFA done in Germany. The german doctor who did the RFA is now of the opinion that even if the CT PET scan is clear I should go ahead with RFA to the tumor "scars".

Is that so ? Can anyone throw some more light on this opinion? Any suggestions and advise welcome!

Shitul

Comments

  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    SDP

    Are they saying to Re-RFA the liver?

    I did RFA on the liver...they couldn't get all of it, so they switched over to Cyberknife for radiosurgery of the remaining part of the tumor.

    We Cyberknifed because RFA could only go so far...and mine was a huge tumor about 8cm in the liver.

    I'd ask about whether RFA would be more effective than Cyberknife...Cknife is pretty accurate, laser driven, with high intense radiation to surgically "cut" the tumor out.

    I'd ask around some more and gather some more information...my them would be WHY?

     

     

     

  • sdp
    sdp Member Posts: 181
    Sundanceh said:

    SDP

    Are they saying to Re-RFA the liver?

    I did RFA on the liver...they couldn't get all of it, so they switched over to Cyberknife for radiosurgery of the remaining part of the tumor.

    We Cyberknifed because RFA could only go so far...and mine was a huge tumor about 8cm in the liver.

    I'd ask about whether RFA would be more effective than Cyberknife...Cknife is pretty accurate, laser driven, with high intense radiation to surgically "cut" the tumor out.

    I'd ask around some more and gather some more information...my them would be WHY?

     

     

     

    RFA to the new spots
    They mean that they will do RFA to the new spots even if the chemo has killed them. The new spots were where the earlier resection was done and had lit up on the Ct- pet but the radiologist could not give a dimension to them as he said that they were very small.

    So, the dr doing the RFA says he will ablate the tumor "scars" ! I believe that means he will do the RFA to the place where the spots lit up in the previous scan, even if the same don't show up in the latest Ct pet scan ( due to necrosis etc) . I have never heard of this before and was wondering if this is something normal or unusual ?
  • janderson1964
    janderson1964 Member Posts: 2,215 Member
    If I were you I would listen

    If I were you I would listen to the doctor and RFA them. I am a firm believer in cutting it out and ask questions later plus RFA is minimally invasive.

  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    sdp said:

    RFA to the new spots
    They mean that they will do RFA to the new spots even if the chemo has killed them. The new spots were where the earlier resection was done and had lit up on the Ct- pet but the radiologist could not give a dimension to them as he said that they were very small.

    So, the dr doing the RFA says he will ablate the tumor "scars" ! I believe that means he will do the RFA to the place where the spots lit up in the previous scan, even if the same don't show up in the latest Ct pet scan ( due to necrosis etc) . I have never heard of this before and was wondering if this is something normal or unusual ?

    I Don't Know...

    I don't know, man...

    He's going to attack spots that he can't currently see on the new scan - and his idea is to attack spots that were seen on a 'previous' scan and not the new one?

    That's a new one on me...I really don't know which way would be right or wrong?

    Sorry I couldn't be of more help.

  • sdp
    sdp Member Posts: 181

    If I were you I would listen

    If I were you I would listen to the doctor and RFA them. I am a firm believer in cutting it out and ask questions later plus RFA is minimally invasive.

    Updates
    I plan on having the next scan soon. Probably in a week or so.

    Once the report is in I will send the scan disc to the German doc and see what his proposal is.

    I will keep you updated on this as this is quite a new one and I don't see such an instance though I did try to search for it on the net. Howevr, my search was not very thorough and I thought I would put it up on the discussion forum here And maybe one of us has been thru something similar.

    Thanks
  • sdp
    sdp Member Posts: 181

    If I were you I would listen

    If I were you I would listen to the doctor and RFA them. I am a firm believer in cutting it out and ask questions later plus RFA is minimally invasive.

    Elevated cancer markers.....

    My blood report shows elevated cancer markers , CEA is now 4.3 and in. Jan 2013 it was 2.6 and after resection it was 1.6

    The ca19.9 is now 18.6 , in jan 2013 it was 10.7 and after resection it was 8.8.

    earlier doc had mentioned that pet-ct to be done a month after completion of the maintenance chemo of erbitux , now he agrees to get ct-pet done ASAP. It is now exactly two weeks since completion of maintenance chemo of erbitux. So, I guess the 12 rounds of erbitux and its side effects of severe acne with postures etNora's for nothing ! Getting appointment for pet-ct scan in the next few days ... Will keep you updated on the results.

     

     

  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
    sdp said:

    Elevated cancer markers.....

    My blood report shows elevated cancer markers , CEA is now 4.3 and in. Jan 2013 it was 2.6 and after resection it was 1.6

    The ca19.9 is now 18.6 , in jan 2013 it was 10.7 and after resection it was 8.8.

    earlier doc had mentioned that pet-ct to be done a month after completion of the maintenance chemo of erbitux , now he agrees to get ct-pet done ASAP. It is now exactly two weeks since completion of maintenance chemo of erbitux. So, I guess the 12 rounds of erbitux and its side effects of severe acne with postures etNora's for nothing ! Getting appointment for pet-ct scan in the next few days ... Will keep you updated on the results.

     

     

    dear sdp

    the chemo you did was not for nothing, you likely have a met, the chemo may have slowed it down, then again maybe not.

    the chemo has prejuidiced your immune system and developed resistance of your tumour cells, potentially this growth reflects the chemos ineffectiveness in your case.

    ask your onc about removab, ask your onc about undoing chemos damage to your immune system.

    just some questions that you can answer yourself, then see your doctors answer.

    if you were a gardener would you let the weeds grow ? especially when you life depends on food from the garden.

    you are the garden.

    hugs,

    pete

    ps we all have different journey's, and our own unique path, i pray your path finds a long remission, its possible. best wishes with whatever you decide.

    the baby lion grew up with the baby sheep eating grass. one day he grew up and started hunting, he lived well. from the movie finding joe. its on my blog. really motivational for me.

  • sdp
    sdp Member Posts: 181

    dear sdp

    the chemo you did was not for nothing, you likely have a met, the chemo may have slowed it down, then again maybe not.

    the chemo has prejuidiced your immune system and developed resistance of your tumour cells, potentially this growth reflects the chemos ineffectiveness in your case.

    ask your onc about removab, ask your onc about undoing chemos damage to your immune system.

    just some questions that you can answer yourself, then see your doctors answer.

    if you were a gardener would you let the weeds grow ? especially when you life depends on food from the garden.

    you are the garden.

    hugs,

    pete

    ps we all have different journey's, and our own unique path, i pray your path finds a long remission, its possible. best wishes with whatever you decide.

    the baby lion grew up with the baby sheep eating grass. one day he grew up and started hunting, he lived well. from the movie finding joe. its on my blog. really motivational for me.

    Scan
    Tumor markers show an increasing trend. (see below). Finally got a pet-Ct scan done today. Reports will be done in 18 hours.... Anxiously awaiting with abated breath.

    CEA  
    At diagnosis Jan 2012                     - 935
    After surgery Oct 2012.                    - 2.5
    After adjuvant chemo Nov 2012.     - 1.6
    Jan 2013                                           - 2.6
    March 5th 2013.                      - 4.3
    ( normal is < 3.8 for non smoker, < 5.5 for smoker)

    Ca 19-9
    At diagnosis Jan 2012                     - 1200
    After surgery Oct 2012.                    - 8.6
    After adjuvant chemo Nov 2012.     - 8.8
    Jan 2013 (after erbitux maint.)       - 10.7
        March 5th 2013.                      - 18.2 ( normal is < 27)
  • sdp
    sdp Member Posts: 181
    sdp said:

    Scan
    Tumor markers show an increasing trend. (see below). Finally got a pet-Ct scan done today. Reports will be done in 18 hours.... Anxiously awaiting with abated breath.

    CEA  
    At diagnosis Jan 2012                     - 935
    After surgery Oct 2012.                    - 2.5
    After adjuvant chemo Nov 2012.     - 1.6
    Jan 2013                                           - 2.6
    March 5th 2013.                      - 4.3
    ( normal is < 3.8 for non smoker, < 5.5 for smoker)

    Ca 19-9
    At diagnosis Jan 2012                     - 1200
    After surgery Oct 2012.                    - 8.6
    After adjuvant chemo Nov 2012.     - 8.8
    Jan 2013 (after erbitux maint.)       - 10.7
        March 5th 2013.                      - 18.2 ( normal is < 27)

    Scan reports are in.....looks like NED
    Finally scan reports are in. The three spots On the liver which were there in the last scan seem to have resolved and the synopsis of the report says as follows,

    The whole body PET scan shows
    No demonstrable metabolically active focus/lesion in the liver. There is resolution of metabolic activity within previously described metabolically active lesions with calcifications in segments II, IV A and V. Further decrease in size of segment hypodense lesion with calcification from 2.1 x 2.7 to current 1.9 x 2 cm
    No abnormal FDG uptake at the hepatic resection margin
    No size significant or FDG avid adenopathy within abdomen
    No evidence of FDG avid active disease elsewhere within the body

    I hope it stays that way.......