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Metastasis to liver - treatment options

Bellen
Bellen Member Posts: 281

Hello - I am an 11 yr survivor of AC and was recently diagnosed with liver Mets through a biopsy - CT scan said several lesions in right lobe.  Wondering if there are others who have been diagnosed with liver mets and what your treatment options were, or what treatment you had.   Have posted on the AC and Liver sites as well.  Would very much appreciate any input - thank you.  Best wishes to all.  

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Comments

  • Trubrit
    Trubrit Member Posts: 5,535 **
    Ablation

    Hello Bellen. 

    I had an Thermal Microwave Ablation on my 2.2 cm liver met back in April 2014.  I have been NED since, and hope to continue that way. 

    I guess not everybody is a candidate for an Ablation, but it is definitely something to look into. It was 100% less invasive than a resection. The recovery time was next to nothing, and the side effects are minimal twinges where the scar tissue is. 

    Good luck in whatever avenue you have to persue. 

    SUE

  • Bellen
    Bellen Member Posts: 281
    Trubrit said:

    Ablation

    Hello Bellen. 

    I had an Thermal Microwave Ablation on my 2.2 cm liver met back in April 2014.  I have been NED since, and hope to continue that way. 

    I guess not everybody is a candidate for an Ablation, but it is definitely something to look into. It was 100% less invasive than a resection. The recovery time was next to nothing, and the side effects are minimal twinges where the scar tissue is. 

    Good luck in whatever avenue you have to persue. 

    SUE

    Liver Mets

    Hi Sue - Did you have other lesions in your liver as well?  Would you know whether that procedure is appropriate for several mets or when only one is present. CT report says largest is 2.8 cm, but there are others In right lobe. Thank you for response. Best wishes. Will ask about this.

  • Trubrit
    Trubrit Member Posts: 5,535 **
    Bellen said:

    Liver Mets

    Hi Sue - Did you have other lesions in your liver as well?  Would you know whether that procedure is appropriate for several mets or when only one is present. CT report says largest is 2.8 cm, but there are others In right lobe. Thank you for response. Best wishes. Will ask about this.

    Not much help

    I don't think I will be much help, but others will come along soon and share their wealth of knowledge. 

    I had just one Liver met. At 2.2 cm, it was actually a little bigger than they like to ablate. I think the cut off is 2 cm. On the CT scan, it measured as 1.5 cm, but when they got in there; they found it was bigger. Also, the position of the mets makes a difference wether it can be ablated or not. 

    I think they can ablate more than one at a time, but don't quote me on that. I think someone here had two done. 

    Cyber Knife. Not sure if anyone on here has had it.

    Y90 - placement of radioactive beads on the tumour itself. 

    Resection - The big surgery, and what most seem to have, with great success. 

    SUE

  • beaumontdave
    beaumontdave Member Posts: 1,176 **
    Hi and Welcome, if all the

    Hi and Welcome, if all the mets are in the right lobe, resection would be the first choice, I imagine. They can take a whole lobe if they need to. It's usually the first, best choice for treatment unless other factors are involved. In 2011 I had three mets in the liver removed by "scoops" the surgeon called them. Two years plus later, they had to dig out another 3cm met that was in the margin area of a previous lesion, and I'm coming up on 2 years NED since. The doc originally asked me if I wanted ablation, radiosurgery, or resection, and I said I wanted the stuff out. Some like Sue have done very well with other treatments, but my feeling is, if you can get them resected, do it, because it has the best chance of staying gone and maybe taking out whatever tiny "seeds may be near the mets. Anyway, that's my take, best of luck to you..............................Dave

  • Bellen
    Bellen Member Posts: 281

    Hi and Welcome, if all the

    Hi and Welcome, if all the mets are in the right lobe, resection would be the first choice, I imagine. They can take a whole lobe if they need to. It's usually the first, best choice for treatment unless other factors are involved. In 2011 I had three mets in the liver removed by "scoops" the surgeon called them. Two years plus later, they had to dig out another 3cm met that was in the margin area of a previous lesion, and I'm coming up on 2 years NED since. The doc originally asked me if I wanted ablation, radiosurgery, or resection, and I said I wanted the stuff out. Some like Sue have done very well with other treatments, but my feeling is, if you can get them resected, do it, because it has the best chance of staying gone and maybe taking out whatever tiny "seeds may be near the mets. Anyway, that's my take, best of luck to you..............................Dave

    Liver mets

    Thank you Dave for responding. That sounds encouraging if it is possible - the CT scan says "several" lesions and in the right lobe, so I'm hoping I have some options - won't know until see Cancer Clinic. In Canada, we play a waiting game for all of our biopsies and Cancer Appts unfortunately.  Very nerve wracking. Best to you.

  • gfpiv
    gfpiv Member Posts: 59
    mets

    To me, the HAI pump (preferably at Memorial Sloan Kettering in NYC, or some other expert hospital) would be a good thing to look into for mets limited to the liver.  Frankly, it saved my life, after I was given no hope by multiple other oncologists.  Unfortunately, I expect MSK is not an option for you in Canada - I'm sure they wouldn't pay for it, and I don't know which, if any, hospitals up there actually do HAI.  I can't even begin to imagine how I would be able to self-pay for all the HAI-related treatments I've had; the initial HAI implant and colon resection alone was close to $80k USD I believe.  Seems like your options may be to hope for a surgeon that will resect (I suspect you may not be a candidate for ablating them all right now), or else do some chemo first to shrink them down (likely systemic; perhaps chemoembolization of the liver also?).  In some cases I believe that if your lesions are all on one lobe, they can even cut off blood supply to half your liver, have the good half regenerate to roughtly full size and get rid of the "bad" lobe.  Y90/Sir Spheres is also an option I'd look into in extremis, though not sure if that's a possibility for you.  Good luck!

    -Chip

  • smb245
    smb245 Member Posts: 2
    edited August 2016 #8
    gfpiv said:

    mets

    To me, the HAI pump (preferably at Memorial Sloan Kettering in NYC, or some other expert hospital) would be a good thing to look into for mets limited to the liver.  Frankly, it saved my life, after I was given no hope by multiple other oncologists.  Unfortunately, I expect MSK is not an option for you in Canada - I'm sure they wouldn't pay for it, and I don't know which, if any, hospitals up there actually do HAI.  I can't even begin to imagine how I would be able to self-pay for all the HAI-related treatments I've had; the initial HAI implant and colon resection alone was close to $80k USD I believe.  Seems like your options may be to hope for a surgeon that will resect (I suspect you may not be a candidate for ablating them all right now), or else do some chemo first to shrink them down (likely systemic; perhaps chemoembolization of the liver also?).  In some cases I believe that if your lesions are all on one lobe, they can even cut off blood supply to half your liver, have the good half regenerate to roughtly full size and get rid of the "bad" lobe.  Y90/Sir Spheres is also an option I'd look into in extremis, though not sure if that's a possibility for you.  Good luck!

    -Chip

    HAI

    Hi Chip - I am looking at HAI at Sloan Kettering.  Can you share a little bit more about your experience with it?  I am still Chemo Niave as I was just diagnosed within the last week. I have been told by one surgeon that my liver is currently unresctable, however, if we can get my tumors to shrink I could become a candidate for surgery.  My surgeon thinks HAI would be my best option.  Concernerd because I live in Arizona and wondering about possible side affects while I was home and away from cancer hospital. 

  • Bellen
    Bellen Member Posts: 281
    edited August 2016 #9
    Liver Mets

    Hello Chip and others - thank you for your response. I will let the group know after my Clinic appt - still have not met with anyone and really stuck on my own right now.....wondering what the prognosis is.  

  • mom_2_3
    mom_2_3 Member Posts: 952
    Trubrit said:

    Welcome to the forum

    I'm sorry you have had to find yourself here. Not the club where people rush to join. 

    Edited out. 

    SUE

    Brutal?

    Sue, 

    Are you sure your comment hearing HAI can be brutal is correct?  You mentioned it on another thread as well but corrected the title to refer to HIPEC (which I have heard can be tough).  I don't think I have ever spoken to anyone with an HAI that says it was brutal.  I wouldn't want to scare any individuals off from this therapy as it can be quite effective.

     

    Thank you!

  • Trubrit
    Trubrit Member Posts: 5,535 **
    mom_2_3 said:

    Brutal?

    Sue, 

    Are you sure your comment hearing HAI can be brutal is correct?  You mentioned it on another thread as well but corrected the title to refer to HIPEC (which I have heard can be tough).  I don't think I have ever spoken to anyone with an HAI that says it was brutal.  I wouldn't want to scare any individuals off from this therapy as it can be quite effective.

     

    Thank you!

    You are right, mom_2_3

    My most sincere apologies!  I also did this in another post, which I edited. I had forgotten that I had also replied to this post. 

    I don't know where my head was, but it was definitely HIPEC that I was thinking about and not HAI. 

    Thank you so much for pointing this out, I really do appreciate it. 

    And smb245, I am sorry that I let this slip by.  I hope my post did not cause you too much concern and worry; I would hate to have added to the already heavy burden load you are carrying at this time. 

    SUE

  • Trubrit
    Trubrit Member Posts: 5,535 **
    smb245 said:

    HAI

    Hi Chip - I am looking at HAI at Sloan Kettering.  Can you share a little bit more about your experience with it?  I am still Chemo Niave as I was just diagnosed within the last week. I have been told by one surgeon that my liver is currently unresctable, however, if we can get my tumors to shrink I could become a candidate for surgery.  My surgeon thinks HAI would be my best option.  Concernerd because I live in Arizona and wondering about possible side affects while I was home and away from cancer hospital. 

    Welcome to the forum

    I'm sorry you have had to find yourself here. Not the club where people rush to join. 

    Edited out. 

    SUE

  • dancer2
    dancer2 Member Posts: 49
    liver mets

    i started a session but only two responded. I was diagnosed in oct of 15 with a colon tumor (cancer) and one lesion in liver and two tiny spots one in each lobe...liver spot was ablated out the following april and was told by the radiologist it was successful and no new spots anywhere and that was just at the end of may of 2016. a month later had to have pt/ct scan for my oncologist and he just told me my liver glowed and i now have six new tiny spots in the lungs and four in the liver and said come back in 3 months. i, of course, want them out and since the oncologist said nothing about seeing anyone else i went back to the radiologist who explained matters to me and his suggestion was the thereasphere procedure which you can look up. however, he did not say he talked with my oncologist or not so i went back to my colon surgeon and she basically told me that metastisized cancer is in the blood and one needs chemo and gave me a card for another doctor ( and she recommends no one) and i see that doc tomorrow. at this point in my journey i have come to realize we are all basically alone, so be on top of it. I have had two doctors tell me they are baffeled why my onc said what he did. one told me to go see a certain doc at the mayo in minnesota if i wanted to hear from the best. my original doc at least told me to go see what this local doc has to say...don't ask about prognosis, it will play with  your mind. as you can tell from this site, many live with it and deal with it as it comes.........it's getting a good doctor imho. this is a great site and full of good, helpful information.

  • dancer2
    dancer2 Member Posts: 49
    I saw a new oncolgist

    I saw a new oncolgist/hematologist/internist today who went over all reports and looked at several scans. Was told that basically i was left without any treatment for six months and told me there are many chemo drugs  they can use and each of us will respond differently. She also mentioned that most of them will 'just melt the mets away'. Suggested the implanted port with a pack you wear home for three days, then have two weeks off. She was very good at assessing my situation and got right on with writing the referrals so she can get it in quickly. So glad I read this page. Wonderful forum! God Bless us all!

  • dancer2
    dancer2 Member Posts: 49
    liver mets

    hi, dancer2 here....this new oncologist i just saw also wants another biopsy on liver lesion and have it checked for EGFR and KRAS mutant...anyone know about those?

  • Bellen
    Bellen Member Posts: 281
    edited August 2016 #16
    Liver mets -

    Hello dancer2 - Please let us know what treatment is eventually planned for you.  Wishing you well.  I had a CT scan July 4, which indicated concern for mets, and told by cancer clinic to have liver biopsy. It is now Aug 21 and I do not have an Oncologist booked yet.  Very upsetting.  The biopsy report has not been explained by an Oncologist yet - but does say it is consistent with adenocarcinoma of colorectal origin, so I'm in the dark right now about a lot of stuff.  My biopsy said tumour cells are positive for cytokeratin 20, CDX2 and villin.  I would be very appreciative of anyone and all who post re: treatment options.  Best to all.

  • beaumontdave
    beaumontdave Member Posts: 1,176 **
    dancer2 said:

    I saw a new oncolgist

    I saw a new oncolgist/hematologist/internist today who went over all reports and looked at several scans. Was told that basically i was left without any treatment for six months and told me there are many chemo drugs  they can use and each of us will respond differently. She also mentioned that most of them will 'just melt the mets away'. Suggested the implanted port with a pack you wear home for three days, then have two weeks off. She was very good at assessing my situation and got right on with writing the referrals so she can get it in quickly. So glad I read this page. Wonderful forum! God Bless us all!

    I did the port and pack, as

    I did the port and pack, as did many here, and it's a reasonably easy way to go, just don't screw up the line, like I did twice, or it's off to the ER with you for a fix.............................Dave

  • dancer2
    dancer2 Member Posts: 49
    edited August 2016 #18
    hi bellen....am having a port

    hi bellen....am having a port in this week, plus the usual tests, then if i have read the referral right another biopsy and it seems like the new oncologist wants to ablate the largest lesion. then i will start with three days of continuos chemo and off two weeks and only she knows how long but i remember six or 12 treatments. since she works out of a hospital near me i wanted to know why a port...she told me basically it's a vein issue since she wants to have a continuos flow going in and imho it is because of the near six months of nothing but that is not verbatim, just how i rememberd what all she said.....plus with a port, they can give the chemo, take blood, and when u need a scan i understand they can put the agent through the port for that also....guess i will find out if i am one who will or not like the port simply because i am very active and use my upper body a lot.......get copies of all your path reports and scan cd's and go see an oncologist..........i had to go back to my original radiologist to have him explain the last scan where four new lesions popped up in one month.....but at least i feel like something is going to be done now and none of us know how it will all turn out. But it can work out for the best. i am not sure if this site allows links to articles about this otherwise i would send a link from a paper by a doctor out of mayo in rochester. a very good presentation on how he treats colon/rectal cancer with metatastic liver lesion/s. and one that is easy to read.....take care of yourself

  • dancer2
    dancer2 Member Posts: 49
    edited August 2016 #19
    dave, how did you screw up

    dave, how did you screw up the line on the port if you don't mind me asking? Because i am an active person  and do not want to give up my dance, and it's at pro level so it can get quite strenuous

  • beaumontdave
    beaumontdave Member Posts: 1,176 **
    dancer2 said:

    dave, how did you screw up

    dave, how did you screw up the line on the port if you don't mind me asking? Because i am an active person  and do not want to give up my dance, and it's at pro level so it can get quite strenuous

    The line went from the pack

    The line went from the pack/bulb with the chemo, which was on my waist, up under my shirt to the needle in the port, just below my collar bone. I'm a contractor and I did lots of physical stuff without issue. Twice though, whatever I did untwisted the couplers, and I wouldn't notice the unhooked line immediately, so by the time I did, the line was clogged. After the second time, I learned to wrap some tape around the line connectors to stop screwing up the line...........................Dave

  • beaumontdave
    beaumontdave Member Posts: 1,176 **

    The line went from the pack

    The line went from the pack/bulb with the chemo, which was on my waist, up under my shirt to the needle in the port, just below my collar bone. I'm a contractor and I did lots of physical stuff without issue. Twice though, whatever I did untwisted the couplers, and I wouldn't notice the unhooked line immediately, so by the time I did, the line was clogged. After the second time, I learned to wrap some tape around the line connectors to stop screwing up the line...........................Dave

    I also learned to wear an

    I also learned to wear an undershirt, even in the heat, because a tucked in shirt under another shirt protected the line better.......................Dave