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YOUR OPINION PLEASE.

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

If your liver met, has disappear thanks to chemo, is it necessary to have surgery? have it happened to any of you?.
Any answer will be appreciated.

John23's picture
John23
Posts: 2140
Joined: Jan 2007

Re:
"If your liver met, has disappear thanks to chemo, is it necessary to have surgery?"

What did the surgeon say? Did he explain why he's looking to remove something
he can't see?

Did you notice if he needs a new Lexus? Maybe a kid starting college? His pool
needs resurfacing? Does he gamble heavily? Maybe owes some bookie?

You have to ask some more questions!

He's not into cannibalism, right? I like liver, too....but...

John

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

going to do! We all know that surgery is the only possibility for Long term expects so I was asking my self how are they going to do or what are they going to do, by the way your Holiness ( hahaha I'm catholic) remember that here no surgeon expects anything,Health care is FREE!.
I Kiss your hand your Holiness.LOL.
Hugs.

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

I remember when my primary was all gone from pre-surgical treatment.

Went ahead with the J-pouch surgery anyway...I'm not good at watching and waiting...and when I gamble, I always lose...even in Monte Carlo! (only thing I ever won was my life...I guess I should consider that enough of a win!!ROFL!!!)

Dutch hugs for a very difficult decision...
Kathi

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

So l understand you been operated but if not tumor how did they managed to find something?

Annabelle41415's picture
Annabelle41415
Posts: 6247
Joined: Feb 2009

With myself having rectal cancer they removed my rectum and then made a new rectum out of the colon. Surprising what they can do nowadays.

Kim

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

don't knew about as had no problems with rectum!.

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Any small tumor that had disappear just with chemo treatment ?.It looks must be relatively common to me!.
Hugs!

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

all gone, only thing left were the little red stars from the radiation.

They worked off of scans/scopes/etc when the tumor was there...and mine was the size of a golf ball, down to nothing...

Dutch hugs, Kathi

KathiM's picture
KathiM
Posts: 8077
Joined: Aug 2005

My 2-inch tumor (golf ball) was very close to the spinchter...rectal cancer part of 'colorectal'.

There was a good chance that I would be left with a permanent external bag.

A FABULOUS surgeon removed my rectum, sigmoid colon (going up from the end...lol), and released the descending colon from the top (sort of a smile), folded it in half, opened the middle, sutured everything back together as a big bag, and reconnected everything, and tucked all of it back into my abdomen. I was using my 'new' rectum right after surgery...took a bit of time, but I'm still using it, just fine.

Dutch hugs, Kathi

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

LOL,
Best my flyingdutchwoman!

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Betsydoglover's picture
Betsydoglover
Posts: 1255
Joined: Jul 2005

Hi Pepe - very good question. I can only tell you my experience - summarized in my signature below. My liver met(s) was/were not detectable on scans after 3-4 cycles of Xeloda/oxaliplatin/Avastin (summer/fall 2005). After 6 cycles (about the equivalent of 9 cycles of Folfox+Avastin), we took a chemo break - thought it would probably be for a couple of months at most. Kept scanning, much evaluation. More than 5.5 years since diagnosis, my liver is still clear. (I did informally consult with a liver surgeon in 2007, but he wouldn't touch me since there was no scan detectable disease).

I often wonder if I should have seen a liver surgeon after 1 round of chemo, but no one ever expected the chemo to work so well. And, had I done so, I undoubtedly would have liver surgery - it is the cure, but given that I had a lung recurrence (see signature) and still have a clear liver, it would have been unnecessary surgery.

As I said, this is only my experience and it is not the norm, but it is what's happened to me.

Betsy
diag. Stage IV, 5/05, liver met
lap sigmoid colectomy, 6/05
6 cycles Xeloda/oxaliplatin/Avastin (NED after 2)
11/08 9x13mm right lower lobe lung nodule; removed via VATS 4/09
6 cycles Xeloda + Avastin,
NED (PET every 3 mo)
Currently on Avastin only

bruins1971's picture
bruins1971
Posts: 227
Joined: Nov 2010

Betsy it's awesome to see that you've made it past the five year mark since your DX. Although you have had some troubles since bring alive five years down the road is a blessing.

C Dixon
Posts: 202
Joined: Jan 2010

For me, Pepe, I would want that tissue out if they wanted to take it out because of microscopic cells. It is a hard surgery but not impossible. I had my whole right lobe removed and was home in four days.

Catherine

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

Yes, it has happened to me. I had three mets to the liver prior to chemo. When I consulted with Liver surgeon, he said said "no surgery, I cant see any mets on the liver." ONC told him, you will do the surgery, you know where they were from the first scan/pet! Surgeon talked to me and said he was a surgeon and could not operate where there were no mets. To check further he decided to do
an ultrasound in his office, so I would not waste a trip to San francisco. He found a new met that the radiologist didn't pick up, and agreed to do the surgery. He cut 50% and opened up the liver he had cut off and there were 2 of the 3 missing mets. He decided to do another 10% and there was the third. Thank God, he did the surgery.

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

And my 3 liver mets died after chemo and lots of other things that I did back in 2004. What test shows your liver mets disappeared? MRIs are the absolute best for liver mets, not CT or PET scans.

My other question would be did the met disappear or does it show up as dead tissue? Very important! Dead means dead but disappear means it doesn't show up anymore but may just be too small for the scan to detect and could still be there. Remember it takes millions of cancer cells before a tumor presents itself on a scan and that's why the industry wants us to be NED 5 years before we are deemed cancer free. NED is no evidence of disease by testing and does not mean you are cancer free........yet.

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

I n my last CT there was a1 cm spot , radiologist ,radio oncologist and oncologist agree it was necrosed tissue , no lighting on PET.!
Hugs!

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

Sounds like it's all dead tissue so surgery shouldn't be necessary but I sure would ask for an MRI before I made my decision and of course talk to your surgeon.

Good for you Pepe!!!

Nana b's picture
Nana b
Posts: 3045
Joined: May 2009

How man liver mets did you have originally? I would tell your onc my story, that is if you are hesitant at all! Good luck,

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

Of course I will ! Thank you!

pepebcn's picture
pepebcn
Posts: 6352
Joined: Aug 2010

yes he is my wife's first cousin! wants to me operated! Hahahahaha.Good in one hand bad in the other!

scouty's picture
scouty
Posts: 1976
Joined: Apr 2004

Surgery is the best way to get to NED. Your cousin obviously loves you. Here in the US, some insurance companies probably wouldn't pay for it!

I don't think you will find a single person on this board that is NED after just doing chemo. I am the only person here that I know of that had mets die and never had surgery on them. I know I am in a huge minority too so don't go by the obvious luck that I had, go by the stats. Chemo is a starter and maybe good at clean up but I have seen way too many here where that clean up/mop up chemo didn't work. Surgery is the best if you can get it but try to get your cousin to do a MRI first to make the tough surgery is necessary.

lisa42's picture
lisa42
Posts: 3661
Joined: Jul 2008

Hi Pepe,

When first dx, I had 12 visible tumors in my liver that lit up on the PET/CT. After 6 months of Folfox, nothing lit up anymore and only 3 still showed up on the CT. My onc said I didn't need to do anything because those remaining three were now dead tissue. My surgeon contacted me and said he wanted to get those remaining three out of there. He also told me that sometimes when things don't show up on the scans anymore, he's had the experience of discovering in surgery that they are sometimes still there (he uses a handheld ultrasound device on the liver before cutting into the actual liver). Sure enough, in addition to the three he found three more tumors. So, I had 50% of my liver removed with a total of 6 tumors in that, all of which tested positive for cancer even though nothing was lighting up on the PET/CT anymore.
Unfortunately, as you probably already know, I did have recurrence in my liver. I originally had tumors in basically all parts of my liver when dx. So, I knew that even though I was having part of my liver removed, that the parts that were remaining had once had tumors in it & still could have microscopic cancer cells in it. The only way I could do anything about that was to take out my entire liver! So, knowing that I had a recurrence in the liver since then in the areas where tumors were and went away, I would recommend you have the surgery where those spots once were.

It's not a fun surgery by any means, but I think it would make your chances of a liver recurrence far less likely.

Lisa

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