What do you think??? liver mets question

hopefulone

Hi all. I hope you are all doing well .I'm confused and probably venting a bit. synopsis. Hubby stage IV , liver mets. First we were told three of them, largest around 2 cm, then another surgeon said 6 or 7, recently , we were told 5 by the oncologist, largest 1.3cm approx and 4 smaller ones, and NOW, after having ANOTHER interventional radiologist review the same ct results as the last one that oncologist had to explore other options, back to 3 !, all under a cm, maybe as small as 4 or 6 mm. Here's the kicker. In the beginning , we were told to do chemo to shrink for possible options, rfa, resection, etc. Now, THIS radiologist who reviewed ct says , keep doing what you are doing, as long as they remain stable, stay with chemo. It actually doesn't look too bad! Thats your best option. If they PROGRESS, maybe he'd consider other options!.... We are very frustrated. We thought the goal was to shrink them (and appararantly they have shrunk quite a bit!) to get to other options. We plan on speaking to his onc about this at next appt in 3 weeks as she's out of town. Does this make any sense to any of you with liver mets? or anyone? Sorry if I've rambled . God Bless. Diane

goldfinch

Diane,
I don't blame you for being confused and needing to vent. I'd feel the same way. I hope you can get some good answers from your onc.
Mary

livefreeordie

Hi, I am not an ONC, but I agree wtih him(them).
They are small tumors, and it sounds like the chemo is working. I've read of a couple of stage IV survivors here that were cured with just chemo and no resection. My tumor is 13 CM on my liver, they will not operate unless chemo shinks it.
I've only had 5 chemo treaments, and need 3 more till I get another CT scan for results.
I dont think mine will shrink away completely, but who knows...everyone get differant results
with this stuff..

sladich

I've had a liver resection and at the time was told that was my best chance for a cure. There was no other cancer in my body. I did have a recurrence in the liver and went through chemoembolization and RFA. So far so good. It's been 7 months - all clear.

Debbie

robinvan

Diane,
In my case, +/- 3 liver mets in right lobe, it was important to get the opinion on liver resection options from an experienced liver surgeon. He was able to evaluate whether or not it was a good option. If the tumours are in one lobe they can sometimes take it out even if there are multiple tumours (as long as they are not too numerous.) My Onc initially said liver resection was out because I had multiple tumours. My general surgeon who did the bowel resection strongly recommended I see the liver surgeon for an opinion. I'm glad I did. I did have a small isolated recurrence 2 years later. It's been treated with RFA/Chemo.
Good luck in your search for options. Keep looking until you find the one that gives the best chance for long-term survival or cure.
Blessings... Rob; in Vancouver

jams67

This treatment seems to be changing so rapidly that I don't think the professionals know for sure, thus the confusion.
I had my liver resection done a very good hospital after CT/PET and great docs. This was August '05. I had one large and one smaller tumor on the left lobe and was told that they would remove the left lobe and resection transverse colon. When the surgeon went in he removed the left lobe, he also used ultra sound on the right lobe and found another tumor which meant he removed a portion of the right lobe also about 50% of the liver, hoping he had gotten all of it. Then he removed the colon and 36 lymph nodes, 10 of which were malignant. I then went on chemo after healing, about 6 weeks to 2 mo.
I have been NED now for 2 years. There is probably more that one way, as we say in TX "to milk a cow". If you have heard conflicting though similar reports from different docs, then you may need to just go with the best of the bunch and follow their proffessional advice.
I guess my answer is that their may not be an answer.
Jo Ann

hopefulone

Thank you all for your responses. I'm frustrated because we were originally told the goal was to shrink the mets for other options. Now that they've shrunk and stable , we are being told the opposite, to wait for signs of progression and then explore other options. In any event, we have another appointment with surgical oncologist who we've seen before to "get the facts" . Seems like there should be some consistancy in stories as to how many, where, what size and the "next step" since it was the same CT viewed by all. Originally we were told in different lobes, but this particular ct report all says right lobe. Their opinions on the next step may differ, but the facts shouldn't. We are thankful that they are so "small" however as we all know, there is no such thing as a little bit of cancer. God Bless . Thanks again. Diane

Betsydoglover

Hi Diane - I can sure understand your frustration, especially when everyone interprets your husband's CT scans differently. Interpreting them is apparently an "art" and "things" that show up look different to different doctors. Doesn't help a patient to feel comfortable, however.

It is so great that your husband's mets have shrunk. I don't know what the real answer is - actually pretty sure there isn't one. Liver resection (or increasingly, RFA) is the textbook cure for Stage IV CRC. BUT, I am one of those whose mets disappeared with only chemo. My oncologist's intent was always to refer me to 2 or 3 liver surgeons and also to a radiologist. In fact she did that (referred to NIH to both a liver surgeon and interventional radiologist). But, since my scans )CT, PET, MRI) were clean at that time (and still now), they wouldn't touch me. On the one hand, this is a great situation to be in. On the other hand, every time I read about someone who has liver surgery and the surgeon finds additional tumors that appeared on no scans, I freak. Still, only a crazy person would operate on me at this point. And as my oncologist says - you want to stay away from the crazy surgeons!

You need to talk with your docs and try and understand their different opinions. Hopefully then you can make a decision. Meanwhile, it is so wonderful that your husband is doing well. Confusing as it is, it gives you time to decide on the next step.

Take care,
Betsy