Questions re chemo after liver resection

strato

My husband is about to have surgery to remove a tumor from his liver. The tumor is a metastasis of the rectal cancer he was diagnosed with 2 years ago.

First we were told his tumor was inoperable. However now we found 2 surgeons willing to do the surgery, one at Sloan Kettering and one at the Lahey Clinic.

The surgeon at Sloan Kettering wants my husband to take part in a clinical trial being conducted at Sloan Kettering in which he is to have 6 months of chemo after the surgery administered by way of an arterial hepatic pump that would be inserted into the liver during the surgery.

The doctor at Lahey Clinic doesn't believe in the pump and says my husband should be on 6 months of chemo after the surgery consisting of 5 FU, irinotecan and avastin.

Has anyone had experience with the pump? And has anyone had chemo with 5 FU, irinotecan and avastin?

Any information would be greatly appreciated, we need to make a decision quickly.

Thanks so much.

taraHK

Wow - this is a tough call. I am glad that you found two surgeons who believed surgery was an option, and they both seem to have good follow-up plans. Are you able to ask them a few more questions (for example, why doesn't the doctor at Lahey believe in the pump? Why does the Sloan-Kettering surgeon think the pump will be more effective? Are they able to give you some research data to support their recommendations). I've never been in a clinical trial but I know people are monitored very carefully during them. Also, clinical trials have to go through pretty rigorous ethical clearance. I don't have experience wtht 5FU, Irinotecan and avastin but I was on a somewhat similar regime: FOLFOX (5FU plus oxaliplatin plus leucovorin) plus Avastin. I tolerated it pretty well. I had rectal cancer with metastasis to lung. Good to you with the decision-making and good luck to your husband with his treatment.

fez1

My husband had a similiar experience. At Sloan the surgeon really pushed the HAI pump. I think that the pump was perfected there so they continue to use it although most other major cancer centers have stopped. We had 3 other opinions that told us that there was no hard data that the HAI pump yielded better results that systemic chemotherapy.If they can fully remove the tumor surgically that's your best option according to the research. You can go to the colon cancer coalition web sight to verify this. Chemo is an adjuvant therapy- used as sort of added protection against reocurrance of mets. The fact that your tumor can be resected is very good news. The pump is not without it's disadvantages. On the other hand,if you are leaning towards it,now is the time to have the pump inserted while they are resecting your liver tumor. And the place to have the HAI pump inserted is at Sloan- they are the experts in that therapy. Also, I believe that, at Sloan, your husband will also have systemic chemo with Irinotecan etc. as well as chemo (FUDR) through the pump. That's what they presented to us. So the only difference between the 2 approaches is the pump insertion and use of direct chemo into the liver.

jenhopesprays

I had 5 rounds of 5 FU the a liver resection then more folfox w/ avastin with no pump.


Here are two long term survivors who had the pump:

At this site check out this personal web page: Cheer3
She is cured!!!!
and then

http://www.mycrcconnections.com/profile/StuartPresson
He is four years out!!

More food for thought!!


Jennifer

KFalvey

My opinion on this is if you can get chemo only to the affected area, the better off you are. I did do 5Fu, irinotecan and avastin after my 1st recurrance (not in the liver), and it didn't work either. I've had another recurrance since. I've decided not to have anymore adjuvent chemo, but if I only had a recurrance in the liver and they could do that procedure with the hepatic pump, only putting the chemo directly in the liver,I might try it. That way you are not poisoning your whole body needlessly. But as I said, this is only my opinion. Good Luck on making your decision.
Kandy

sladich

Hi there. My first recurrence was in the liver and I also underwent a liver resection and had the HAI pump. Unfortunately, the fluid around the pump became infected and I had to have it taken out. However, it was so nice not to have the side effects of the systemic chemo. Every other 2 weeks they would fill the pump and on the other 2 weeks I was on the irinotecan. The infection took forever to clear up and I had another recurrence in the liver (1 year later). I had a Chemoembolization, RFA, and chemoembolization at the end of 2006. So far my liver has been clean. I did have another recurrence but it was in my left lung. Best of luck in whatever you decide.

Debbie

dlpkuhn08

Great! I also took the chance and had a liver resection and they had to remove my gallbladder in order to insert the arterial hepatic pump. I had six months of chemo delivered through this pump and also received systemic chemo with the 5 FU, irinotecan and avastin. I will be having my liver pump removed this September. I and my Dr.s were pleased with the results. I have colon cancer, stage 1V with mets to the liver. Next CT in August. Good luck with your decision. If you need further information feel free to contact me via e-mail.

Diana

ruggersocks

In December 2007, I had ablation done on my liver tumour. In February 2008, I had surgery on the tumour they found in my lung. Then in April 2008, I finished 8 cycles of 12 of Folfiri.

I'm doing ok, just dealing with the side effects of chemo. I'll have a CTscan next week which hopefully will show nothing!!

Keep us posted. You're in my prayers.

Cheryl