Liver Biopsy - genetic testing

cfight Member Posts: 69
edited March 2014 in Esophageal Cancer #1

My father has been fighting EC (Stage IV) since December 09. He's beginning his third line of treatment -- there's a tumor in his liver that hasn't responded to any treatment. The other tumors/cancer is his arm, esophagus and liver have all disappeared. The oncologist is recommending therasphere AND is planning to take a biopsy so he can run tests and identify the genetic make up of the tumor. The goal is to introduce a chemotherapy option that has a better chance of stopping the tumor growth based on the genetic make up.

I know a lot of people have mets to the liver and I was unaware of this type of testing for someone who is already 9 months into treatment. I wanted to alert people who may not have explored this option yet.

I'm keeping my fingers crossed that third times' a charm!

May all of you find strength in the journey!


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  • cfight
    cfight Member Posts: 69
    unknown said:

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    Hi William,
    I just got

    Hi William,

    I just got clarification from my mom. It's not therasphere When I was speaking with the doctor he probably didn't pick up on my therasphere comment. It's Stereotactic Radiosurgery -- he'll be getting 6 treatments. Apparently the radiologlist (spelling) is very hopeful that it will get rid of the tumor because of its location. We're hoping this procedure knocks him into remission. And of course, you know I use that term lightly. The doctor also said that the chemo cocktail and radiosurgery work hand in hand and increases the effectiveness of the treatment. Have you heard of this before? More information below.

    stereotactic Radiosurgery and Stereotactic Body Radiotherapy (SBRT)
    What is stereotactic radiosurgery and how is it used?
    What equipment is used?
    Who will be involved in this procedure and who operates the equipment?
    How is the procedure performed?
    Is there any special preparation needed for the procedure?
    What will I feel during and after the procedure?
    What is stereotactic radiosurgery and how is it used?

    Stereotactic radiosurgery, also called stereotactic radiotherapy, is a highly precise form of radiation therapy initially used to treat tumors and other abnormalities of the brain. Now radiosurgery is also being used to treat cancer in other parts of the body in a procedure called stereotactic body radiotherapy (SBRT).
    Despite its name, stereotactic radiosurgery is a non-surgical procedure that delivers precisely-targeted radiation at much higher doses than traditional radiation therapy while sparing healthy tissue organs nearby.
    Stereotactic radiosurgery relies on several technologies:
    three-dimensional imaging that determines the exact coordinates of the target within the body
    systems to immobilize and carefully position the patient
    highly focused gamma-ray or x-ray beams that converge on a tumor or abnormality radiation
    in some cases, image-guided radiation therapy (IGRT),which uses medical imaging to confirm the location of a tumor immediately before or during the delivery of radiation to further improve the precision and accuracy of the treatment
    Three-dimensional imaging, such as CT, MRI, and PET/CT is used to locate the tumor or abnormality within the body and define its exact size and shape. These images guide the treatment planning—in which beams of radiation are designed to converge on the target area from different angles and planes—as well as the careful positioning of the patient for therapy sessions.
    Although stereotactic radiosurgery is often completed in a one-day session, physicians sometimes recommend multiple treatments, especially for tumors larger than one inch in diameter. The procedure is usually referred to as fractionated stereotactic radiotherapy when two to five treatments are given.
    Stereotactic radiosurgery and SBRT are important alternatives to invasive surgery, especially for patients who are unable to undergo surgery and for tumors and abnormalities that are:
    hard to reach
    located close to vital organs
    subject to movement within the body
    Radiosurgery is used to treat:
    many types of brain tumors, including:
    benign and malignant
    primary and metastatic
    single and multiple
    residual tumor cells following surgery
    intracranial, orbital and base-of-skull tumors
    arteriovenous malformations (AVMs), a tangle of expanded blood vessels that disrupts normal blood flow in the brain and sometimes bleeds.
    other neurological conditions
    SBRT is currently used and/or being investigated for use in treating malignant or benign small-to-medium size tumors in the body, including the:
    head or neck
    Stereotactic radiosurgery works in the same way as other forms of radiation treatment. It does not actually remove the tumor; rather, it damages the DNA of tumor cells. As a result, these cells lose their ability to reproduce. Following the treatment, benign tumors usually shrink over a period of 18 months to two years. Malignant and metastatic tumors may shrink more rapidly, even within a couple of months. When treated with radiosurgery, arteriovenous malformations (AVMs) begin to thicken and close off slowly, typically over several years.
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    What equipment is used?

    There are three basic kinds of equipment, each of which uses different instruments and sources of radiation:
    The Gamma Knife®, which uses 192 or 201 beams of highly focused gamma rays all aiming at the target region. The Gamma Knife is ideal for treating small to medium size intracranial lesions. See the Gamma Knife page ( for more information.
    Linear accelerator (LINAC) machines, prevalent throughout the world, deliver high-energy x-rays, also known as photons. The linear accelerator can perform radiosurgery on larger tumors in a single session or during multiple sessions, which is called fractionated stereotactic radiotherapy. Multiple manufacturers make this type of machine, which have brand names such as Novalis Tx™, XKnife™, and CyberKnife®. See the Linear Accelerator page ( for more information.
    Proton beam or heavy-charged-particle radiosurgery is in limited use in North America, though the number of centers offering proton therapy has increased dramatically in the last several years. See the Proton Therapy page ( for more information.
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