Liver Resection

lostit2003

My husband has Stage IV colon, dx in Dec 2010. He has had 13 treatments of folfox+Avastin. His CEA numbers are down from around 330 to 16. He has stopped treatments for a while to let his body recover. Last set of scans was 6 weeks ago. He has 8-9 spots and they have only reduced about 10% but they do show inactive which is great.

My question is his dr say he is not a candidate for a liver resection and I know this is his best chance for long term survival. Has anyone had a liver resection with that many spots?

Dr says when his numbers start to come up he will start treatment again but it will be a different one. We see him this week. What is the usual next step in chemo?


Thanks,
Tina

herdizziness

Next Step
I can't tell you what the next step in chemo is, but I'm sure that it should be changing as while they aren't growing they aren't shrinking either. Have a serious talk with your onc about this, and see what they say. I suggest maybe asking about Xeloda, while it is pill form and you must remember to take it, it worked well for me, he would take this along with other chemo form. But each person is different.
Good drop in CEA count.
My spots were around 15, and I am now qualified for liver re-section. So don't give up hope on that, I had, but things change.
Winter Marie

lostit2003

herdizziness said:

Next Step
I can't tell you what the next step in chemo is, but I'm sure that it should be changing as while they aren't growing they aren't shrinking either. Have a serious talk with your onc about this, and see what they say. I suggest maybe asking about Xeloda, while it is pill form and you must remember to take it, it worked well for me, he would take this along with other chemo form. But each person is different.
Good drop in CEA count.
My spots were around 15, and I am now qualified for liver re-section. So don't give up hope on that, I had, but things change.
Winter Marie

He's been taking the 5-FU, I
He's been taking the 5-FU, I think it and Xeloda are basically the same just in different forms but I'm not sure. When I looked up Xeloda it said that it turns into 5-fu in your body.

I'm so glad you're getting sure great results. Have you sch your liver resection yet?

Thanks,
Tina

Nana b

lostit2003 said:

He's been taking the 5-FU, I
He's been taking the 5-FU, I think it and Xeloda are basically the same just in different forms but I'm not sure. When I looked up Xeloda it said that it turns into 5-fu in your body.

I'm so glad you're getting sure great results. Have you sch your liver resection yet?

Thanks,
Tina

bump

bump

Kathleen808

bump
bump

gfpiv

HAI for Liver Mets
Tina,

If your oncologist is planning a change in treatment, he's almost certainly planning something Irinotecan-based (e.g. FOLFIRI). The good news is that he won't be doing any more Oxaliplatin; many feel that Irinotecan side effects are more manageable.

Are your husband's mets limited to the liver? If so, have you looked into hepatic pump treatment (HAI)? It delivers high-intensity chemo only to the liver, and has gotten some folks on this board from unresectable to resectable. (I just started, and hope to fall into that same category someday.)

Anyway, depending on your husband's health situation, HAI may or may not be something worth considering. There are only a handful of centers that do it (esp. MSKCC in NYC)...and if you're being treated at one that doesn't, they will likely never mention it to you as an option. If you're interested, you can search other related threads in this forum for more information. Let me/us know if you have questions.

Best of luck with your husband's treatment.

-Chip

lostit2003

gfpiv said:

HAI for Liver Mets
Tina,

If your oncologist is planning a change in treatment, he's almost certainly planning something Irinotecan-based (e.g. FOLFIRI). The good news is that he won't be doing any more Oxaliplatin; many feel that Irinotecan side effects are more manageable.

Are your husband's mets limited to the liver? If so, have you looked into hepatic pump treatment (HAI)? It delivers high-intensity chemo only to the liver, and has gotten some folks on this board from unresectable to resectable. (I just started, and hope to fall into that same category someday.)

Anyway, depending on your husband's health situation, HAI may or may not be something worth considering. There are only a handful of centers that do it (esp. MSKCC in NYC)...and if you're being treated at one that doesn't, they will likely never mention it to you as an option. If you're interested, you can search other related threads in this forum for more information. Let me/us know if you have questions.

Best of luck with your husband's treatment.

-Chip

Thanks
I've haven't heard of HAI but I'll do some research before we see the Dr. We live in a rural area in Tennessee so the clinic we get treatment at may not offer it. It may be time to move on to a bigger hospital.

Does radiation work on mets to the liver?

Thanks so much
Tina

Unknown

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lostit2003

unknown said:

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That's great!!
Thanks Kathy that is very hopeful!!

Kerry S

ask about chemo embolization
Tina,

I would ask about chemo embolization. I had that done to my liver 12/08. They had opened me up to do a resection and said no way and just closed me back up.
The doc that did it said he killed off ½ of my liver.

My liver was clear a month later and has never had a recurrence.

Kerry

pluckey

I had a resection March 17,
I had a resection March 17, 2010. I Had 9 tumors on allover the liver. CEA 1600 went down to under 20 over a 9-month period of chemo - 5FU, Erbitux,Ironotecean...the 2 biggest tumors shrunk by 50% in the first few months, then shrinkage from there was a lot less ...stabilizing and calcifiying.

they told me I was not a candidate, "too complicated" was what they used. I ended up going to NYC - Sloan Kettering, Dr. Yuman Fong, he removed 8 tumors and the 9th one is really close to the hepatic vein, he zapped it. You need to ask every doctor you see "what will make my husband a candidate for liver resection?" Ask it in many different ways to surgeons, oncs, second opinions....no one gave me a straight answer...I wanted to know what I had to look like in order for them to cut me open and do it.....

Some doctors feel anyone with that many tumors in the liver and the high frequency of recourrance to the liver make the surgery too risky or not of benefit...

Good Luck and keep researching! It can be done

Peggy

Nana2

Hi Tina,
My husband was told
Hi Tina,
My husband was told he was NOT a candidate for liver resection by two Doctors locally, but we went to see a Liver surgeon at a teaching hospital and we were told surgery WAS possible and his was done in March. They removed the right lobe of his liver and did microwave ablation to the spots that were on his left lobe. He has recovered from the surgery and is today receiving his 4th of 12 folfox treatments. After his last scan, the oncologist told us the cancer was all back, but when we saw his liver surgeon two days later and she read the scans, she explained that the spots were all where she had done the ablation and that those were fluid filled pockets that would eventually disappear. She went on to explain that the Doctors from the local hospitals don't understand what they do at the teaching Hospital. So we remain hopeful and will ALWAYS go to see her after our scans are done. This is not to say that it is a certain option for your husband, but I'm sure it's worth seeing a liver surgeon at a good teaching hospital to get a second opinion. That's what the good folks on here recommended to us and we are SO glad we did. Hang in there and keep up the faith!
April
Oh, and PLucky who posted on here came to visit my husband and I at Loyolla after his surgery one day while she was getting her chemo treatment there. Small world huh? She gave us the pep talk. Just remember you are not alone. (HEY, THANKS AGAIN PEGGY)

lostit2003

Nana2 said:

Hi Tina,
My husband was told
Hi Tina,
My husband was told he was NOT a candidate for liver resection by two Doctors locally, but we went to see a Liver surgeon at a teaching hospital and we were told surgery WAS possible and his was done in March. They removed the right lobe of his liver and did microwave ablation to the spots that were on his left lobe. He has recovered from the surgery and is today receiving his 4th of 12 folfox treatments. After his last scan, the oncologist told us the cancer was all back, but when we saw his liver surgeon two days later and she read the scans, she explained that the spots were all where she had done the ablation and that those were fluid filled pockets that would eventually disappear. She went on to explain that the Doctors from the local hospitals don't understand what they do at the teaching Hospital. So we remain hopeful and will ALWAYS go to see her after our scans are done. This is not to say that it is a certain option for your husband, but I'm sure it's worth seeing a liver surgeon at a good teaching hospital to get a second opinion. That's what the good folks on here recommended to us and we are SO glad we did. Hang in there and keep up the faith!
April
Oh, and PLucky who posted on here came to visit my husband and I at Loyolla after his surgery one day while she was getting her chemo treatment there. Small world huh? She gave us the pep talk. Just remember you are not alone. (HEY, THANKS AGAIN PEGGY)

Thanks for all the info
Thanks for all the posts. Looks like we have a lot to talk to the Dr about tomorrow.

Nana b

lostit2003 said:

Thanks for all the info
Thanks for all the posts. Looks like we have a lot to talk to the Dr about tomorrow.

Yes, for sure, talk to a
Yes, for sure, talk to a liver surgeon. If the spots are close to the stem (trunk), then you can't do a resection because you need that.

your liver is like a tree, it has a trunk with arms. Arms grow off these Trunks, if the cancer is on the arm it can be cut, but your regrowth will only be limbs... You can never cut the bottom truck, so if the cancer is there, we are in trouble. And if the cancer attacks enough arms, we only have limbs left. Hope that makes sense!