For those with liver mets, no spread elsewhere:

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coloCan
coloCan Member Posts: 1,944 Member
This artilce is rather comprehensive and current as to options for those with mets only in liver; the two shorter items cited at end should also be read:

Can Metastatic Colorectal Cancer Be Cured?
at:

cancernetwork.com/print/article/10165/2044871?printable=true

Those squeamish about stats be forewarned as authors are blunt

Comments

  • Varmint5
    Varmint5 Member Posts: 384 Member
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    Encouraging maybe?
    I thought it was more encouraging than many articles I've read. There's some good info in this article. Thanks. Here's a better link - I had to hunt for the article:

    http://www.cancernetwork.com/colorectal-cancer/content/article/10165/2044871

    Sandy
  • jasminsaba
    jasminsaba Member Posts: 157 Member
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    Fantastic ...
    I think that stated stats in this article are incredibly uplifting and greatly encouraging ... up to 30-40% of patients with organ-limited metastases can be potentially CURED? wow - that's fantastic.
  • coloCan
    coloCan Member Posts: 1,944 Member
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    Fantastic ...
    I think that stated stats in this article are incredibly uplifting and greatly encouraging ... up to 30-40% of patients with organ-limited metastases can be potentially CURED? wow - that's fantastic.

    This site has a tendency to have a "Financial Disclosure"
    section at end of article which may or may not color content.....Apparently no connection to drug industry here.
  • pete43lost_at_sea
    pete43lost_at_sea Member Posts: 3,900 Member
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    steve, great article thanks
    I posted about these limitations a year ago, just a warning from pubmed and i got into hot water over it. nethertheless, the message is clear here, if you have a low bmi ie you are not fat, your chances of avoiding CASH are improved. so why not be healthy. just think about the big M for mcdonalds being equal to M for mortality. thats what stops me walking inside each and every time i go past. these studies are just confirmation that my extreme approach to health is whats required to get the body ready for surgery. and i hope its not needed , but if it is so be it.

    it still all comes down to the liver,the liver, the liver. Anyone interested could do worse than read sandra cabots book the liver and bowel bible as a starting point.

    hugs,
    pete


    Limitations of Chemotherapy
    FIGURE 1

    Comparison of Survival of a Group of Patients With Colorectal Metastases to the Liver and a Second Group With Carcinomatosis
    The role of chemotherapy is to enhance the outcomes of surgery and/or permit potentially curative resection to be performed. Unfortunately, chemotherapy has potential disadvantages, which relate to direct toxic effects on the liver, leading to an increased risk of potential postoperative complications. There is now a large body of evidence showing that systemic chemotherapy can result in nonalcoholic fatty liver disease and sinusoidal injury. The chemotherapy-associated liver disease ranges from steatosis to steatohepatitis (CASH).[62] Steatosis resulting from chemotherapy and/or any other etiology has been shown to lead to a higher rate of complications following hepatic resection. However, the development of CASH appears to hold greater significance.[63] Of note, CASH appears to be more closely associated with the use of irinotecan-based chemotherapy and to occur more commonly in patients with higher body mass index.[64] The development of CASH has been associated with a higher postoperative mortality rate related primarily to postoperative liver failure. In one series, the 90-day mortality rate in patients with steatohepatitis was 14.7% vs 1.6% for those who did not have steatohepatitis.[65] In contrast to treatment with irinotecan, oxaliplatin-based chemotherapy has been typically associated with liver sinusoidal injury.[62,65,66] In more severe cases, perisinusoidal fibrosis, sinusoidal obstruction, and portal hypertension have been observed. In contrast to CASH, the development of sinusoidal dilation has not been associated with an increased risk of perioperative morbidity and mortality.[67,68]
  • NJC
    NJC Member Posts: 73 Member
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    Dave (Dr. Bartlett) is an
    Dave (Dr. Bartlett) is an extremely talented surgeon, and one of the top in his field. In fact, he was responsible for the development of the "new" HIPEC procedure while at the University of Pittsburgh. He is often referred to from Sloan, MD Anderson, etc., and has practiced at each, respectively.

    He is my wife's surgeon and is very much the reason she is still here, as well as his multi-disciplinary team.

    She's gone from "should have been dead by now" to NED after presenting with 15-20 difuse, mucinous liver mets shortly after the birth of our son 18m ago.

    Independent of my wife's future outcome, he has certainly made a significant difference in her outcome, thus far.

    -Joe
  • Varmint5
    Varmint5 Member Posts: 384 Member
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    NJC said:

    Dave (Dr. Bartlett) is an
    Dave (Dr. Bartlett) is an extremely talented surgeon, and one of the top in his field. In fact, he was responsible for the development of the "new" HIPEC procedure while at the University of Pittsburgh. He is often referred to from Sloan, MD Anderson, etc., and has practiced at each, respectively.

    He is my wife's surgeon and is very much the reason she is still here, as well as his multi-disciplinary team.

    She's gone from "should have been dead by now" to NED after presenting with 15-20 difuse, mucinous liver mets shortly after the birth of our son 18m ago.

    Independent of my wife's future outcome, he has certainly made a significant difference in her outcome, thus far.

    -Joe

    Joe...
    I'd like to hear more. My daughter's situation is very similar to your wife's - she just turned 33, was diagnosed in Oct about 7 weeks after the birth of her son, her first child. She has "numerous" liver mets. Would you mind sharing more of your wife's story and treatment with me either here or in a private message? I'd appreciate it very much. Thanks.

    Sandy
  • Varmint5
    Varmint5 Member Posts: 384 Member
    Options
    NJC said:

    Dave (Dr. Bartlett) is an
    Dave (Dr. Bartlett) is an extremely talented surgeon, and one of the top in his field. In fact, he was responsible for the development of the "new" HIPEC procedure while at the University of Pittsburgh. He is often referred to from Sloan, MD Anderson, etc., and has practiced at each, respectively.

    He is my wife's surgeon and is very much the reason she is still here, as well as his multi-disciplinary team.

    She's gone from "should have been dead by now" to NED after presenting with 15-20 difuse, mucinous liver mets shortly after the birth of our son 18m ago.

    Independent of my wife's future outcome, he has certainly made a significant difference in her outcome, thus far.

    -Joe

    Joe...
    Oops - posted twice again. Sorry.
  • relaxoutdoors08
    relaxoutdoors08 Member Posts: 521 Member
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    steve, great article thanks
    I posted about these limitations a year ago, just a warning from pubmed and i got into hot water over it. nethertheless, the message is clear here, if you have a low bmi ie you are not fat, your chances of avoiding CASH are improved. so why not be healthy. just think about the big M for mcdonalds being equal to M for mortality. thats what stops me walking inside each and every time i go past. these studies are just confirmation that my extreme approach to health is whats required to get the body ready for surgery. and i hope its not needed , but if it is so be it.

    it still all comes down to the liver,the liver, the liver. Anyone interested could do worse than read sandra cabots book the liver and bowel bible as a starting point.

    hugs,
    pete


    Limitations of Chemotherapy
    FIGURE 1

    Comparison of Survival of a Group of Patients With Colorectal Metastases to the Liver and a Second Group With Carcinomatosis
    The role of chemotherapy is to enhance the outcomes of surgery and/or permit potentially curative resection to be performed. Unfortunately, chemotherapy has potential disadvantages, which relate to direct toxic effects on the liver, leading to an increased risk of potential postoperative complications. There is now a large body of evidence showing that systemic chemotherapy can result in nonalcoholic fatty liver disease and sinusoidal injury. The chemotherapy-associated liver disease ranges from steatosis to steatohepatitis (CASH).[62] Steatosis resulting from chemotherapy and/or any other etiology has been shown to lead to a higher rate of complications following hepatic resection. However, the development of CASH appears to hold greater significance.[63] Of note, CASH appears to be more closely associated with the use of irinotecan-based chemotherapy and to occur more commonly in patients with higher body mass index.[64] The development of CASH has been associated with a higher postoperative mortality rate related primarily to postoperative liver failure. In one series, the 90-day mortality rate in patients with steatohepatitis was 14.7% vs 1.6% for those who did not have steatohepatitis.[65] In contrast to treatment with irinotecan, oxaliplatin-based chemotherapy has been typically associated with liver sinusoidal injury.[62,65,66] In more severe cases, perisinusoidal fibrosis, sinusoidal obstruction, and portal hypertension have been observed. In contrast to CASH, the development of sinusoidal dilation has not been associated with an increased risk of perioperative morbidity and mortality.[67,68]

    Agree Agree Agree
    Pete,
    Yes, the reason I am trying so hard is to prevent recurrence but if it does occur I want to be in shape for surgery with the best outcomes; Need to cover all our bases.
    NB