it's back in two months after TACE and MWA to liver mets

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sdp
sdp Member Posts: 181

About two months ago I had TACE followed by microwave ablation to three mets'

Post treatment scan in few days of tace and next day of ablation showed good response and they got it all as per the docs at that time.

 

However,  rising markers after the first month or so led to a pet-ct in 6 weeks of previous treatment and the scan showed three mets at same place as the earlier scan ( pre tace and pre ablation ). I was surprised at this fast growth - the pet-ct report shows the size as 3 cm to 4 cm.average for the three mets individually.

Now the treatment is SIRT ( Similar to tace but instead of chemo it is radioactive beads). Mapping etc was done on Thursday and the actual Sirt procedure is in a few hours.

The dr doing the procedure says she has calculated the tumour load in the liver and it is approx 5% (?) And she intends to inject beads with a total radiation dosage of 1450 units ( I don't specifically remember the unit) 

She says the normal dosage they do usually is 2000 or so but for my tumor load 1450 was enough ! And possibly according to her more is not better - I thought they calculated dosage on weight and height and some surface area formula - similar to chemo dosage - but I guess that is not the case.

How frequent is the SIRT followed by an ablation ? Is that the correct way to go to avoid or rather delay further recurrence. Any suggestions would be appreciated on the way forward after the SIRT .

 

 

Comments

  • Trubrit
    Trubrit Member Posts: 5,800 Member
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    Oh, I am so sorry to hear this news

    You are going through the mill for sure. 

    I am sorry that new mets have appeared, and I hope that the next treatment works well for you. 

    I can't help you with your question, but surely someone here will be along with some kind of advice. 

    Keep strong. 

    Sue - Trubrit

  • lp1964
    lp1964 Member Posts: 1,239 Member
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    Dear Friend,

    Don't know anything about the procedure, but I wanted to send my well wishes and support.

    Laz

  • herdizziness
    herdizziness Member Posts: 3,624 Member
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    I wish

    I had an answer for you, but I have no idea about TACE or SIRT.  Hopefully someone will know. Wishing you th best of luck in this unknown journey.

    Winter Marie

  • Easyflip
    Easyflip Member Posts: 588 Member
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    Well

    that Tace was a bust. Better luck with the Sirt. At least they were caught early and it looks like you're getting a smaller dosage than normal. There are many on the boards who have had multiple liver procedures, those little buggers can be stubborn! Keep the faith and keep us posted. Best wishes!

    Easyflip/Richard

  • janderson1964
    janderson1964 Member Posts: 2,215 Member
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    I am sorry I forgot to

    I am sorry I forgot to respond to your PM. To answere your question above about ablation. They will scan you 1 month after SIRT to see how you responded. If you show response you could keep responding up to 6 months from the one dose. I had scans done every 2 months after the first scan and had ablation done to the tumor 5 months after SIRT. I wanted to obtain maximum shrinkage on the liver tumor to optimise the response to the ablation but I didn't want to wait to long and risk the tumor starting to grow again. It is a tight window of opportunity.

  • sdp
    sdp Member Posts: 181
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    I am sorry I forgot to

    I am sorry I forgot to respond to your PM. To answere your question above about ablation. They will scan you 1 month after SIRT to see how you responded. If you show response you could keep responding up to 6 months from the one dose. I had scans done every 2 months after the first scan and had ablation done to the tumor 5 months after SIRT. I wanted to obtain maximum shrinkage on the liver tumor to optimise the response to the ablation but I didn't want to wait to long and risk the tumor starting to grow again. It is a tight window of opportunity.

    thanks for all responses

    The procedure went of well - another dr did the final procedure as the head of dept was on leave and he had done the mapping and embolisation of certain vessels so that the sirt doesn't leak to other organs.

    Well the fresh set of eyes and perspective had a positive outcome as he found another vessel to GI tract that he had to embolise -

    So it got all delayed but worth it for me. Managed to prevent or avoid any other issue later.

    I feel fine and meds to keep it all under control seems to be doing their job. So it has been much better than my expectation and imagination ( sometimes we worry much prior to the procedure and have all kinds of things in mind)

    U have asked about the post treatment - they suggest scan in 6 to 8 weeks and then take a call. No chemo recommended.

    Dear Janderson - would the ADAPT option be worth evaluation and implementing ? Seems I am following thru all the procedures that u have been through - so ur posts have been of help to me immensely. Thanks for that. 

     Also the dr is suggesting weekly blood test for the liver values as that they want to monitor "just in case ".

     

  • janderson1964
    janderson1964 Member Posts: 2,215 Member
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    sdp said:

    thanks for all responses

    The procedure went of well - another dr did the final procedure as the head of dept was on leave and he had done the mapping and embolisation of certain vessels so that the sirt doesn't leak to other organs.

    Well the fresh set of eyes and perspective had a positive outcome as he found another vessel to GI tract that he had to embolise -

    So it got all delayed but worth it for me. Managed to prevent or avoid any other issue later.

    I feel fine and meds to keep it all under control seems to be doing their job. So it has been much better than my expectation and imagination ( sometimes we worry much prior to the procedure and have all kinds of things in mind)

    U have asked about the post treatment - they suggest scan in 6 to 8 weeks and then take a call. No chemo recommended.

    Dear Janderson - would the ADAPT option be worth evaluation and implementing ? Seems I am following thru all the procedures that u have been through - so ur posts have been of help to me immensely. Thanks for that. 

     Also the dr is suggesting weekly blood test for the liver values as that they want to monitor "just in case ".

     

    I think ADAPT is worth

    I think ADAPT is worth looking into. I was doing ADAPT and irinotecan one week on one week off between SIRT and ablation with good results. I just started ADAPT only but two weeks on and one week off. I am on my tenth day and it is very doable. I have little to no side effects. Just occasional mild upset stomach but i have stomach issues already from my enlarged spleen.

  • Holdtight
    Holdtight Member Posts: 151
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    Similar Situation

    Hi!  I just had an ablation in the upper right lobe of my liver - this is the 4th ablation for me.  This met was quite large and I did feel it tugging across my side with pain radiating and since the ablation discomfort has subsided. I will need to follow up in 4 weeks with a CT Scan or MRI.  However, before this 4th attempt the radiologist recommended the SIRT to me. Giving me some brochures to read.  Reading your comment today has given me hope if this procedure needs to be done.  Did they have to go into the groin to insert a cath to project the radiation.  This kind of scares me to have this done.  also, I have two rather large scars on the liver from the previous ablations do you know if the damage is more receiving the radiation verses the ablations.  Thanks so much for your input and I wish you all the best in your recovery.  

  • janderson1964
    janderson1964 Member Posts: 2,215 Member
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    Holdtight said:

    Similar Situation

    Hi!  I just had an ablation in the upper right lobe of my liver - this is the 4th ablation for me.  This met was quite large and I did feel it tugging across my side with pain radiating and since the ablation discomfort has subsided. I will need to follow up in 4 weeks with a CT Scan or MRI.  However, before this 4th attempt the radiologist recommended the SIRT to me. Giving me some brochures to read.  Reading your comment today has given me hope if this procedure needs to be done.  Did they have to go into the groin to insert a cath to project the radiation.  This kind of scares me to have this done.  also, I have two rather large scars on the liver from the previous ablations do you know if the damage is more receiving the radiation verses the ablations.  Thanks so much for your input and I wish you all the best in your recovery.  

    They go through the groin

    They go through the groin twice. Once for mapping and embolisation then for the radioactive beads at a later date. Dont let it scare you. I thought it was much easier than the liver ablation. I dont know if i can answer your second question accurately. I didnt have any ablations before SIRT but I did have 3 liver resection surgeries which changed the whole anatomy of my liver through the regeneration process.

  • sdp
    sdp Member Posts: 181
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    Holdtight said:

    Similar Situation

    Hi!  I just had an ablation in the upper right lobe of my liver - this is the 4th ablation for me.  This met was quite large and I did feel it tugging across my side with pain radiating and since the ablation discomfort has subsided. I will need to follow up in 4 weeks with a CT Scan or MRI.  However, before this 4th attempt the radiologist recommended the SIRT to me. Giving me some brochures to read.  Reading your comment today has given me hope if this procedure needs to be done.  Did they have to go into the groin to insert a cath to project the radiation.  This kind of scares me to have this done.  also, I have two rather large scars on the liver from the previous ablations do you know if the damage is more receiving the radiation verses the ablations.  Thanks so much for your input and I wish you all the best in your recovery.  

    back home after sirt !

    Hi 

    Am back home from Germany after the sirt. not much side effects but have following meds to take:-

    Hydrocortisone

    Urofalk 

    Panadol

    Scan is recommended two months later. No chemo recommended.

    However I have asked some Dr's about metronomic chemo.Also I learnt that there is some new startup in Munich which has made some Inroads into immunotherapy but it seems it is 2 years  away to be offered to the public 

    - they need to do the trials etc - supposedly funding is on way. Have asked if there is a way to join the trial. However,  no response so far as it seems it is a fairly new setup for this. Will keep u updated.

    However, my local oncologist is keep that I do a full fledged folfiri and erbitux. but at this stage I don't want to exhaust the second line chemo.

    Anyone have any suggestions out of those enumerated above,

    Immunotherapy or folfiri+erbitux or metronomic ( like adapt )?