Nick~Glad U checked N ~ Have the docs mentioned RADIOEMBOLIZATION as a possibility for your Liver me

LorettaMarshall
LorettaMarshall Member Posts: 662 Member
edited August 2016 in Esophageal Cancer #1

(Note:  This letter intended to be an answer to Nick98338 - http://csn.cancer.org/comment/1552160#comment-1552160

"Going On Nine Months - - "EGD found the esophagus tumor last November. Already stage IV. No surgery possible. Radiation and Taxol Carboplatin eliminated the esophagus tumor. Now just dealing with the mets in the liver. Recently started folfiri. Hanging in there. ")

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 Well Hello Nick,

 It would interest me to know what symptoms caused you to have an esophagogastroduodenoscopy – (EGD)?  Had you been having trouble with heartburn for some length of time and been taking omeprazole?  This is so often the case when patients write here for the first time.  Some have unexplained weight loss or trouble swallowing, and a change in their diet causes weight loss.  In any event, you’re here and we’re here to help if we can.  Some here are patients, some are survivors with stories you will find inspiring. 

 Acid reflux, heartburn or difficulty swallowing seems to be something people think TUMS or PEPTO BISMOL will take care of, but that is far removed from the truth.  So since you didn’t write anything on your “about me” page, I’m left to wonder about how old you are.  (I’m 77) And who are the doctors that are treating you?  And always I like to know if the new patient writing here has had a SECOND OPINION?  It’s never too late to have a 2nd opinion, even if you’re presently undergoing treatment at another facility.  Some people are reluctant to even mention it—afraid they will hurt the doctor’s feelings.  My soul, whose feelings take precedence? 

 It’s good to know that the Carbo/Taxol/Radiation combo did a good job of eradicating the tumor in the Esophagus.  I see you are now on another chemo combo of Fluorouracil, Irinotecan and Leucovorin (FOLFIRI).  With all that you’ve been through already with these powerful drugs, do the cancerous tumors stand a chance?  We would hope they deliver a “knock out! “  I know you’re pleased to have made the progress that you have but these drugs are not without side effects, as you well know already.  Nevertheless, I’ve given you some references below just in case there are questions involving these particular drugs.

 I did want to mention one procedure that has been shown to reduce cancerous tumors in the Liver.  It is often given to patients who have had a primary cancer that has now spread to the Liver.  We had a young man here named Jim several years ago now.  He presented with Esophageal Cancer Stage IV. The cancer was in his Liver as well.  In addition to the traditional chemo and radiation for his Esophageal cancer, his doctors treated him with a treatment known as “radioembolization”.  It goes by the names of Therasphere or Sir-Spheres.

Nick, I just wanted to share this info with you because I know our friend Jim had good success.  The doctors treated one lobe of the Liver, side effects were minimal, mostly fatigue.  Unfortunately, before the second session could be started, Jim’s cancer metastasized to other organs as well.  And so the doctors did not go forth with the second session.  But if your metastasis is limited to the Liver thus far, one would think that this treatment might be an option for you.

  And when you look at these videos below, you will see other similar videos on the sidebar that explain it even further.  Just thought it might be something that your doctors might consider.  You might want to ask about it.  If the facility where you are being treated cannot provide that type of treatment, might it be possible that they could set you up with a reputable facility that does provide it?  It is usually done on an outpatient basis.  I believe one of the videos indicate that it can be administered while one is undergoing chemo. 

 With that, I will close.  But I’m glad you wrote here.  There are others here who are long-time survivors with a Stage IV diagnosis, and I’m sure they’ll be along to chat with you.  It’s always encouraging to talk with someone that has traveled the path before you.  They help to “light” the way and sometimes even help to “lighten” your burden.

 May God continue to bless you with continued successes going forward,

 Loretta

 (Wife of William (Bill) diagnosed w/Adenocarcinoma @ the GE junction, EC Stage III (T3N1M0) in Nov. of 2002—had a successful Ivor Lewis Minimally Invasive Esophagectomy performed by Dr. James D. Luketich @ the University of Pittsburgh Med. Ctr. On May 17, 2003.  William just had another checkup and is still cancer free and celebrating 14 years of additional good quality of life that we never dreamed possible. 

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 See the following videos here that describe the radioembolization process. Published on Jan 14, 2016

 1.  https://www.youtube.com/watch?v=YndyQkSZl5I

 “This animated Mode of Action video has been created by Sirtex Medical to serve as an educational resource that provides a narrative look at Selective Internal Radiation Therapy (SIRT) using SIR-Spheres® Y-90 resin microspheres. SIRT using SIR-Spheres microspheres is a targeted liver tumor treatment that delivers millions of radioactive microspheres directly to inoperable liver tumors. SIR-Spheres Y-90 resin microspheres are the only fully FDA-approved microsphere radiation therapy for the treatment of colorectal liver metastases. This video covers explanation and animation of the SIR-Spheres® Y-90 resin microspheres procedure.”

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 2.   https://www.youtube.com/watch?v=hh0Farhu4Hw

 Selective Internal Radiation Therapy

 “Published on Jun 19, 2014 - Saint Elizabeth Cancer Institute is now offering an innovative treatment for liver cancer called Selective Internal Radiation Therapy (SIRT). This procedure offers a new option for patients with otherwise inoperable tumors. We are proud to be the first to offer this targeted treatment in Lincoln. In this video, interventional radiologists Dr. Vander Woude and Dr. Razdan explain the benefits of SIRT. " -
To learn more about SIRT, please visit www.SaintElizabethOnline.com/Cancer”

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 3.    https://www.youtube.com/watch?v=mVLE8E3Cyzw

 SIR-Spheres Y-90 resin microspheres Patient Information Video

 “Published on Apr 8, 2013 - This video has been created by Sirtex Medical to educate patients on Selective Internal Radiation Therapy (SIRT) using SIR-Spheres® Y-90 resin microspheres. SIR-Spheres Y-90 resin microspheres are the only fully FDA-approved microsphere radiation therapy for the treatment of colorectal liver metastases. The information presented here is not intended as a substitute for medical care. Please talk with your healthcare provider about any information you get from this video.”

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 4.  https://www.youtube.com/watch?v=_rRZcZhIQEg

 “Published on Apr 2, 2014 - Sarah Cannon Radiation Oncology Physician-in-Chief Andrew Kennedy, MD, discusses metastatic colorectal cancer in this web chat recorded on April 2nd. Topics include difficulties of treating mCRC; treatment options, including Selective Internal Radiation Treatment (SIRT); imaging insights; response and survival rates, treatment safety and impact on quality of life; considerations for patients over the age of 70; and side effects of interventional oncology treatment/imaging. This web chat is sponsored by Sirtex Medical Inc.”

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 5.   https://medlineplus.gov/ency/article/003888.htm

 “EGD - esophagogastroduodenoscopy

  Esophagogastroduodenoscopy (EGD) is a test to examine the lining of the esophagus, stomach, and first part of the small intestine.

 How the Test is Performed - EGD is done in a hospital or medical center. The procedure uses an endoscope. This is a flexible tube with a light and camera at the end…”

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6.  http://chemocare.com/chemotherapy/drug-info/irinotecan.aspx

 7.  http://chemocare.com/chemotherapy/drug-info/fluorouracil.aspx

 8.  http://chemocare.com/chemotherapy/drug-info/leucovorin.aspx

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9.  http://www.mcancer.org/liver-cancer/radioembolization

 “Radioembolization

 What is radioembolization for liver cancer?

 Radioembolization is an outpatient therapy in which tiny radioactive beads are sent to tumors through the bloodstream. The beads stick in the tumors and release radiation that kills nearby cancer cells. This treatment permits a high dose of radiation to be focused directly inside tumors; generally, nearby healthy tissue receives minimal radiation. In the month following treatment, the radiation found in the particles gradually disappears.

 Multidisciplinary Liver Tumor Care

 When liver tumor patients at the University of Michigan receive this therapy, it means that doctors and nurses are providing cancer care according to a personalized treatment plan developed by specialists in the U-M Comprehensive Cancer Center's multidisciplinary tumor program. Members are experts in hepatology, surgery, medical oncology, radiation oncology, and diagnostic and interventional radiology. Their frequent meetings allow patients to have the expertise of a multidisciplinary team of physicians with a focus on liver cancer - without having to schedule individual appointments.

 Radioembolization is a good option for patients with primary and secondary (metastatic tumors) in the liver. The goal of this therapy is to shrink tumors and prevent them from growing again. In some cases, there can be enough shrinkage for the patient to be re-considered for surgery or liver transplantation.

 Since 2007, as many as 40 liver tumor patients have been treated annually at the University of Michigan using radioembolization.

 What to expect

 Radioembolization is performed as an outpatient therapy and involves threading a catheter through the femoral artery in the groin to the arteries feeding the tumor in the liver using X-ray guidance. The radioactive beads are then delivered to the tumor. The procedure is done using light sedation. Most patients return home to light activity within four hours. Some patients require small doses of nausea medicine for a few days after returning home.

 Typically, there is one episode of treatment. However, if the cancer is on both sides of the liver, the treatment may be split to two (one for each side of the liver), to maximize safety. These are performed approximately 8 weeks apart. In certain situations, this treatment can be repeated in the future…”

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10.  http://www.cancercenter.com/treatments/radioembolization/

 Here is a good short video explaining the radioembolizatioin treatment.  It is called TheraSphere.  It is used to treat tumors in the Liver.  Tiny radioactive glass beads 1/3 the size of a hair follicle are inserted into the Femoral artery that goes directly to the Liver and has been highly successful in eradicating a good percentage of tumors in the Liver.

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