Are liver mets resectable? Article says it depends on who you ask.

myAZmountain

Trubrit said:

I disagree

Anyone not using a top rated hospital is risking their lives.

I live in rural Nevada. I am monetarily poor. I travel a 320 mile round trip to see my Oncologist and radiation oncologist. My treatment with both, and with the hospital I had both of my surgeries, has been excellent. I am alive to tell the tale.  

All of our lives are at risk. For some of us, going to a top rated hospital is out of the question. Going to a Cancer centre is out of the question, but we can still recieve quality care from good Oncologists. 

I am happy for those who are able to pick and choose, but don't make it sound like its the end of the line for those who can't. 

Tru

Trubrit--

I live in rural AZ and am wondering which hosptial you travel to? I have appt at Mayo Phoenix in 2 weeks for second opinion--just curious wher you have chosen to go. Thx and bless you!

pcmeiners

Anyone not using a top rated hospital

"Anyone not using a top rated hospital is risking their lives."

Agree, the ststement was a bit dramatic. Just going by my experience where I live. 3 month to get treatment, doctors more interested in consultation fees (causing delay) then health issues, doctor performing a biopsy with an xray not ultra sound , long derlays in appointments, staff losing mediccal records (all different doctors). Also note it is not critical to have radiation/chemo at a top cancer center, but it gives you an edge to be be diagnoised and a treatment regiment setup by one ( quickly) to be performed near your home. Going to a top rated/teaching hospital gives you a 5% better outcome, and less chances of  experiences like mine.

 

 

beaumontdave

I agree that the best

I agree that the best hospitals are the ideal way to go for top level treatment, but getting things done fast is important too. In my case, wanting it done quickly meant a referral to a local surgeon in a nearby town and a ten day wait. Had I decided to go to UCLA or City of Hope, out here in Cali, what would my wait times have been for a single 5cm mass in my sigmoid section? After the colectomy and chemo I got Kaiser through the state's high-risk program, and they won't top any lists on cutting-edge treatment, but they do hustle you into the tests, scans, and surgeries quickly, and with the fine line I was walking at recurrance, I was happy to be in a place that got it done. Since surgery has been the means of my being NED now, I'm comfortable with Kaiser, if it should come back spread, and surgery wasn't an option, I would head to MD Anderson or the equivalent facility post haste.........................................Dave

LSU2001

After being told I was inoperable

Hey everyone,

I have Stage IV rectal cancer and all my mets were in my liver.  I had over 20 lesions/tumors total  8 large and the rest small to medium, and on both lobes.  I was initially told that I was inoperable and I would need pallative chemo-radiation on my primary tumor and then chemo (Folfox with avastin).  i did the radiation and despite the pain of the treatments and the long term effects, I had a complete clinical response to the radiation therapy.  I visited several liver surgeons in my area, and even went to Oschner Cancer Center in New Orleans to see a liver specialist.  All said the same thing, I would never be able to have a liver resection, there were just too many spots.  Fast forward about 6 months, after getting pissed off at the way I was treated at Oschner I asked my oncologist for a referral to MD Anderson in Houston.  I went in about a month later and had all types of scans, tests, etc.  the oncologist I saw, said the same thing everyone else was saying, Inoperable and that I had maybe two years with treatment.  The thing that impressed me most about the MDA doc was that he said, he could see no way to operate but that he would refer my case to their Hepato-billiary dept. 

About two weeks later the onc called me out of the blue and told me that the liver surgeon wanted to meet with me because he thought he could operate.  Wooooo Hoooo finally!! 

In any case the surgeon put me through even more tests and scans and then told me that he felt very confident that he could operate successfully, but I would have to have two resections about 6 weeks apart.   So a month or so later, I went to MDA to have my left lobe remove the spots their first.  I had good results from that and healed quickly. I only missed about 4 weeks of work.  Then about 3 weeks after my resection, I had to have a portal vein embolization done to force my left lobe to grow bigger than I should be.  Because almost 6 weeks to the day of my first resection I had my second to remove the entire right lobe.  This was a much harder recovery because of all the recent surgies etc.  anyway, on my first follow up appt. with the liver surgeon, He walked into the room and the first words out of his mouth were, "Now we can talk about longevity"  while I did have a recurrence in my liver since surgury and I had my 36th chemo treatment last wednesday, I feel the resections were very successful and saved my life at the time>

I firmly believe that had I taken the advice of numerous doctors and surgeons I would be dead now.  By pushing the issue and insisting that I wanted to continue to search for someone who was willing to at least try to resect my liver, I was able to find just that surgeon.  

So I guess what I am saying is Never Give UP and the best advocate for you is you!!

TIm

abita

LSU2001 said:

After being told I was inoperable

Hey everyone,

I have Stage IV rectal cancer and all my mets were in my liver.  I had over 20 lesions/tumors total  8 large and the rest small to medium, and on both lobes.  I was initially told that I was inoperable and I would need pallative chemo-radiation on my primary tumor and then chemo (Folfox with avastin).  i did the radiation and despite the pain of the treatments and the long term effects, I had a complete clinical response to the radiation therapy.  I visited several liver surgeons in my area, and even went to Oschner Cancer Center in New Orleans to see a liver specialist.  All said the same thing, I would never be able to have a liver resection, there were just too many spots.  Fast forward about 6 months, after getting pissed off at the way I was treated at Oschner I asked my oncologist for a referral to MD Anderson in Houston.  I went in about a month later and had all types of scans, tests, etc.  the oncologist I saw, said the same thing everyone else was saying, Inoperable and that I had maybe two years with treatment.  The thing that impressed me most about the MDA doc was that he said, he could see no way to operate but that he would refer my case to their Hepato-billiary dept. 

About two weeks later the onc called me out of the blue and told me that the liver surgeon wanted to meet with me because he thought he could operate.  Wooooo Hoooo finally!! 

In any case the surgeon put me through even more tests and scans and then told me that he felt very confident that he could operate successfully, but I would have to have two resections about 6 weeks apart.   So a month or so later, I went to MDA to have my left lobe remove the spots their first.  I had good results from that and healed quickly. I only missed about 4 weeks of work.  Then about 3 weeks after my resection, I had to have a portal vein embolization done to force my left lobe to grow bigger than I should be.  Because almost 6 weeks to the day of my first resection I had my second to remove the entire right lobe.  This was a much harder recovery because of all the recent surgies etc.  anyway, on my first follow up appt. with the liver surgeon, He walked into the room and the first words out of his mouth were, "Now we can talk about longevity"  while I did have a recurrence in my liver since surgury and I had my 36th chemo treatment last wednesday, I feel the resections were very successful and saved my life at the time>

I firmly believe that had I taken the advice of numerous doctors and surgeons I would be dead now.  By pushing the issue and insisting that I wanted to continue to search for someone who was willing to at least try to resect my liver, I was able to find just that surgeon.  

So I guess what I am saying is Never Give UP and the best advocate for you is you!!

TIm

Only 2 years without surgery?

Only 2 years without surgery? That is depressing. I thought it would be much longer if get chemo to shrink what is there. That being said, I have been trying to have hope. But that 2 years number is so depressing. My doctor didn't tell me how long I have now that I have a recurrence. And I am not going to ask now.

LSU2001

After being told I was inoperable

I was 48 when I was daignosed in 2016. And yes, 2 years give or take but my cancer was so far advanced with so many mets in the liver that I initally had a very poor prognosis.  I really don't think the tumors were going to respond to treatment, but they did somewhat.  They shrank some but not a lot.  I was very lucky that my liver tumors were in places that they could be resected by a confident and skilled surgeon.  

abita

LSU2001 said:

After being told I was inoperable

I was 48 when I was daignosed in 2016. And yes, 2 years give or take but my cancer was so far advanced with so many mets in the liver that I initally had a very poor prognosis.  I really don't think the tumors were going to respond to treatment, but they did somewhat.  They shrank some but not a lot.  I was very lucky that my liver tumors were in places that they could be resected by a confident and skilled surgeon.  

I had 3 original large tumors

I had 3 original large tumors in my liver that were removed by a very skilled surgeon. Even did the mop up chemo. We thought I was "cured". My first post chemo scan showed a recurrence. My tumors did shrink with the 4 rounds of chemo I had before my surgery but I became allergic to that drug. Going to start back on it again anyway because we know it works. Mine are not resectable because of location even though they are small. I am starting the treatment plan, but am getting a second opinion. I refuse to believe that this is my prognosis 

tanstaafl

LSU2001 said:

After being told I was inoperable

Hey everyone,

I have Stage IV rectal cancer and all my mets were in my liver.  I had over 20 lesions/tumors total  8 large and the rest small to medium, and on both lobes.  I was initially told that I was inoperable and I would need pallative chemo-radiation on my primary tumor and then chemo (Folfox with avastin).  i did the radiation and despite the pain of the treatments and the long term effects, I had a complete clinical response to the radiation therapy.  I visited several liver surgeons in my area, and even went to Oschner Cancer Center in New Orleans to see a liver specialist.  All said the same thing, I would never be able to have a liver resection, there were just too many spots.  Fast forward about 6 months, after getting pissed off at the way I was treated at Oschner I asked my oncologist for a referral to MD Anderson in Houston.  I went in about a month later and had all types of scans, tests, etc.  the oncologist I saw, said the same thing everyone else was saying, Inoperable and that I had maybe two years with treatment.  The thing that impressed me most about the MDA doc was that he said, he could see no way to operate but that he would refer my case to their Hepato-billiary dept. 

About two weeks later the onc called me out of the blue and told me that the liver surgeon wanted to meet with me because he thought he could operate.  Wooooo Hoooo finally!! 

In any case the surgeon put me through even more tests and scans and then told me that he felt very confident that he could operate successfully, but I would have to have two resections about 6 weeks apart.   So a month or so later, I went to MDA to have my left lobe remove the spots their first.  I had good results from that and healed quickly. I only missed about 4 weeks of work.  Then about 3 weeks after my resection, I had to have a portal vein embolization done to force my left lobe to grow bigger than I should be.  Because almost 6 weeks to the day of my first resection I had my second to remove the entire right lobe.  This was a much harder recovery because of all the recent surgies etc.  anyway, on my first follow up appt. with the liver surgeon, He walked into the room and the first words out of his mouth were, "Now we can talk about longevity"  while I did have a recurrence in my liver since surgury and I had my 36th chemo treatment last wednesday, I feel the resections were very successful and saved my life at the time>

I firmly believe that had I taken the advice of numerous doctors and surgeons I would be dead now.  By pushing the issue and insisting that I wanted to continue to search for someone who was willing to at least try to resect my liver, I was able to find just that surgeon.  

So I guess what I am saying is Never Give UP and the best advocate for you is you!!

TIm

followup chemistries

So one area of improvement that remains is the post surgical treatment to prevent recurrence.  Here I would nominate some extended form of ADAPT therapy (oral 5FU drug + celecoxib), extended by any number of off label adjuncts, mostly supplments with chemo and immune enhancing propeties and other benefits.