Decisions about liver treatment

Hello everybody. This week has been very eventful as far as my daughter's treatment options for her liver. She started on Folfiri last week after LAR recovery - switched from Folfox because CEA was climbing prior to surgery.

So we have consulted with two liver surgeons this week, both well-respected and recommended. Both have reviewed my daughter's case (33 year old new mother with stage IV, multiple liver mets). They were both sent the original CT scan and the most recent from about 4 weeks ago.

We got a call Tuesday from the assitant of the doctor at the big city NCI hospital and this is what she said, in a nutshell. She said that the most recent CT shows dramatic tumor shrinkage and cell death despite the CEA going back up, so this doctor recommends continuing chemotherapy until it is no longer working and then consult again. At that time there would be three possible options: resection, tumor ablation, HAI pump with HAI pump being the most likely. They said to check back with them in three months with a new CT scan. Continue what we're doing for now.

Wednesday we saw another liver surgeon, in person. We liked him very much - head of transplant team at largest hospital in daughter's city at other end of state. This cancer currently in application process for NCI status. This doctor said that my daughter has good liver function but too much tumor, to many tumors, to leave enough liver to resect. He advises against the HAI pump due to increased risk of liver damage - wants to keep liver as healthy as possible in event of future resection and need to remove lots of liver. He wants her to continue with Folfiri and do Theraspheres now with goal being eventual staged resection. My daughter and her husband are leaning toward this option for several reasons, maybe foremost that it can be started now while she is on chemo instead of waiting. Also, it is local and less hardship for these young new parents.

Her oncologist wants her to get a couple of Folfiri treatments in before doing Theraspheres to make sure the tumors are responding - CEA is good marker for her. He doesn't want to start another treatment without knowing this. He said that the Theraspheres could influence the CEA and it would not be clear which was working, the chemo or spheres, so he wants to be sure she is on the right chemo first. This makes sense to me.

I looked this surgeon in the eye and told him that our goal is a cure and asked if he would join our team with this as our goal. He looked me in the eye and shook my hand and said yes. We really liked him. He thinks outside the box. He also said that HAI remains an option after Theraspheres if needed, but HAI first then Theraspheres would be much more risky.

Are any of you familiar with Theraspheres? I know Suzanne Lindley had Sirtex spheres. Also, I really value the insight of all of you here and would appreciate knowing what you think of all this, how comfortable you would feel.

Thanks!

Sandy