advice needed

I think chemo is gonna benefit you a couple of ways. It will control the growths and buy you time to explore your surgery options.

What do they mean when they say chest wall? Surface of the lungs, pleura, ribs? And what kind of chemo do they recommend?

Im rooting for you man, a big time!

Laz

Is the spot on the liver small?  Did he say why surgery wasn't an option?

I would go for RFA if I could.  I have too many, I now have seven on my liver, but I don't see why you can't!  I am out of chemo's now, I've been through them all, and we just went back to Oxi/Avastin/xeloda, although it worked the first time I did it in 2010, when I did it late in 2012 it no longer worked, which is when I went to Irinotecan and Erbitux.  Then I went to Irenotecan and Vectibux which worked until December.  But that quit working so can only hope that maybe thsee tumors are from the second new primary that was in the sigmoid and the Oxi/Xeloda/Avastin will work once again.  I can only hope but expect it not to.

If I could do RFA I would, if chemo's still works for you I know at Stanford they do TACE (I know from Pete's stuff that a person might think it's a therapy only available in Germany, but a lot of hospitals do it here, and one also might think it wasn't CHEMO since Pete makes it appear that he isn't into chemo, but it IS CHEMO that goes direct to the liver while they also cut off the oxygen to the tumors) the nice thing about TACE is that it doesn't go everywhere else in the body just to the liver where you need it.  I personally would go this route but since we don't know if chemo works on it for me anymore, it would be pointless to go through that since the chemo needs to work on the tumors.  They consider it a standard treatment for unresectable heptocellular carcinoma.  You might check into this as well as the RFA.

Wishing you luck there.

Winter Marie

Jeff i have no advice ....just wanted to say I am here and thinking about you a great deal....you seem to have clicked into full high gear.....this is a good thing.....sending love and a hug

maggie

janderson1964 said:

He is a liver surgeon. One of

He is a liver surgeon. One of the best in the country. He alreadyndi 3 liver resections on me. Thats what makes this so shocking. The oncologist I am seeing is very good on seeking out surgical options first. I am on the way to get 6 copies of the scan so I can shop it around.

and it sounds to me like you are going to find an answer to this set-back.  Keep pushing forward, we'll be right behind to help hold you up.

Sending hope and love~AA

Jeff, if you're going for short range radiation near the surface, you especially might check out proton therapy.  It's only at a handful of centers but the big advantage is that the protons deposit most of their energy in the target tumor.  No "exit wound/path" radiation load. 

Proton therapy plus chemo  

How close in time will aggressive surgeons operate on liver to treatments with xeloda only (days or weeks, particularly with no Avastin)?  Bleed potential may worry the surgeons far beyond your optimal net utilities to protect themselves.   With my wife's oral chemo, we did oral chemo with UFT up to 24 hrs before abdominal surgery where some Japanese papers mention actual 5FU based chemo (mostly UFT) hours before colon resections.  Of course, we used those other CAM adjuncts and antimetastatic agents for cancer surgery. We also figure in supernutritional wound support too for better wound healing and to prevent sepsis, especially IV vitamin C after surgery with outside support.

One step at a time, whatever it takes.  We have to carry the ball on organizing advanced multimodal treatments.  Hope you can find those surgeons that will support your efforts above and beyond.  We all have repeatedly seen the importance of getting past "no" on advanced surgeries where higher surgical skill, great confidence (both), and your special knowledge are factors.  Carefully framing the situation, like WM mentions, and practice with multiple dr interviews can turn "no" into "yes".  

Jeff, I don't have any advise / insight but I wanted to say you are in my thoughts and prayers and I'm following your updates. Wishing you the very best! 

Sincerely,

Phil

janderson1964 said:

My surgeon says the spots on

My surgeon says the spots on the liver could be ablated but doesn't want to do it because of the two chest wall nodules. The cheswall nodules would be very close to the surface, just under the ribs, maybe VATS is an option. It seems as though he is giving up since it is now "extrahepatic disease" which he contradicted himself by saying surgery might be an option if I respond well to chemo. He was the only doctor I still trusted over the past 8+ years. Not any more. I am seeing my first oncologist today to get a treatment plan together but I will shop other hospitals in the meantime. I am not taking no for an answer. Its just another case of a surgeon not wanting to think outside of the box when there are plenty who will think outside of the box. The trick is finding one of those surgeons. I have several copies of the images and am ready to go shopping.

Find a real pro of a surgeon!  This will make a lot of difference.   The first surgeon would not even atempt to do surgery on my mets.  The second removed 20 out of 28 mets!   The confidence of a great surgeon will make a lot of difference.

Best Always,  mike