liver met question

mikew42
mikew42 Member Posts: 114 Member
edited March 2014 in Colorectal Cancer #1
OK, when I met with my onc. two weeks ago, I asked if I could be a long term survivor. I have 1 liver met and have been on chemo for 3 full rounds of out of 6. Liver met has shrunk 50% to 1 cm and onc. thinks that at my next MRI (next Monday) it may be gone totally. He said that I have met the two conditions for possible long term survival. One, the chemo seems to be working and two, I can tolerate the chemo (no real side effects so far). My question is this. Everywhere I read is that the only true "cure" for mets is resection of the liver. Can someone be "cured" if the treatment is only chemo? Thanks in advance for any replys. Mike

Comments

  • alihamilton
    alihamilton Member Posts: 347 Member
    #2
    I really do not know the answer to that one but I do know that some mets in the liver cannot be resected due to their location. My husband has 2 and one is in a difficult location. They are talking about resection or radiofrequency ablation. It has not been suggested that he has more chemo at this point and I may ask his oncologist why that is. If the chemo can kill the cancer cells, then that would be great for you....the liver bleeds easily on resection so if you can avoid that, all the better.
  • carmen07
    carmen07 Member Posts: 120 Member
    #3
    Mike
    My husband and I also had the same question for our oncologist. He had two lesions that decreased in size with his chemo therapy. One lesion could no longer be seen, and the other was barely visible on his cat scan.
    He had the right lobe of his liver removed. The pathologist did find both lesions. One lesion the cancer cells were completley dead. The other lesion did have some live ones. So even though his CEA level was normal and the lesion could not be seen, their were some live cancer cells in one of the lesions. I also wonder if he had more chemo would that have killed the rest of that cancer. His lesions were small to begin with. 8mm and 1.0.
    We asked our oncologist before surgery why not just leave and we were told that the percentage for cure was much smaller. Resection of the liver was considered a more aggresive form of cure.
    We are going this week for follow-up visit to maybe start the chemo. I will ask the doctor that question again, because I would like to know in more detail about the pathology report, and also if the cancer cells do die with the chemo if this is good for patients that can not have the surgery due to the location.
    Does your doctor believe that you should not have the liver surgery?
  • mikew42
    mikew42 Member Posts: 114 Member
    #4
    carmen07 said:

    Mike
    My husband and I also had the same question for our oncologist. He had two lesions that decreased in size with his chemo therapy. One lesion could no longer be seen, and the other was barely visible on his cat scan.
    He had the right lobe of his liver removed. The pathologist did find both lesions. One lesion the cancer cells were completley dead. The other lesion did have some live ones. So even though his CEA level was normal and the lesion could not be seen, their were some live cancer cells in one of the lesions. I also wonder if he had more chemo would that have killed the rest of that cancer. His lesions were small to begin with. 8mm and 1.0.
    We asked our oncologist before surgery why not just leave and we were told that the percentage for cure was much smaller. Resection of the liver was considered a more aggresive form of cure.
    We are going this week for follow-up visit to maybe start the chemo. I will ask the doctor that question again, because I would like to know in more detail about the pathology report, and also if the cancer cells do die with the chemo if this is good for patients that can not have the surgery due to the location.
    Does your doctor believe that you should not have the liver surgery?

    Carmen,
    Thanks for your reply. My liver tumor was resectable as it is on the outer part of the liver. Both my surgical oncologist and my regular oncologist agreed that we should try chemo first because if it didn't work, we could always go in and get it. My surgical onc. thought that if we need to get it RFA would be best. Mike
  • carmen07
    carmen07 Member Posts: 120 Member
    #5
    mikew42 said:

    Carmen,
    Thanks for your reply. My liver tumor was resectable as it is on the outer part of the liver. Both my surgical oncologist and my regular oncologist agreed that we should try chemo first because if it didn't work, we could always go in and get it. My surgical onc. thought that if we need to get it RFA would be best. Mike

    I believe some patients can be cured if they respond well to treatment but I too have read that resection is the best form for cure. In my husbands case the surgeon told us after his surgery he was very happy that the pathologist reported that both spots were removed since it was difficult for him to know because they had disapeared. He told us that it was good that we did remove because they did find a small amount of live cells.
    Maybe you will want a second opinion from another surgeon to see if they feel that chemo alone is the best cure for you.
    As far as the surgery my husband did real well. Its about 5 weeks now and he has returned to work for the last two weeks. Best of luck to you, and it sounds like your lesion will disapear if you responded that well after 3 treatments. Keep us posted.
  • ipetrou
    ipetrou Member Posts: 33
    #6
    I think whenever it is surgically possible to remove a tumor (of any size, anywhere) that is what they want to do. There's the problem that, without actually taking it out, no one knows if there are a few cancer cells left or not b/c the tests simply cannot tell you that. Congrats on responding so well to the chemo - that's terrific.
  • StacyGleaso
    StacyGleaso Member Posts: 1,233 Member
    #7
    Hi Mike...

    Not sure if chemo alone can do the trick. I had the liver resection, and they took 40% of the liver, and all of the cancer. Except for the wonderful souvenir of a scar, can't even tell I was ever affected by this disease. Going on 3 yrs all clear now...

    Hang in there,

    Stacy
  • sharonM
    sharonM Member Posts: 12
    #8
    Hi Mike, although I am new to all this I will add what I have been told and or read. Resection is considered the "gold standard" in the medical community. I read an interesting article at the chemo place about colon cancer and mets to the liver. I guess at one point in time the cure rate was considered 30% after a liver resection, now apparently they perform the surgery with aid of an ultrasound and that has increased odds of cure to 50%. Sounds promising to me and my liver met. Of course I guess it all depends upon location. My surgeon told me that approx. 2-3% of people with stage IV will have a complete recovery with just chemo. My oncologist tells me no one survives stage IV, it always grows back. I try not to talk to my oncologist and I am sure Stacy would have some choice words for him!!!! Hope this helps.

    Take Care,
    Sharon
  • carmen07
    carmen07 Member Posts: 120 Member
    #9
    Hi Mike
    It's me again. Well I asked our oncologist about curing w/chemo alone and the answer is yes, but the percentage is small. They feel 2%. Resection when posible or RFA if the lesion is not in a area that is posible to remove-they feel is the best chance. Hope this helps.
    You also have to remember that in 2004 they came out with two new drugs, and I don't really know how they come up with the percentages and stats.
    Hope this helps. Wish you all the best on your test results for Monday.
  • mikew42
    mikew42 Member Posts: 114 Member
    #10
    carmen07 said:

    Hi Mike
    It's me again. Well I asked our oncologist about curing w/chemo alone and the answer is yes, but the percentage is small. They feel 2%. Resection when posible or RFA if the lesion is not in a area that is posible to remove-they feel is the best chance. Hope this helps.
    You also have to remember that in 2004 they came out with two new drugs, and I don't really know how they come up with the percentages and stats.
    Hope this helps. Wish you all the best on your test results for Monday.

    Hi Carmen,

    Thanks for asking your onc. My onc doesn't like giving percentages. I guess my surical onc. concern is that if I have a response to chemo, and there is nothing on the scan, what is he taking out? As for the two new drugs, I am actually on one of them (Avastin). I was the first in my onc.'s office to get it. From what I've been hearing, the results from Avastin are looking good. Anyway, thanks again for the information.
  • StacyGleaso
    StacyGleaso Member Posts: 1,233 Member
    #11
    sharonM said:

    Hi Mike, although I am new to all this I will add what I have been told and or read. Resection is considered the "gold standard" in the medical community. I read an interesting article at the chemo place about colon cancer and mets to the liver. I guess at one point in time the cure rate was considered 30% after a liver resection, now apparently they perform the surgery with aid of an ultrasound and that has increased odds of cure to 50%. Sounds promising to me and my liver met. Of course I guess it all depends upon location. My surgeon told me that approx. 2-3% of people with stage IV will have a complete recovery with just chemo. My oncologist tells me no one survives stage IV, it always grows back. I try not to talk to my oncologist and I am sure Stacy would have some choice words for him!!!! Hope this helps.

    Take Care,
    Sharon

    Sharon...

    How 'bout handing over the address to your oncologist's office, as I'd like to plan a road trip! Physicians can be such morons!

    Ok, I'm slowly stepping away from the soapbox...

    Stacy

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