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Portal Vein Embolization, Liver Resection and M D Anderson

pf78248
pf78248 Member Posts: 209
edited March 2014 in Colorectal Cancer #1
A little history - my husband David was dx stage 3c in 4-08 and was given 12 Folfox treatments after his resection., He was also given Erbitux in a clinical trial until he was tested and found he had the K-RAS mutation. He completed chemo in October and was NED at that time. Two months later a CT scan showed a single liver met. Now Stage 4. He was given Folfori and Avastin. In May 2009 he was on the operating room table for RFA because he’d been told he was not resectable. No RFA was done because the tumor was not detectable on the scans. So maintenance Xeloda was given until October 5 of this year.

We decided to go to M D Anderson. While we have all the confidence in the world in our oncologist, we needed some second (and third) opinions for the liver resection/RFA.

Our M D Anderson oncologist and surgeon, after considerable testing, exploratory laprascopy and ultrasound, as well as a liver biopsy, have determined that David will have Portal Vein Embolization (PVE) next week with a target date of four weeks later for resection. Of course we are beyond happy with this news.

My questions are has anyone had experience with this two phased approach? What recovery issues were from the PVE? Was recovery from liver resection similar to the colon resection? We are interested in your experiences and outcomes. Did anyone have their surgeries at MDA? What did you think?

Thanks so much for all that great people on this board. David and I have received such valuable information and I am in awe of the Semi Colons and their strength and courage. Our experience so far at M D Anderson has been wonderful. An amazing place.

Hugs,
Priscilla

Comments

  • snommintj
    snommintj Member Posts: 601
    PVE and resection
    PVE is performed prior to resection to supercharge the liver. The technical term is hypertrophy. It's performed routinely in cases where a large portion of the patients liver is going to be removed. The procedure requires some time to take full effect and that's why they are making you wait before resection. I haven't had PVE, but I have had arterial embolization. The recovery was minimal and I barely noticed anything. As for the resection, I've had two and both required some significant down time, but these surgeons have it down pretty well. I spent 7 days in the hospital on my first surgery and 4 on my second. Full recovery takes about 6-8 weeks. Occasionally abscesses and infections to pop up. I experienced an infection after my second resection that lasted 5 months and nearly killed me many times. So I'm 50/50 on infections after surgery.
  • maglets
    maglets Member Posts: 2,576
    snommintj said:

    PVE and resection
    PVE is performed prior to resection to supercharge the liver. The technical term is hypertrophy. It's performed routinely in cases where a large portion of the patients liver is going to be removed. The procedure requires some time to take full effect and that's why they are making you wait before resection. I haven't had PVE, but I have had arterial embolization. The recovery was minimal and I barely noticed anything. As for the resection, I've had two and both required some significant down time, but these surgeons have it down pretty well. I spent 7 days in the hospital on my first surgery and 4 on my second. Full recovery takes about 6-8 weeks. Occasionally abscesses and infections to pop up. I experienced an infection after my second resection that lasted 5 months and nearly killed me many times. So I'm 50/50 on infections after surgery.

    Hi Priscilla: I have had two liver resections and they do take some down time for recovery. I was 5 days in hospital and my advice would be to get good pain control before you leave the hospital. I needed pain control for maybe week at home. Never had any problems with infections but it was surely great to have someone making low-fat simple meals for a few days. Sometimes the gall bladder will be removed too so this would change your husband's reaction to fat. I lost weight the first time but on the second I had a dietary help and took lots of protein for tissue healing...I really liked boiled eggs.

    I had one of those bed sides that helped getting upright but it really wasn't needed...no trouble with mobility, getting to bathroom, bathing etc. I had staples to close the wound and a nurse took those out...no probs.

    best thoughts to you and your hubby
    ~mags~

    ps i did 6 months of xeloda after the first resection...2 years and then another tiny spot on liver so resection and then another 6 months on xelox..the oxaliplatin was a new one to me. finished at the end of June and so far so good
  • pf78248
    pf78248 Member Posts: 209
    snommintj said:

    PVE and resection
    PVE is performed prior to resection to supercharge the liver. The technical term is hypertrophy. It's performed routinely in cases where a large portion of the patients liver is going to be removed. The procedure requires some time to take full effect and that's why they are making you wait before resection. I haven't had PVE, but I have had arterial embolization. The recovery was minimal and I barely noticed anything. As for the resection, I've had two and both required some significant down time, but these surgeons have it down pretty well. I spent 7 days in the hospital on my first surgery and 4 on my second. Full recovery takes about 6-8 weeks. Occasionally abscesses and infections to pop up. I experienced an infection after my second resection that lasted 5 months and nearly killed me many times. So I'm 50/50 on infections after surgery.

    That infection must have been horrible for you. I'm sure glad you recovered from it. Thanks so much for your insight. I know age and general health condition is a factor, too. Sounds like we have some serious recovery ahead.

    Wishing you the very best for your cancer journey.
    Priscilla
  • pf78248
    pf78248 Member Posts: 209
    maglets said:

    Hi Priscilla: I have had two liver resections and they do take some down time for recovery. I was 5 days in hospital and my advice would be to get good pain control before you leave the hospital. I needed pain control for maybe week at home. Never had any problems with infections but it was surely great to have someone making low-fat simple meals for a few days. Sometimes the gall bladder will be removed too so this would change your husband's reaction to fat. I lost weight the first time but on the second I had a dietary help and took lots of protein for tissue healing...I really liked boiled eggs.

    I had one of those bed sides that helped getting upright but it really wasn't needed...no trouble with mobility, getting to bathroom, bathing etc. I had staples to close the wound and a nurse took those out...no probs.

    best thoughts to you and your hubby
    ~mags~

    ps i did 6 months of xeloda after the first resection...2 years and then another tiny spot on liver so resection and then another 6 months on xelox..the oxaliplatin was a new one to me. finished at the end of June and so far so good

    Mags,

    Thanks for your advice and experience. Glad you didn't get any infections and it's nice to hear from both of you who have had two sucessful resections. Great advice on the diet, too, as we both started low fat high protein diets as soon as we learned from the Doctors at MDA that David was "eligible" for resection. His for liver health and mine to lose a few pounds. Sure didn't know about the gall bladder, too.

    Good luck and best wishes to you.

    Priscilla