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Vanderbilt

cbcardb12
cbcardb12 Member Posts: 84
edited March 2014 in Colorectal Cancer #1
My husband met with Dr. Emily Chan today. We consider it a very informative meeting! Basically, she agreed with my husband's MO that Erbitux is really the last and best first line of chemotherapy left. He is due to start back on chemo on 1/6/10. Erbitux & irinitan (sp). I did ask about the possibility of installing a HAI pump, and she said that although it is not as yet in widespead use, and Vandy doesn't do them, they are an option. She said that she didn't have my husband's CT scans, and she would need to see those to determine if the cancer had spread anywhere other than the liver. If it hasn't (a PET scan would be used to determine this) then she thinks we should definitely feel it is an option that could get us to a liver resection. If there is any lymph node involvement, or anywhere else besides the liver, then it is absolutely not an option. She also said that the only place that she would recommend getting it installed is at Memorial Sloan Kettering in NYC. So, our next step is to find out whether it has spread anywhere else, and if not, work diligently to get to NY. We asked questions about everything we could think of: is there such as thing as curative & pallative chemo? He answer is that there are. If the goal is to attempt cure, then a dr. would be very aggressive with dosages, and would definitely not let a patient stop treatment for any reason. But for palliative, which is what my husband currently is doing, you are allowed to take breaks. I don't like that, but ok. One big question and concern that I had was why the rectal cancer had not been addressed. She said that basically, the thing that would kill him are the tumors in his liver, and that if they can't get the liver to a point where a resection can be performed, it does no good to do surgery on the rectal cancer because the liver cancer is the true problm. She stated that at the point the only reason to do surgery on the rectum is if he is have pain and other problems, and he is not. Hope this helps someone out there, and I'll keep you up to date with our story.

In the meantime, everyone have a wonderful, joyous holiday, and a happy New Year!!

Carolyn

Comments

  • tootsie1
    tootsie1 Member Posts: 5,036
    Thanks for sharing the info
    I'm glad you got some clarification. Such a lot of information to have to digest, some of it somewhat rough news. But I think it's always good to know exactly what you're dealing with.

    *hugs*
    Gail
  • sfmarie
    sfmarie Member Posts: 602
    Carolyn
    Even if here is lymph node involvement or involvement other than the liver, which I pray there is not, there are other treatments for the liver than resection. While resection seems to be the "gold" standard, there is SIR Spheres, Cyberknife, HAI pump etc. Check out www.beatlivertumors.org. Don't give up and seek other opinions. My sister has stage IV cc, spread to liver, lymph and peritoneum. 8 months of chemo and she is a candidate for liver and HIPEC. She sought out many many opinions and found a doctor willing to give it a try, she needs 6 more months of chemo. Blessings, Marie
  • linandtom
    linandtom Member Posts: 67
    sfmarie said:

    Carolyn
    Even if here is lymph node involvement or involvement other than the liver, which I pray there is not, there are other treatments for the liver than resection. While resection seems to be the "gold" standard, there is SIR Spheres, Cyberknife, HAI pump etc. Check out www.beatlivertumors.org. Don't give up and seek other opinions. My sister has stage IV cc, spread to liver, lymph and peritoneum. 8 months of chemo and she is a candidate for liver and HIPEC. She sought out many many opinions and found a doctor willing to give it a try, she needs 6 more months of chemo. Blessings, Marie

    HIPEC for your sister
    Do you know who will be doing your sisters HIPEC? Also what chemo combination was she on for 8 months?
  • AnneCan
    AnneCan Member Posts: 3,673
    My treatment plan
    My orignal treatment/curative plan was chemo/radiation for 5 weeks, a break, then colorectal surgery. They thought I might have one small met on my liver. After the 5 weeks of radiation/chemo, my colorectal tumours (2) had shrunken & scans indicated I had 4 liver mets. This meant the radiation had worked but the chemo hadn't (I was on 5-FU + oxalplatanin). My surgeon said they could not do the colorectal surgery at this time; the liver needed to be addressed because otherwise the liver mets would grow while I was off chemo preparing for & having surgery. I was put on folfiri + avastan. My scan, after only 4 treatments, showed no detectable cancer in my colon & 3 of my 4 liver mets had shrunken, while the other had stayed the same. This was the 1st really great news on this journey & my husband & I celebrated with a small bottle of champayne. Although I was devastated when my plan changed & my surgery wasn't done, I now believe it was the better plan for me. There are different routes for success on this journey & I believe I am on a good one now.
  • cbcardb12
    cbcardb12 Member Posts: 84
    AnneCan said:

    My treatment plan
    My orignal treatment/curative plan was chemo/radiation for 5 weeks, a break, then colorectal surgery. They thought I might have one small met on my liver. After the 5 weeks of radiation/chemo, my colorectal tumours (2) had shrunken & scans indicated I had 4 liver mets. This meant the radiation had worked but the chemo hadn't (I was on 5-FU + oxalplatanin). My surgeon said they could not do the colorectal surgery at this time; the liver needed to be addressed because otherwise the liver mets would grow while I was off chemo preparing for & having surgery. I was put on folfiri + avastan. My scan, after only 4 treatments, showed no detectable cancer in my colon & 3 of my 4 liver mets had shrunken, while the other had stayed the same. This was the 1st really great news on this journey & my husband & I celebrated with a small bottle of champayne. Although I was devastated when my plan changed & my surgery wasn't done, I now believe it was the better plan for me. There are different routes for success on this journey & I believe I am on a good one now.

    Thanks for the positive responses
    We really do feel that things are going to work on for my husband. We feel more prepared and hopeful that we have through this whole journey. I commented to my husband that the only thing that was upsetting was feeling that we had to travel over 300 miles just for someone to give us the information that we should have been getting all along here at home. But, anyway, it was wonderful to get away & have a vacation of sorts. My husband will start back on chemo in January while we figure out whether the HAI pump is an option. We have also started looking at our other options this coming year.

    Thanks for the advice and information.

    Carolyn
  • krf
    krf Member Posts: 98
    Hi Carolyn. My husband
    Hi Carolyn. My husband (stage IV rectal) is being treated at Wake FOrest and he is not a surgical candidate at this time. Your post made me do a little research and I found this on the MSK website about HAI:

    Researchers from the following institutions participated in the study in addition to MSKCC: University of Southern California; University of California at San Francisco; Wake Forest University School of Medicine; Dana-Farber Cancer Institute; and Fox Chase Cancer Center.

    There are three surgical Oncs at Wake- Dr. Levine, Dr, Shen, and Dr, Stewart.

    If you come to Wake, let me know! We live about 15 minutes from the hospital and I would be happy to be a tour guide/lunch date/hand holder.

    Kim
  • cbcardb12
    cbcardb12 Member Posts: 84
    krf said:

    Hi Carolyn. My husband
    Hi Carolyn. My husband (stage IV rectal) is being treated at Wake FOrest and he is not a surgical candidate at this time. Your post made me do a little research and I found this on the MSK website about HAI:

    Researchers from the following institutions participated in the study in addition to MSKCC: University of Southern California; University of California at San Francisco; Wake Forest University School of Medicine; Dana-Farber Cancer Institute; and Fox Chase Cancer Center.

    There are three surgical Oncs at Wake- Dr. Levine, Dr, Shen, and Dr, Stewart.

    If you come to Wake, let me know! We live about 15 minutes from the hospital and I would be happy to be a tour guide/lunch date/hand holder.

    Kim

    Hi Kim
    Although we live near Atlanta, GA, we are actually from Greensboro (me) & High Point (hubby), NC, and have in-laws in the Winston Salem area! This is actually quite exciting! I know Winston well. Went to the School of the Arts summer program there, and spent many summer days at Old Salem. I love it. I am going to do some more research.

    Thanks for the infor!

    Carolyn
  • krf
    krf Member Posts: 98
    cbcardb12 said:

    Hi Kim
    Although we live near Atlanta, GA, we are actually from Greensboro (me) & High Point (hubby), NC, and have in-laws in the Winston Salem area! This is actually quite exciting! I know Winston well. Went to the School of the Arts summer program there, and spent many summer days at Old Salem. I love it. I am going to do some more research.

    Thanks for the infor!

    Carolyn

    LOL- I went to college and
    LOL- I went to college and then lived in the East Atlanta Village when first married! I loved ATL- but when our first was born, we went back to our families here in NC. I needed my mom when I became one! And thank goodness that we have both our families here now that we are going through this.
    Good luck- and say hi to EAV for me- I do miss our old 'hood.
    Kim