Is surgery on liver possible?
My husband was diagnosed with stage IV colorectal cancer in November. Since then he has had a stent put in his heart, received a power port and six weeks of chemo and radiation followed by a short reprieve and then two weeks ago surgery to remove the primary tumor. Thanking God he did not have to have a colostomy. He does have lesions on his liver that we have to attack next. I believe there are lesions on both sides and so surgery may not be possible and they may just do chemotherapy. We are going next week to a teaching hospital for a second opinion on treatment. Has anyone heard of doing surgery on the liver when there are lesions on both sides? We still can hardly believe this is all happening. My husband is sixty five...eleven years older than me. We rode our bikes 21 miles last summer. He's never really been sick. We could sure use some encouraging words.
Nana
Comments
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Hi Nana
Welcome to the board. My hubby has not had surgery for his liver, yet, he also has mets in the lungs so that limits his options.
Lots on the board have had liver surgery so they will be answering once they log on. We have 2 who are about to undergo liver surgery in the next few weeks. I'm not sure if they have mets on both sides so I will let them address that.
Just wanted to say welcome. Lots of Stage IV on the board. If you click on our names you can read our stories. My hubby is just getting chemo right now and he is doing great.
Take care - Tina0 -
Nana
Nana,
Welcome to the board. As mentioned previously, clicking on the username to see more details.
My condensed story....
I was diagnosed in November 2008 during a scheduled c-section with our 3rd child. I had 5 bilobar mets with the largest being 5 cm. There were 3 mets on my left liver lobe, 1 on the right and 1 smack in the middle. After 2 rounds (4 treatments) they shrunk by 40% and I was scheduled for a liver resection. My liver surgeon removed the entire left lobe and did 2 wedge resections of the other two mets. Additionally I had an HAI pump implanted (google hepatic arterial infusion pump) which is a port directed right into the hepatic artery. After surgery I was able to receive chemo right through that pump into my liver. The theory is that such concentrated chemo right to the liver can help to prevent recurrence. I received systemic chemo as well. My last chemo treatment was 11/09 and as of my last scan (Feb 2010) I was still NED. I have been NED for 1 year so far.
So you can have surgery despite bilobar mets. That doesn't mean that your husband will definitely be eligible for surgery as it is more dependent upon where the mets are. Ensure that the opinion you receive about surgery is from a LIVER surgeon and not a general oncology surgeon and most definitely not from an oncologist. I was told by an oncologist that I was not operable as the mets were on both sides. Apparently he was wrong.
If he is not operable now then that doesn't mean he won't be operable in the future. In addition to systemic chemo you can look into the HAI pump, into RFA, into SirSpheres and other liver treatments. There are people on the board that have done it all and we are all here to help you in any way that we can. Additionally, there are people on the board that are Stage IV and have been treating their condition like a chronic illness for a long time or have been NED (in remission) for a long time. There is lots of hope for your husband.
Where are you located? What hospital?
Best of luck to you and let me know if I can assist you.
Amy0 -
Ostomy ?
Re:
"Thanking God he did not have to have a colostomy. "
Just a short note to let you know, that there are many, many of us here,
that have either a colostomy or an ileostomy.
It isn't the "end of the world", and not nearly as life-changing
as cancer.
Hoping for better health for you both!
John0 -
Hi Nana
Sorry to hear about your hubby's cancer! Glad to hear they got the primary tumour.
I'm stage 4 and had a liver resection in 2004. I had the right lobe removed and a lesion in the left lobe "cauterized" (not sure what he did but he basically burnt it out). A few years later i had a small recurrence in the liver and had Radio-Frequency Ablation (RFA).
What is RFA?
Sometimes they can do RFA in combination with a resection. I think, from what was said by Mom-2-3, that there could be some options. It will be important to have the situation assessed by a good liver surgeon. They have an up-to-date sense of what can be done.
The handling of liver mets is improving daily!
Peace and blessings... Rob; in Vancouver
"What is not cured by the knife may be cured by fire." Hippocrates0 -
liver resectionrobinvan said:Hi Nana
Sorry to hear about your hubby's cancer! Glad to hear they got the primary tumour.
I'm stage 4 and had a liver resection in 2004. I had the right lobe removed and a lesion in the left lobe "cauterized" (not sure what he did but he basically burnt it out). A few years later i had a small recurrence in the liver and had Radio-Frequency Ablation (RFA).
What is RFA?
Sometimes they can do RFA in combination with a resection. I think, from what was said by Mom-2-3, that there could be some options. It will be important to have the situation assessed by a good liver surgeon. They have an up-to-date sense of what can be done.
The handling of liver mets is improving daily!
Peace and blessings... Rob; in Vancouver
"What is not cured by the knife may be cured by fire." Hippocrates
Ill just reiterrate what they others have said, it can be possible. Talk to a liver spec. As always the more opinions the better and it seems the options are changing almost daily. Peace be with you there are so many stage four sucess stories on here. check them out, and welcome to a site I wish I would have found years ago!!0 -
Thank you so much formom_2_3 said:Nana
Nana,
Welcome to the board. As mentioned previously, clicking on the username to see more details.
My condensed story....
I was diagnosed in November 2008 during a scheduled c-section with our 3rd child. I had 5 bilobar mets with the largest being 5 cm. There were 3 mets on my left liver lobe, 1 on the right and 1 smack in the middle. After 2 rounds (4 treatments) they shrunk by 40% and I was scheduled for a liver resection. My liver surgeon removed the entire left lobe and did 2 wedge resections of the other two mets. Additionally I had an HAI pump implanted (google hepatic arterial infusion pump) which is a port directed right into the hepatic artery. After surgery I was able to receive chemo right through that pump into my liver. The theory is that such concentrated chemo right to the liver can help to prevent recurrence. I received systemic chemo as well. My last chemo treatment was 11/09 and as of my last scan (Feb 2010) I was still NED. I have been NED for 1 year so far.
So you can have surgery despite bilobar mets. That doesn't mean that your husband will definitely be eligible for surgery as it is more dependent upon where the mets are. Ensure that the opinion you receive about surgery is from a LIVER surgeon and not a general oncology surgeon and most definitely not from an oncologist. I was told by an oncologist that I was not operable as the mets were on both sides. Apparently he was wrong.
If he is not operable now then that doesn't mean he won't be operable in the future. In addition to systemic chemo you can look into the HAI pump, into RFA, into SirSpheres and other liver treatments. There are people on the board that have done it all and we are all here to help you in any way that we can. Additionally, there are people on the board that are Stage IV and have been treating their condition like a chronic illness for a long time or have been NED (in remission) for a long time. There is lots of hope for your husband.
Where are you located? What hospital?
Best of luck to you and let me know if I can assist you.
Amy
Thank you so much for responding. We are located near Chicago and are going to Loyola next week. He had his colon surgery at Provena St. Joseph hospital in Joliet. Our surgeon and oncologist told us surgery is off the table and so I too am hoping they are wrong. Your story is so encouraging. Thank you for sharing it. I will include more info about the liver later as I am just reading all the reports as I'm collecting them for our second opinion. My husband was so reluctant about going. I'm so glad now that we are.
April0 -
I'm so sorry John, I didn'tJohn23 said:Ostomy ?
Re:
"Thanking God he did not have to have a colostomy. "
Just a short note to let you know, that there are many, many of us here,
that have either a colostomy or an ileostomy.
It isn't the "end of the world", and not nearly as life-changing
as cancer.
Hoping for better health for you both!
John
I'm so sorry John, I didn't mean it sound that way. My husband has a good friend who has been telling him that too. He was just so happy when he woke up and found out they didn't have to do it. I'm just happy for him for every victory right now. I know what a colostomy is, but what is an ileostomy?0 -
Liver surgery with bilobar disease
Sorry to hear about your dx & situation. At my dx I had multiple mets on both lobes of the liver & was unresectable. After a very good response to chemo, I had a PVE (portal vein embolization) and then a liver resection in February of 2009. Then I had adjuvant chemo, and now I'm enjoying life again.0 -
ChicagoNana2 said:Thank you so much for
Thank you so much for responding. We are located near Chicago and are going to Loyola next week. He had his colon surgery at Provena St. Joseph hospital in Joliet. Our surgeon and oncologist told us surgery is off the table and so I too am hoping they are wrong. Your story is so encouraging. Thank you for sharing it. I will include more info about the liver later as I am just reading all the reports as I'm collecting them for our second opinion. My husband was so reluctant about going. I'm so glad now that we are.
April
While you are in Chicago have some fun. My daughter works in downtown Chicago and lives about 15 minutes from the downtown. We love visiting her, we are in Michigan. Keep us advised of your visit. Take care - Tina0 -
Liver Surgery
I had mets all over my liver, one very big tumor on my hepatic artery. I went on chemo (FOLFOX with Avastin) before I had surgery and it shrunk the tumors (or eliminated them) so I was then operable. I had about 60-70% of my liver removed. I also had a hepatic pump installed so it delivered chemo right into my liver and it was very successful. No recurrence in colon or liver in almost 6 years. I had been in good health beforehand and felt great around the time of my diagnosis. It was pure luck they caught it. I was/am stage IV, no symptoms at the time. Often they will do chemo to shrink tumors or eliminate them, then operate when it's more manageable.
I know what you mean about "the bag". With everything else going on I felt it was the next to last thing I needed.
Best of luck with it.
-phil0 -
hello Nana and welcomePhillieG said:Liver Surgery
I had mets all over my liver, one very big tumor on my hepatic artery. I went on chemo (FOLFOX with Avastin) before I had surgery and it shrunk the tumors (or eliminated them) so I was then operable. I had about 60-70% of my liver removed. I also had a hepatic pump installed so it delivered chemo right into my liver and it was very successful. No recurrence in colon or liver in almost 6 years. I had been in good health beforehand and felt great around the time of my diagnosis. It was pure luck they caught it. I was/am stage IV, no symptoms at the time. Often they will do chemo to shrink tumors or eliminate them, then operate when it's more manageable.
I know what you mean about "the bag". With everything else going on I felt it was the next to last thing I needed.
Best of luck with it.
-phil
another stage 4 here with 2 liver re-sections. My liver was covered in lesions...the point I would like to make is 3 surgeons turned me down before I found a liver surgeon who said
yes. We did surgery first and chemo afterwards...2 years later a tiny spot appeared and there was more surgery and then chemo again.
all best of luck to you and your hubby.
mags0 -
Liver surgeryPhillieG said:Liver Surgery
I had mets all over my liver, one very big tumor on my hepatic artery. I went on chemo (FOLFOX with Avastin) before I had surgery and it shrunk the tumors (or eliminated them) so I was then operable. I had about 60-70% of my liver removed. I also had a hepatic pump installed so it delivered chemo right into my liver and it was very successful. No recurrence in colon or liver in almost 6 years. I had been in good health beforehand and felt great around the time of my diagnosis. It was pure luck they caught it. I was/am stage IV, no symptoms at the time. Often they will do chemo to shrink tumors or eliminate them, then operate when it's more manageable.
I know what you mean about "the bag". With everything else going on I felt it was the next to last thing I needed.
Best of luck with it.
-phil
At diagnosis, I had many tumors on both sides of my liver. The mets were much too extensive to be resectable. I was fortunate in being referred immediately to a comprehensive NCI cancer treatment center. At the time that my colon was resected, an HAI pump was installed. After a little less than 6 months of chemo both systemically and through the HAI pump, my liver became resectable. I had portal vein embolization first, which causes the protion of the liver that will remain to start growing prior to the liver resection. Five weeks later, 5 of the 7 lobes of my liver were removed and a small wedge was removed from one of the remaining lobes. In short, resection when there are tumors in both lobes of the liver is certainly possible, although not always. In my opinion, it is more likely to happen if the first place that you seek treatment is a comprehensive NCI cancer treatment center. Once you have received treatment else where and perhaps become resistant to some of the types of chemo available, your options may become more limited.0 -
liver lesions
My liver was pretty messed up as well. I was inoperable at the time but after chemo the tumors shrank and/or died enough to get the resection. Remember not all surgeons have the same abilities. I liken it to golfers. Some can make the shot, some think they can but really cant and some just cant and know it. My surgeon was extrmeley confident and skilled. So I went from inoperable and feeling very hopeless to an NED on my last scan. I hope that my story will provide you guys with some hope and confidence moving forward.0 -
Liver resection
Nana,
I am so sorry about your husband's diagnosis. My husband also is stage four with liver mets and he underwent surgery last Wednesday for a liver resection. His surgery was at M D Anderson with Dr. Abdalla who is my hero. David was told he was unresectable, too, by two surgeons, but coming to M D Anderson gave us a plan. There were a couple of bumps on the road but after successful portal vein embolization, David had 75 percent of his liver removed in an 8 hour very complex surgery. Eight days later, his bilirubin is normal and he will be discharged tomorrow and we will stay in Houston for follow up care for a week or so.
Don't give up hope. Go to the NCI website and get a referral to a comprehensive cancer center. Many insurance companies include them in network and may even help with hotels, transportation, etc. The thing about these hospitals is you meet with an entire team - oncologists, radiologists, surgeons, dieticians, etc. that are specialized in gastro cancers. So they really know there stuff. In retrospect, I wish we had come here very early. So don't hesitate.
I don't post too often, but I sure have found this board a wealth of support and information with a lot of extremely brave survivors and their supportive caregivers.
Please let me know if I can answer any other questions for you.
Sending you hugs,
Priscilla0 -
Priscilla,pf78248 said:Liver resection
Nana,
I am so sorry about your husband's diagnosis. My husband also is stage four with liver mets and he underwent surgery last Wednesday for a liver resection. His surgery was at M D Anderson with Dr. Abdalla who is my hero. David was told he was unresectable, too, by two surgeons, but coming to M D Anderson gave us a plan. There were a couple of bumps on the road but after successful portal vein embolization, David had 75 percent of his liver removed in an 8 hour very complex surgery. Eight days later, his bilirubin is normal and he will be discharged tomorrow and we will stay in Houston for follow up care for a week or so.
Don't give up hope. Go to the NCI website and get a referral to a comprehensive cancer center. Many insurance companies include them in network and may even help with hotels, transportation, etc. The thing about these hospitals is you meet with an entire team - oncologists, radiologists, surgeons, dieticians, etc. that are specialized in gastro cancers. So they really know there stuff. In retrospect, I wish we had come here very early. So don't hesitate.
I don't post too often, but I sure have found this board a wealth of support and information with a lot of extremely brave survivors and their supportive caregivers.
Please let me know if I can answer any other questions for you.
Sending you hugs,
Priscilla
Thanks for
Priscilla,
Thanks for updating us + telling us about your husband's liver surgery. Please pass on my best wishes to him for a speedy recovery; it sounds like he is well on his way!0 -
Nana-
I was like Phil-
Nana-
I was like Phil- lesions all over the liver and a mass on the hepatic artery.
I was treated at Loyola for colon tumor, ilesostomy and chemo. I was told I was not resectable as well - more from the place of "not sure it will do you any good" vs "it can't be done".
You've gotten lots of good advice here. Get 2nd opinions and get the doctors to tell you - "What do you look for in determining if a patient is resectable?" It's not just the numbe of tumors and where they are, it's age, overall health besides the cancer, any liver disease, patient strenght, weight and how you handle chemo etc...the necrosis of the presumaby shrunken tumors. they want to see calcified/dried up tumors - meaning they responded to chemo.
I just had liver resection at Sloan Kettering in NYC. 8 tumors removed and one ablated. It's possible!!!
((HUGS))
Peggy0 -
thank you thank youpluckey said:Nana-
I was like Phil-
Nana-
I was like Phil- lesions all over the liver and a mass on the hepatic artery.
I was treated at Loyola for colon tumor, ilesostomy and chemo. I was told I was not resectable as well - more from the place of "not sure it will do you any good" vs "it can't be done".
You've gotten lots of good advice here. Get 2nd opinions and get the doctors to tell you - "What do you look for in determining if a patient is resectable?" It's not just the numbe of tumors and where they are, it's age, overall health besides the cancer, any liver disease, patient strenght, weight and how you handle chemo etc...the necrosis of the presumaby shrunken tumors. they want to see calcified/dried up tumors - meaning they responded to chemo.
I just had liver resection at Sloan Kettering in NYC. 8 tumors removed and one ablated. It's possible!!!
((HUGS))
Peggy
I just want to say thanks so much to all of you for sending such encouraging words. I feel like I've found such a great support group here. I posted questions on another site and had not received any responses and that can be so discouraging when you're looking every day and there is nothing.
I am very encouraged about the possibility for surgery now for my husband. Or at least something other than just chemo. It sounds like there are alot of options we just haven't heard of before so I will be anxious to see what the Doctors at Loyola have to say.
We went yesterday to an ear nose and throat specialist because he has been hoarse on and off since October. I was so afraid he had a tumor, but he checked out fine. The Doctor scoped him down as far as his vocal chords and everything looked fine. Has anyone else experienced hoarseness?
Also he is two weeks since his colon resection and left the hospital looking plump and with good color. Now that the IV fluids have left his body he is getting thin and is soooo tired. His appetite is pretty poor too and he said he is just passing a few little stools now and then (if I can be so personal) is that all normal?0 -
Peggypluckey said:Nana-
I was like Phil-
Nana-
I was like Phil- lesions all over the liver and a mass on the hepatic artery.
I was treated at Loyola for colon tumor, ilesostomy and chemo. I was told I was not resectable as well - more from the place of "not sure it will do you any good" vs "it can't be done".
You've gotten lots of good advice here. Get 2nd opinions and get the doctors to tell you - "What do you look for in determining if a patient is resectable?" It's not just the numbe of tumors and where they are, it's age, overall health besides the cancer, any liver disease, patient strenght, weight and how you handle chemo etc...the necrosis of the presumaby shrunken tumors. they want to see calcified/dried up tumors - meaning they responded to chemo.
I just had liver resection at Sloan Kettering in NYC. 8 tumors removed and one ablated. It's possible!!!
((HUGS))
Peggy
Sloan is where I go too.
They do great work, no complaints at all.
Hope you are doing well
-phil0
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