Please HELP ... need your feedback

jasminsaba
jasminsaba Member Posts: 157 Member
in Colorectal Cancer #1
Hi everyone,

This is in follow-up to my previous post regarding liver-resection ... here is some background:

Mom was diagnosed on June 27th, 2011 with mCRC with two lesions (17mm & 7 mm) in the right lower lobe of the liver. Her primary was located in the sigmoid colon and was take out laproscopically on 6/29/2011 with clear margins.

She completed 6 cycles of FOLFOX (4 with Avastin) on 10/12/2011 had a PET/CT two weeks ago which showed no evidence of metastatic or residual disease and indicated that the two liver lesions (17 mm and 7 mm) are no longer seen on the scan. A follow up MRI was done on the liver last week in preparation for the surgical consult to discuss liver resection which took place this morning. The surgeon is now recommending RFA since the 7mm is completely GONE from the scan and the 17 mm has been reduced to a 9 mm necrotic mass. He and the oncologist (we met with both this morning) don't think it would be wise to subject her to a very invasive surgery ( liver resection) at this point and delay the remaining chemo treatments (6 cycles left) by a couple of months ... instead, they feel confident they can address the small 9 mm mass with RFA and continue to monitor her liver every 3 months with various scans. Should there ever be a need, they can always go back and do a resection (hopefully not going to be needed ... and hopefully, that will always remain an option).

I am a conflicted mess this morning ... I had prepared my homework for a meeting with the docs regarding liver resection. The RFA was a major curve ball although I recognize and appreciate the many blessings in this situation. As the oncologist said, this is a luxury situation; however, I remember seeing many posts on various sites regarding the pros and cons of each treatment and wondered if you'd be willing to share your thoughts?

Her oncologist mentioned that if the tumor had been bigger than 1cm then she would have recommended the resection, but 9 mm is simply to small and should be well covered under the radius of the RFA probe. Also, the surgeon (chief of surgery at a major hospital here in Dallas) mentioned that despite his expert skills, he suspects that he'll have a very hard time finding the tumor ... I am sooo confused. On one hand, I am so very grateful for the fantastic news of her great response to chemo, on the other hand, RFA concept is new to our discussions and scares me a bit.

Does anyone on here have any experience with RFA? success stories you'd be willing to share?

Any thoughts or bits of information you can share about your case would be greatly appreciated.

Thank you VERY MUCH.

- Jasmine

Comments

  • CherylHutch
    CherylHutch Member Posts: 1,375
    #2
    RFA
    Hi Jasmine,

    Although I have had no experience with RFA and the liver, I have had the RFA procedure done on my lung and removed a tumour this way.

    I have nothing but praise and awe for the RFA procedure. If I had done the resection of the lung, this is like the invasive liver surgery. It would require quite the recovery time, where the patient is in a lot of discomfort. Surgery is invasive, there's no getting around that... but if it is the only option, then one does what they have to do.

    But if one is offered to have the same tumour/area removed by RFA, my recommendation is to go with it. Do not even think "What if? How come? Why?" RFA (Radio Frequency Ablation) is a marvel of medical science. In simple terms, they go to the area of the tumour, with a probe that is usually hooked up with a CAT Scanner so that the surgeon or radiologist who is performing the procedure can direct the probe right into the middle of the tumour that is to be removed. Once the probe/needle is in position, they blast it with radio frequency waves. Similar to how a microwave works... where the tumour is basically burnt from the inside out. The difference between RFA and Microwave is the RFA only burns the tumour, not the surrounding healthy tissue. It burns the tumour down to scar tissue and then over the course of the next few months that scar tissue is absorbed by the healthy tissue and voila... totally healed.

    Now, I'm not sure what the recovery time is like for a liver RFA vs a Lung RFA. I was given a general anesthetic for my procedure, which I'm assuming your mom will be too. For the simple reason that a GA was used, I was told that I would probably have to stay in the hospital overnight for "observation". Well, I went to the hospital in the morning, had the procedure at 11am, was in recovery by noon (recovery from the general anesthetic), was taken up to a ward by 1pm. By then I was wide awake and twiddling my thumbs. I felt totally fine... but they kept me there for the afternoon. At 5pm I was taken down for a chest xray to see if my lung was holding up (always the possibility that the lung would collapse because of the probe into it) and the xray showed I was fine... so I was told I could go home.

    Seriously, I felt so fine and so normal, I could have gone shopping or out to a movie or anything. I had absolutely no reaction or need for recovery. So an RFA procedure would always be my procedure of choice if that is an option. I realize the lung and the liver are two totally different organs/areas, but I think you and your mom will be amazed at the difference between recovery from RFA and recovery from invasive surgery.

    Hope this helps somewhat in your knowledge of learning our options when we are offered them.

    Cheryl in Vancouver
  • jasminsaba
    jasminsaba Member Posts: 157 Member
    #3
    CherylHutch said:

    RFA
    Hi Jasmine,

    Although I have had no experience with RFA and the liver, I have had the RFA procedure done on my lung and removed a tumour this way.

    I have nothing but praise and awe for the RFA procedure. If I had done the resection of the lung, this is like the invasive liver surgery. It would require quite the recovery time, where the patient is in a lot of discomfort. Surgery is invasive, there's no getting around that... but if it is the only option, then one does what they have to do.

    But if one is offered to have the same tumour/area removed by RFA, my recommendation is to go with it. Do not even think "What if? How come? Why?" RFA (Radio Frequency Ablation) is a marvel of medical science. In simple terms, they go to the area of the tumour, with a probe that is usually hooked up with a CAT Scanner so that the surgeon or radiologist who is performing the procedure can direct the probe right into the middle of the tumour that is to be removed. Once the probe/needle is in position, they blast it with radio frequency waves. Similar to how a microwave works... where the tumour is basically burnt from the inside out. The difference between RFA and Microwave is the RFA only burns the tumour, not the surrounding healthy tissue. It burns the tumour down to scar tissue and then over the course of the next few months that scar tissue is absorbed by the healthy tissue and voila... totally healed.

    Now, I'm not sure what the recovery time is like for a liver RFA vs a Lung RFA. I was given a general anesthetic for my procedure, which I'm assuming your mom will be too. For the simple reason that a GA was used, I was told that I would probably have to stay in the hospital overnight for "observation". Well, I went to the hospital in the morning, had the procedure at 11am, was in recovery by noon (recovery from the general anesthetic), was taken up to a ward by 1pm. By then I was wide awake and twiddling my thumbs. I felt totally fine... but they kept me there for the afternoon. At 5pm I was taken down for a chest xray to see if my lung was holding up (always the possibility that the lung would collapse because of the probe into it) and the xray showed I was fine... so I was told I could go home.

    Seriously, I felt so fine and so normal, I could have gone shopping or out to a movie or anything. I had absolutely no reaction or need for recovery. So an RFA procedure would always be my procedure of choice if that is an option. I realize the lung and the liver are two totally different organs/areas, but I think you and your mom will be amazed at the difference between recovery from RFA and recovery from invasive surgery.

    Hope this helps somewhat in your knowledge of learning our options when we are offered them.

    Cheryl in Vancouver

    Thank you, Cheryl ...
    for sharing your personal experience and I was so pleased to hear your positive feedback about RFA. I've been doing a lot more reading on RFA since yesterday and it definitely seems to be the way of the future as far as treating mets. Far less invasive ... my confusion was a result of many posts on here suggesting that invasive surgery is typically the most aggressive and possibly best way of potentially curing stage IV. My reading has led me to believe that depending on the invidual case, it might not always make a whole lot of sense to go through an invasive surgery to address something that can be treated less invasively.

    I'll continue to do more research on the internet and have reached out elsewhere for feedback ... would welcome feedback from others on this forum as well if you should be willing to share.

    Thanks again.
  • SisterSledge
    SisterSledge Member Posts: 332 Member
    #4
    jasminsaba said:

    Thank you, Cheryl ...
    for sharing your personal experience and I was so pleased to hear your positive feedback about RFA. I've been doing a lot more reading on RFA since yesterday and it definitely seems to be the way of the future as far as treating mets. Far less invasive ... my confusion was a result of many posts on here suggesting that invasive surgery is typically the most aggressive and possibly best way of potentially curing stage IV. My reading has led me to believe that depending on the invidual case, it might not always make a whole lot of sense to go through an invasive surgery to address something that can be treated less invasively.

    I'll continue to do more research on the internet and have reached out elsewhere for feedback ... would welcome feedback from others on this forum as well if you should be willing to share.

    Thanks again.

    invasive surgery
    I think many here promote surgery because their tumors are larger...you are lucky that yours were small :) I'm wondering what the opinions are regarding removal of necrotic tissues. If it is completely dead, why not just let the body reabsorb it as it would naturally?

    Added: I ask this from a personal interest as my tumors were known to be completely dead after chemo but they still did liver resection to remove the mass. I'm relieved to have all traces of the tumor removed but wonder if it was truly necessary...
  • PhillieG
    PhillieG Member Posts: 4,866 Member
    #5
    jasminsaba said:

    Thank you, Cheryl ...
    for sharing your personal experience and I was so pleased to hear your positive feedback about RFA. I've been doing a lot more reading on RFA since yesterday and it definitely seems to be the way of the future as far as treating mets. Far less invasive ... my confusion was a result of many posts on here suggesting that invasive surgery is typically the most aggressive and possibly best way of potentially curing stage IV. My reading has led me to believe that depending on the invidual case, it might not always make a whole lot of sense to go through an invasive surgery to address something that can be treated less invasively.

    I'll continue to do more research on the internet and have reached out elsewhere for feedback ... would welcome feedback from others on this forum as well if you should be willing to share.

    Thanks again.

    RFA
    Like Cheryl, I have had the RFA done to my lungs, not my liver. I've actually have had on average, one RFA done each of the last 4 years with my most recent one being on Oct 17th. It is a very simple procedure as far as all of this stuff goes. With three out of the four RFAs I've had done, I've been able to go home the same day. It was a great option.

    My liver had lesions all over it and I needed to have well more than half of it removed but if there are a few small spots and the RFA ever becomes an option, it would be a great way to go in my opinion.
    Best to you
    -p

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