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RFA Ablation - Partial?

Ace13
Posts: 17
Joined: Apr 2017

Hello all,

Thank you for your messages of hope and info about treatment strategies, outcomes, and side effects. It's been really helpful for me as I support my fiance through stage IV colon cancer.

She has mets in her lymph nodes, ovary, and one spot in the liver. Our oncologist has set up a meeting with the interventional radiology team in a few days (Mon Apr 10/17). It took a little to convince our oncologist to consider RFA for the liver spot; they are a bit resistant due to disease elsewhere.

The odd thing was he suggested they might be able to do partial ablation. Has anyone heard of partial RFA? I don't understand why they wouldn't take out the whole thing.

It used to be 1 cm but they didn't want to do they ablation 5 months ago, and now its 4 x 2.9 cm.

Any thoughts would be helpful. I would like to build a case to fully ablate when we have our meeting. Decreasing the tumor burden is important to us, keep chipping away at the cancer, until we can get rid of it all.

Thanks!

PamRav's picture
PamRav
Posts: 281
Joined: Jan 2017

I had a small liver resection and an abalation last week; all done laparoscopic.  

The colon surgeon wouldn't touch my primary tumor until the liver mets were gone.   I did chemo to shrink the mets , which were 2 lesions on opposites sides of the liver.  One met was completely gone so that area was resected,  the other one was abslated.    Then during that same operative setting the colon surgeon did his thing 

not sure what they mean by a partial ??   do they have plans to address the ovary??

Joan M's picture
Joan M
Posts: 411
Joined: Oct 2016

"Partial" ablation may be due to the size. I was told the usually only do the ablations on tumors that are 3-3.5 cm.  This is probably a better question for the doctor.  I had a microwave ablation on a tumor that was about 3cm - I believe the heat spread out a little farther than the tumor to kill off cells around the edge.  When you find out from your doctor, you should post the answer for us.

Trubrit's picture
Trubrit
Posts: 5193
Joined: Jan 2013

I was told by my liver surgeon that he wouldn't do an ablation on a tumour bigger than 2cm. When he opening me up and got the ultrasound paddle in, my tumour was 2.2, but he went ahead. That was THREE years ago this month. No evidence of disease since. 

I am guessing a partial ablation is because your tumour is so much bigger; but I bet a partial is better than no ablation, especially if they can't resect for some reason. 

No point in looking back and wishing they'd done the ablatoin 5 months ago, but......

Weclome to the forum. I hope you continue to find all the support you need here, as you journey on. 

TRU

Ace13
Posts: 17
Joined: Apr 2017

First, thanks for the comments, and good advice, Tru. It's important to focus on the now and moving forward.

We met with the interventional radiologist today. They are planning to do microwave ablation (instead of radiofrequency). Both seem to be pretty routine procedures for liver mets and have similar outcomes.

Notably, in reference to the partial ablation, we stated two things: 1) to allow infiltrating immune cells access to the tumor (preserve some blood vessel access) gobble up tumor antigen and dead cells, start attacking the remaining cells not only in the liver but also in mets of other organs with a strong activated immune response. 2) typically, ablation also clears the margins including good tissue, which may stimulate a regenerative response to heal and pre-clinical (animal model) data suggests that this could cause further mets. He stated more research is still needed in both areas but there is good reasoning behind the partial ablation strategy.

Hope that is helpful. I'll update as we go. Procedure is schedule for this Friday (Apr 14th).

Ace13
Posts: 17
Joined: Apr 2017

Here's an update on my fiancée's recovery from ablaton.

The ablation procedure went well. The doctor was happy with the how it went, there were no complications. My fiance felt good coming out of the procedure, didn't have too much pain, which lasted maybe a week. She was careful to take it easy and not do too much. The first couple days after she was quite tired and had a bit of flu-like symptoms but they didn't last. So it was a relatively good recovery. 

However, we just got a 2 month follow up scan back and there are two new small spots and the liver and what appears to be a reoccurance at the ablation site. So we've now added erbitux to irinotecan at a lower dose now and hoping that slows things down. Meanwhile I've been searching for possible surgical options to deal with the ovarian mets, but little progress so far. Neither GI nor gynecological surgeons are willing to do the procedure. I am interested in other approaches, so I will look into SIRT, maybe it will be good to go after these new liver spots.

We continue to fight the good fight. 

Ace13
Posts: 17
Joined: Apr 2017

Here's an update on my fiancée's recovery from ablaton.

The ablation procedure went well. The doctor was happy with the how it went, there were no complications. My fiance felt good coming out of the procedure, didn't have too much pain, which lasted maybe a week. She was careful to take it easy and not do too much. The first couple days after she was quite tired and had a bit of flu-like symptoms but they didn't last. So it was a relatively good recovery. 

However, we just got a 2 month follow up scan back and there are two new small spots and the liver and what appears to be a reoccurance at the ablation site. So we've now added erbitux to irinotecan at a lower dose now and hoping that slows things down. Meanwhile I've been searching for possible surgical options to deal with the ovarian mets, but little progress so far. Neither GI nor gynecological surgeons are willing to do the procedure. I am interested in other approaches, so I will look into SIRT, maybe it will be good to go after these new liver spots.

We continue to fight the good fight. 

Phoenix_66's picture
Phoenix_66
Posts: 118
Joined: Jun 2017

Ace, sorry to hear about new spots.  That news can be so crippling but you and your fiance have to stay positive. The mental part of this battle is as important as the physical battle.

Real Tar Heel
Posts: 104
Joined: Nov 2019

Sorry for the unfortunate return of the tumors. Are they unwilling to go back in where they burned them the first time?

Trubrit's picture
Trubrit
Posts: 5193
Joined: Jan 2013

Thank you for the update, Ace. 

I am happy to hear that the Ablation went well, but sad to hear that there are more spots to deal with; plus the ovarian mets to worry about. 

I know you are doing a a great job keeping up on what options she has for treatment, and I pray for the best outcome as you push for treatment for those ovarian mets. 

Definitely continue the fight.

Tru

mysweetheartrusty's picture
mysweetheartrusty
Posts: 19
Joined: Jun 2017

She is so lucky to have you in her corner! Don't let it get ya'll down. Sending prayers for quick healing and more options!

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