How are people with liver mets doing?
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Dee, that is fabulous news you so deserve to have finally! Very happy for you indeed. Time for more celebration.
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Woohoo Dee !!!!
Rosie I responded on Mel's Thread. Take care.
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Hello,
I was curious do most oncologists start with systemic medications before trying local for the Mets to the liver? I am de novo breast cancer Mets to liver I will be starting Zoladex, Femara and Ibrance this week. They haven’t mentioned any local treatments.
Congratulations Alabamadee!
Thank you all for the warm welcome.
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Lost, I’ll tell you how my particular Interventional radiologist put it since it’s all fresh for me. He said I was considered a good candidate for microwave ablation because I had shown good response to systemic treatment (I/L), mets were small (1-3 cm), and a small number of them. My first MO was like yours and didn’t really mention the possibility. My new one brought it up a few months ago because she said I had been having nothing new on scans for a while and ablation has been shown to be helpful in some (not sure if she said said some?) cases. You’ll hopefully hear what others experienced too. I know there are various local treatments and different situations for them.
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Hi Lost,
My MO has not mentioned local treatments but, to be fair, I’ve been at this awhile and the liver mets popped up quickly. Often there is an early focus on systemic to try to get symptoms under control. For instance, in my case, my MO immediately put me on Taxol when I was first diagnosed with a lung full of fluid. That doesn’t seem to be the case for you so you may need to open the conversation.
Wishing you well.
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Dee!!! This is fantastic news. Stable disease! Music to my ears. Let’s keep it that way for a good long time!! You deserve a little peace - enjoy it
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Dee, Hurray - that's great news! I'm so happy for you!
Rosie, I'm glad the ablation went well. I hope it's all smooth sailing from here.
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Dear Dee, so many good news for you finally in one place. Maybe it is not just drugs but also your granddaughter's hugs many times a day (if I am not mixing something here)? Amazing response overall, congratulations! Saulius
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yay Dee and Rosie.
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Lost- I have had 3 MO's-- first one moved from the area, I transferred care from the 2nd one to the current one. None of my MO's have mentioned local treatments, just systemic. To be fair, the first 2 were in my home town- rural- without local treatment choices, but the current MO is in a larger cancer facility and still no discussion of local therapies. But I have not mentioned it to my current MO either. I think most MO's (from the posts here on BCO) concentrate on systemic therapy. A CDK 4/6 inhibitor, an Aromatase Inhibitor, and ovarian suppression (if pre- menopausal) is the standard of care for first line.
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S3k5.... My procedure is scheduled for tomorrow.
. I am praying it works as there is only a 50% chance it will I NEED TO FEEL NORMAL..and get this freakin Fentenyl patch off me.im told the procedure is only 15 min but they keep you an hour after bc it can lower BP.0 -
Thank you for everyone’s input. I have been a little concerned. I work in healthcare and my health insurance is tied to whom I work for. (In network) Before I got the biopsy results confirming my MRI of abdomen, my breast surgeon oncologist had started to say something about Y-90 then shut done because my oncologist hadn’t mentioned anything to me about it.
Once the biopsy confirmed it my regular oncologist had asked me if I also had coverage under my spouse. Which unfortunately I do not. It had me worried that one treatment was better then the other and that due to my insurance I won’t be able to get local treatments.
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Sending ❤️🙏 that your procedure goes well.
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Lost- Insurance is a biggie. I have not checked into local therapies and how my insurance views them. I may find out that my insurance would not pay. And I am changing insurance company yet again in July, then again in Jan to Medicare. I am on the fence about local therapies. I have 4 liver mets (seen on MRI). The biggest is 1.3cm and the others are smaller than that-- smallest is 7mm. I read good things on here from some that have done local treatment, but then others like Nicole that has had a rough go of it from local treatment. Do I want to take the chance if the systemic is overall doing good--- 3 years and still on first line treatment.
Nicole- I hope the block is easy and you get relief from the pain. You have had it really rough. Bless you.
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Lost47,
I would venture to guess that your oncologist was just asking to ask. It's been my experience that ANY of my doctors don't really know zippo about my insurance. I don't think a physician, either, would make a treatment decision based upon insurance -- after all, they can fight it out with insurance companies about what is the appropriate treatment. Never say never, but I know that my oncologist is absolutely clueless when I ask her insurance information. So, for now, I would put this worry to the back of your mind.
On the other hand, many, many oncologists, who are specifically trained to treat breast cancer as a systemic disease, using systemic treatments, aren't crazy about and/or don't recommend local treatments. The field of interventional radiology is a relatively new one, especially in the field of cancer treatment, and it's largely unknown to most MOs in my opinion. I mean, my MO knows that an interventional radiologist can implant a port if it's needed. But I'll bet that most MOs know little about the array of, for example, local liver treatments for BC patients.
Good luck with all of this. It's a lot, I know.
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Dee, what icredible news!!! I am thrilled for you! !!
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Rosie24 – I'm glad that you are feeling well after your microwave ablation!
Werone – Thank you very much for the pointer to the trial at Stanford!! I'm surprised that my oncologist did not mention it. My current Enhertu treatment targets HER2 and I am HER2 low, so maybe she doesn't believe that another HER2 treatment would work for me. Or maybe I'm too heavily pretreated to qualify for the trial.I will ask her about it.
S3K5 – Your reaction to Doxil sounds miserable and scary! So sorry you went through that! Hooray for the shrinking liver and bone mets!!!! It's very encouraging that your cancer is responding to chemo! I hope that Adriamycin will be very effective with minimal side effects! Thank you so much for sharing your experience with liver mets and chemos! I have only had CT scans on the DESTINY04 trial and would like to have a liver MRI. I was finally able to schedule an appointment with my IR for 3/10. For chemos, I've been on Xeloda, Abraxane, and now Enhertu (an antibody drug conjugate that delivers a chemo). When I was diagnosed with Stage 1 in 2009, I was not treated with chemo. For standard of care, my oncologist favors Halaven (eribulin) next. I will ask her why she suggested it over Doxil or Adriamycin. Have you been on Halaven?
Dee – Congratulations on stable disease!! I'm very, very happy for you! It's wonderful to see all your research paying off! I hope that you will have a long run on your trial! Thanks for the prayers and well-wishes!
Nicole – Praying that tomorrow's procedure will eliminate your pain!!
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Dee, congrats!!!!
Nicole, wishing you success in your procedure.
Rosie, good to hear the procedure went well.
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Hello,
Had a bad day. Went to start my medications and my insurance is denying my Femara and Imbrance. However they did allow me to get my Zoladex injection. Everyone I’ve talked to tells me not to worry my doctor will get it straightened out and the medications will be approved. I know that to be true but it’s the premise that an insurance company thinks my life is so worthless that they’re willing to fight my doctor over my treatment.
I work in healthcare. I spent last spring sick with Covid from caring for patients. 12 days off used my own PTO to pay for my leave. I’d just like to think my life is worth more then the money it costs these companies. I’m 47 have been healthy as a horse until now. Had no daily medications and with the exception of a sinus surgery and my tubes tied I’ve cost my insurance nothing and paid into it for years. I’m sorry to vent but I’ve spent 15 minutes crying in a parking lot. I went from liver Mets to mental health or in my case breakdown.
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Oh Lost,
I'm so sorry to hear that you are being jerked around by insurers. It's just unbelievable that these faceless companies hold lives by the string. I'm fortunate, in some ways, that I am in Canada so the femara is covered here. The CDK inhibitors are a different story however. It took two attempts to get approval to take Verzenio and then my extended health denied it, twice. I was ultimately able to access it through the drug company's plan.
Vent away. We all understand how upsetting this is, particularly given the scariness of liver mets. We're here for you. Just imagine the warm embrace of all of us metsters giving you a group hug.
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Lost47, I can see how you would take this personally! But it is actually just the usual way the game of Cancerland is played. (Horrible game we never asked to play.) Most likely your nurse or someone will solve this insurance issue quickly. My recommendation is follow up and make sure they are taking the right steps, but as much as possible don't use your energy staying upset about it. Go do something enjoyable and that is like flipping off cancer and the bean-counters both.
Regarding your earlier question, my first liver mets treatment got me to NEAD, so we did not need to talk about local treatment. At one point a few years later, my onc referred me to the interventional radiologist, but as we were making my Y90 mapping appointment my tumor marker results came in, and the drop was so dramatic we cancelled. That was when Xeloda got me to NEAD again. A good thing about systemic treatment is that when it works we presume it is likely working on any unseen mets in other locations, too. Give your systemic treatment a chance to do its work. In my own case, knowing how this particular cancer tends to behave, I will seek local treatment for liver mets if systemic treatments no longer work or if one or two mets appear to be different from the others, growing while the rest are controlled.0 -
Thank you Sadiesservant,
I’d like to blame the shot for my temper tantrum but I guess that would be to soon. Thank you for the virtual hug. I needed it. I sent a message to my PCP, to see if I could get a referral for some counseling. One day you feel like you got the tiger by the tail and the next the tiger has me by the tail. At least I have sunshine out and tomorrow will be a better day.
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Good move asking for the counselor. The one I saw my first year with mets helped me tremendously. Try to see someone with experience in oncology or at least chronic health conditions.
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Thanks Shetland Pony,
For the words of wisdom and your news that your systemic treatment has gotten you to NEDS. It gives me hope.
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My friends, I just wanted to post a brief quotation from last week's PET-CT report:
"No PET/CT scan evidence for recurrent/metastatic breast carcinoma."
Feeling amazed, lucky, grateful. Wishing all of us could have good news all the time.
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Shetland- wonderful news!
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Dear Shetland, uh, that is breathtaking - let this last forever for you!
Dear Lost47, I am angry at systems that make people go through all of this... for sure you deserve better. Things will be fixed but still...
Saulius
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SP,
Oh, happy day! So glad that your PET is clear and that you are still NED. Wonderful, wonderful news.
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SP- WOOHOO Congrats. Glad to hear that.
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Shetland, Fabulous report!!! Congrats 😁😁😁😁
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