How are people with liver mets doing?
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Gigi - I am so very sorry that you are now in this situation! I don't know exactly what would come next for you, re scans, treatment, etc. I had my last scans in early December and once again they suggest that the lesions on my liver might be slightly larger than they were before. They go back and forth saying they are the same as they've been vs slightly larger. My next scans are due in early March. My oncologist has chosen to watch and wait so far, because of the only slight variations in what the radiologists are seeing. He is preparing me however for what he calls a referral for "liver therapies", beginning with a liver biopsy, depending on what the scans in March show. He has also mentioned the Y-90 possibility depending on what is found. My tumor markers (15-3 and CEA) have been very slowly, but steadily rising over the last 6 mos. They are still within the normal range and not high, but steadily going up. We don't know if that is connected to the liver thing or not. I remain on the Verzenio, fulvestrant, and Zometa; but my onc has raised the possibility of possibly needing to change treatments too, again depending on what the March scans show. It's so frustrating, because while thankfully the pace is very slow, the indications are not good.
I didn't know that you had tested positive for the ESR1 mutation. I did have the MRI to double check what the CT showed re my liver and they used the Eovist contrast. That was last September I think, and that wound up with those radiologists thinking again, that the size of my liver lesions was about the same as it has been for over a year. The CT had shown them slightly larger. December's CT showed them slightly larger again, in contrast to what the MRI had said. It's never ending. I would imagine they will want you to get the MRI, as my onc told me it is the "gold standard" for this sort of thing. I would imagine too, that like in my situation you might be able to watch and wait for awhile, depending on how fast any growth seems to be. I've got my fingers crossed for you big time, Gigi. Please keep us posted with any updates.
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I'm not sure where to post this as the liquid biopsy discussion is not very active and is under "Not diagnosed with Recurrence or Metastases…."
I had the Strata tumor profiling test on a liver biopsy in Aug 2022. Strata is a very comprehesive test and I've had the targeted treaments that were identified. I've had progression four times since the test. The last progression per scan was early this month in the liver.
It's my understanding that tumor biology can change after progression. So after this recent progression I asked my MO for a liquid biopsy test. She responded back asking what the benefit would be. She has offered me a choice of one of three conventional chemos, or there might be a study, or else I'll stop treatment and start hospice.
Communiation with this doctor has been difficult for me at times, however since I'm coming to the end of any treatment options, changing doctors doesn't make much sense. Was I off the mark in my understanding to ask for a liquid biopsy?
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Weninwi-I don't think you were off the mark. Why don't you seek a second opinion, especially if you think that communication is not good with this doc? It's your life at stake.
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Wendy - I'm really sorry about what you are going through right now and want to echo what Chicagoan has said. I think further opinions are definitely in order. Sending a virtual hug too.
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@weninwi , Hi Weninwi, I echo Chicagoan and Threetree that a second opinion is in order.
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Wendy, Per my DD who works at MSK and tracked down liquid biopsy info for me, Dr. Pedram Rezavi is a research/treating MO there who studies liquid biopsies and MBC. MSK does remote second opinions but I don't know whether you can request a specific doctor. There are many potential uses for this but the field is still in the developmental stage so finding someone with expertise takes a bit of searching. I hope you find someone.
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Hello, I have been little bit active in the bone mets thread but I think I will be on liver thread now too 😏… i was diagnosed with bone mets in Feb 2024 and I just had CT and Bone scan as my tumor markers are going up, like really up (Feb 2024 79, July 2024 44, Nov 2024 164, Dec 2024 178)… and my oncologists is saying it’s most likely medication reaction, no need for concern. CT scan shows healing and Bone scan shows progression and I don’t know what to believe and what to go with. My oncologists is saying he is putting more weight on CT scan and not making any changes to my medications and we just did US on the liver as CT picked up something but they are not suspecting anything worrisome, so US is suspecting Mets on the liver and I am absolutely freaked out. I don’t know what to expect, what will doctor suggest.
What are some of the start treatment for liver, is operation an option or radiation? I am currently on 400mg ribociclib, falsodex injections and xgeva injection. Is there specific medication for liver? And what is typical behaviour on liver Mets? Is anyone experiencing any other symptoms or just scans are giving indications on what is going on? Is there a blood work that can be monitored? I am currently doing monthly blood work, just a standard one but not sure if there might be something more specific for liver? With bones we feel pain and kind of suspect what is happening but not sure how liver is reacting? Any tips, suggestions on treatment, medication on what might have helped would be appreciated 🙏
I will try and go through some of the posts but there is so many 😔0 -
vlk2ri- First, you don't know yet if the liver is now involved. Find out the US results first. See what your doctor says. Then, if something is suspected they would probably do a biopsy to verify that the area in the liver is indeed cancer- there can be non-cancerous things seen on the liver too. So you are not there yet.
But, if it is metastasis to the liver, maybe they can just change your meds around. Or they may suggest a procedure- surgery or ablation. But you need more information. Biopsy results to see possible mutations, to see what med might be good to treat it with. And where the tumor is located in the liver to see if surgery or ablation is an option.
I started on Ibrance (a sister to ribociclib) with my liver mets. Then we changed me to Lynparza after the Ibrance stopped working. I was found to have the BRCA mutation on my liver biopsy so it opened up the possibility of using Lynparza. I have never had surgery, ablation, or radiation. Just the oral meds. I did not have any symptoms of the liver being involved. They do "standard" blood tests on me too- to monitor the liver enzymes. Those can be seen on the standard blood work.
So breathe. And I hope I helped some.
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Hi @candy-678,
Thank you for your message! Ultrasound is suspecting Mets to the liver and I just got phone call this morning and my doctor is sending me to do MRI on Friday. Hopefully that gives us some additional info.
I’ve been asking my doctor to switch up meds in case ribociclib is not working anymore which I am suspecting as my TM are high and we see staff on the liver and new sites on the hip.
I am also open for radiation and for liver surgery but he’s been just tossing the chemo into the game. I am not opposed to chemo but I am wondering if switching meds and radiation and surgery could be helpful as well ???
I am not sure what some other people might have done if in similar situation… any tip/ suggestions is appreciated0 -
@vik2ri My liver was riddled with small liver metastases in October last year. I had no symptoms, only the liver tests showed a significant increase. I therefore had an MRI. I was on Ibrance which clearly no longer worked. My onco asked that I start chemotherapy immediately (Taxol, Carboplatin). 6 months later my metas had disappeared. I made a big deal about the chemo but in the end it was very manageable.
This is only my experience. Depending on the type of tumor, other options are possible such as radiotherapy, surgery, etc.0 -
I follow a "Science Communicator" on facebook called Hashem Al-Ghaili (fascinating!). His website wouldn't cooperate but if you are on facebook, look him up as he explains things in laymen terms. He recently posted about liver "histotripsy". I'm not sure it is ready for breast cancer in the liver or what the requirements are, but here is the website to the FDA approved treatment for cancer in the liver:
It is fascinating stuff and I just wanted to add this for hope for the future.
I'm not sure if there is a better thread to post this on but I figured I'd start here.
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