Liver mets: resection, ablation, SBRT, Y-90, anything else?
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JFL. My IR didn't want me to have a scan that soon. In fact he said even a 3 months one might not show accurate results. I think my first one was 4 months and it showed no uptake, he was even surprised at that result. So, I think the mixed result is OK for one month out. Hoping the next scan is perfect.
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Grannax, my IR said something similar, line 5-6 months. I was overdue for my standard 3-month scan and had a fleeting episode where my liver enzymes jumped and then went back down. I wanted to make sure everything was okay, outside of Y90.
Ha, ha. The radiologist who wrote my PET results amended his report today to say that after speaking with my MO and learning of Y90, it is likely the changes were caused by Y90 and that the treatment is working. My MO made a note in the PET orders and reached out to radiology beforehand to give them a heads up. I also informed the tech administering the PET who always does a treatment history and current treatments list. Such incompetence! Nice to know radiology is only going through the motions at my cancer center. That is why I had Y90 at a different facility. Need to send my PET results to IR.
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JFL, I'm very glad to know that Y90 is working for you and you're right about miscommunication. It's hard to always check who knows what.
Right now I'm on cloud heaven, after three days of testing I spent an hour with the IR doc. He compared the last three scans of the right and left liver lobes and the results are dramatic. Mets are either dead or in the the process of necrosis. Many have entirely disappeared. My liver enzymes are normal and the liver is normal in size. Something I learned today, he mentioned you don't always have the same readers who read the scans, I asked who he would recommend and that person will be on the follow up scans.
I like consistency. I'm hopeful that verzenio will work , no chemo has been effective for me on the liver.
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Great news!! Thanks for letting us know.
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max otto welcome to the good news club. Y90 is the bomb!
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Max Otto, fabulous results! Incredible. I am so happy for you. I am hoping that for us who do Y90, it will beat back our liver disease enough so that other treatments will now have a chance to keep them at bay. So true about different readers of scans having somewhat different interpretations. It would be ideal if the same radiologist could read all of our scans.
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Hi all! I just found this thread. I was diagnosed with 2 TNBC liver mets in January of this year. I started Gemzar and Carboplatin in February and my April and July PET/CTs couldn't find cancer in my liver.
I am trying to figure out what to do now. Seems like the doctors want me to stay on GemCarbo for a while longer. But I am wondering if I should do a local liver treatment - SBRT, resection of the scar tissue, etc. Does anyone have any experience with local treatments after becoming NED from systemic treatment?
Any other thoughts on treatment plan going forward? Curious to learn from all of you. Thanks in advance!
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So I’m scheduled for my Y90 mapping tomorrow.. I’m a bit anxious but still full of hope that this will work .. please pray for me 🙏🏻 I’m also trying to figure out how to stay away from my kids for a whole week after the actual surgery especially my 2 year old .. he’s not old enough to reason with him to stay away .. any ideas?? JFL what did you do with your little one?
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My Y90 worked! Praying for all IR procedures to work for everyone! Love, MJH
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My y90 worked for over a year but my August PET showed progression. Now, I see my I R Wednesday to see if another y90 or microwave ablation would work for me. He ordered a liver MRI too, I'll get the result Wednesday. Hoping it didn't show more mets.
Has anyone else had a microwave ablation? Then on 28th I'll see my MO again. She's recommended AA. I'm not excited about all this changing of TX that comes with progression.Cancer is not fun.💞
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Grannax - Sorry about your progression. I had microwave ablation to my one 9mm liver met when I was first diagnosed with Stage 4 in February. I've also been on Ibrance/Letrozole since then. The ablation worked on the liver met. In addition, I've not had any new mets show up on my scans. It was an easy overnight procedure, but I did have bad pain for several days after. My liver met was near a bile duct and my scans show some scar tissue there. I've not had any problems from the scar tissue, but my liver doctor is monitoring it.
~Kar
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Hi All!
So, I went in for the Y90 procedure on Wednesday. It has been way more eventful than I expected it to be. Unfortunately, the attending didn’t honor my wishes of not heavily involving a fellow in the procedure.. it took much longer than anticipated and I started hyperventilating, oversweating and my heart was all wacky with the pain in my abdomen and mid back being unbearable right there on the table. Finally, the doctor switched with the fellow and took over for the last 20 minutes or so... ugh !!
The pain kept creeping up that day and I was really a mess but still went home later that day. The past few days were rough with pain all over the abdominal area as opposed only to liver and the nausea and vomiting were relentless.
I started feeling better after I took the prescription antiacids and the antibiotics now the pain is mostly in liver only. The Zofran is an absolute must .. I couldn’t keep anything down regardless how small.
I hope the next few days prove to be better .. I guess I underestimated the procedure thinking it’s only a minimally invasive one but afterall being on the table carries its own risks no matter how small. I hope this works. I was skeptical at first when they were debating whether to do it all in one sitting or on two separate times .. I have right lobe involvement and a big one in segment 4A which apparently feeds off a different artery. But now I’m glad it’s over with.
I guess it’s also a placement issue that 4 A area is way up high next to diaphragm and really accentuate the pain and messes up with the breathing.. l remember the pain was unbearable after my single 4A microwave ablation. Believe me I can take pain, afterall I was 7 months pregnant with several compression fractures and broken femur and extensive liver and bone mets when I was diagnosed and zero pain meds!!
I don’t mean to be somber but it’s sometimes better to put things in perspective with these procedures to plan accordingly.. if you end up being one of the lucky ones who fly through this that’s awesome!
Regardless, I really have high hopes for this to work 🙏🏻🤞🏼
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Nouzay. Oh my that sounds terrible. I was lucky enough not to have any severe SE. You've already had a microwave ablation? What was that like?
I'm in the middle of a possible change in TX. But, the MRI does not agree with the PET.
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Nouzay, I was thinking about you and wondering how it went. I am sorry you had a rough experience and hope that your Y90 is very effective. I had a rough mapping and groin pain for a week - which surprised me because no one else seemed to have issues. We all have different experiences, based on a variety of factors, including what is going on in our bodies and how the procedure is handled by the person at the helm. Once you recover fully from this, I suspect it will all be worth it because it will put those liver mets into dormant mode. Your statement "Believe me I can take pain, afterall I was 7 months pregnant with several compression fractures and broken femur and extensive liver and bone mets when I was diagnosed and zero pain meds!!". I could have said that myself . . . . except maybe swap out the femur fracture for uncontrollable hypercalcemia
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OMG!!!!! This has not been easy! I'm almost two and half weeks out of the Y90 and I'm still having issues!the first week was the worst with everything out of wack and unimaginable pain the second week the liver pain started to subside, and the nausea and vomiting was controlled by meds but any little thing I eat would turn my stomach into living hell and my back starts to hurting like crazy!! For at least a few hours then it calms down a bit .. the IR says it could be post embolization syndrome or a problem with the gallbladder .. basically he said wait it out unless it gets worse then go to ER.
then five days ago i started to develop this weird rash allover my body .. the itching was so bad I worried I'll get an infection from broken skin. I'm not sure What's going on .. my MO prescribed a steroid course and I even took benedryl on top of it. I worried it could be some drug interaction between Verzenio and the prelosec or the zofran so I stopped both immediately which actually seemed to take care of the stomach pain for 3 days then it all flared again over the weekend and I'm back to the agonizing belly pain and the horrible back pain that keeps me up at night even the itching is still not completely gone .. I also have a sore throat and my ears hurt .. I'm worried the steroids are masking some infection or something!!
I'm not sure what to do!! Anyone has had anything similar to that after Y90?? Please share your experience!! I thought this was supposed to be a simple procedure!
JFL, I know you get it! We all have put up with so much but definitely pregnancy added to this mix is not ideal
Grannax, my ablation was also a little eventful but I think it was only due to the location of the met I had near the diaphragm.. I had referred pain in my shoulder.. it felt like it was broken for a few days .. the doctor said it's because they probably touched the phrenic nerve due to proximity to the ablation zone. I also had a drug interaction between oxycontin and the cypro they prescribed after the surgery and I was emotionally miserable and hallucinating but once I stopped it everything was fine. Unfortunately, ablation didn't work for me as mets just kept creeping up next to the ablation zone that's why I did the Y90 but don't be disheartened.. there seems to be many others with great outcomes.
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nouzayo- id day at this point go to the ER. It could be your gall bladder. Rash can be indicative that the liver is not working properly. It also can be due to normal thugs. Sounds like you are in pain, have several reasons to be checked out.
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Nouzayo, are they watching labs? Or does having the procedure throw all liver function tests into chaos and they don't know if they would represent what is going on? 20yrs ago when I was pregnant I had a pregnancy induced liver issue that caused uncontrollable itching in my hands and feet esp...but no rash. They had to give me a synthetic bile and on an antihistamine for the itching...I agree with leftfootforward things need to checked out....liver or gallbladder emptying could be an issue, I was told if you stop Prilosec suddenly it can also cause stomach pain, a rebound effect.
I don't know if that just makes things confusing, I haven't had y-90 (yet...).
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just an update..I continued to have stomach issues and my heart rate became very irregular and elevated over the past two days reaching 158 I was very weak and dizzy. I really hate going to the ER and it was my son’s second birthday and I didn’t want to spend it this way. I pulled through until yesterday and then went to my MO for labs and IV fluids .. surprisingly potassium levels were low normal even though they were very low on the day of the surgery which causes heart issues. They still gave me a pill to boost it a little and the IV fluids definitely helped a little .. now the heart rate ranges between 88-130 .. still high but better. The liver enzymes are all messed up but i think that’s consistent with the surgery.. I don’t know anymore.. I will see my MO on th
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Nouzay0, are you better?
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Anyone hear from Nouzay0? Worried.
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Sandibeach, I have not heard from Nouzay and think about how she is doing as well. I do see she was last seen on the boards yesterday so that it is a good sign. Nouzay, I hope your symptoms are improving and that you are getting some answers about what is causing your issues.
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Anyone hear from Nouzay?
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All of you may already know about Babs. She passed away yesterday. She was one of us, she had a y90 too. I don't know all the details but I believe that her y90 did not fail her.
When she had her y90, she had the fastest recovery time of anyone here. I think she only took the weekend off and went back to work on Monday. That's why I called her the y90 Queen.
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I was on BCO break, I was so sad to read of Patty’s passing, & now just reading about Bab’s has really got me crying. 😢 Sue.
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The losses just keep coming. I can't handle it. So very sad about Babs. We did share some PMs around and after Y90 and she was given Y90 when her lung mets were not necessarily stable. Y90 handled her relentless liver mets but the lung mets progressed around the same time. A while after that, she had brain mets and extensive bone mets added to the mix and the brain mets really made things take a turn for the worse. Still in shock. She was such a wonderful person and I learned so much from her.
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I am so sad to hear of Babs passing. She recovered amazingly fast from the Y90 if I remember correctly. It is so hard to keep losing all our wonderful friends.
In less than 2 months I will have hit my 3 year mark since my Y90. I know we do not all get the same results but I am so thankful for the time it has bought me. I will take every day I can get! Scans in three weeks.
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Congrats, BabyRuth! 3 years is amazing.
Sandibeach, I haven't heard from Nouzay and am worried as well. Sent her a message a few days ago. Hope she is just busy with her family . . . .
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Has anyone here had a bad response to Y90? Either with side effects or progression?
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I remain concerned about some members we hear it's going poorly then don't hear back from. Notably Emily-Louise and NouzayQ
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Hello Everyone!!
Thank you so much for your concern!! I honestly didn’t think I’ll be missed but I’m deeply touched by your kindness!
JFL I saw your pm a couple of days ago and already replied .. you are so sweet!
I haven't been on BCO because I was in such a bad shape I was very depressed and I felt if I share that stuff with people it may deter them from a perfectly good option to treat liver mets but since I see the question has been posed if someone has had a negative experience I might as well tell you.
The first 5 and a half weeks after surgery were living hell for me with one thing after the other and my ever diminishing trust in medical care just contiued to drop. My IR doctor was hard to reach with very little input onto why this is happening to me. He is actually supposed to be one of the best in the US! After my ER visits My oncologist was trying to help as much as she could by ordering fluids because I got so dehydrated and by accepting to reduce the Verzenio dosage to 100 mg.
My personal theory is that my liver was not functioning optimally after the surgery so I kept getting myriad side effects frim the Verzenio and Elequis - the only teo things I wa taking post week two of surgery- I almost got every side effect in the leaflet which was not the case before !!
The lower Verzenio dose was definitely more tolerable but still I couldn't take it twice a day as prescribed.
Fast forward to 7 weeks after surgery, I was due for scanning and I got mixed news.
The IR doctor - whom I had to restrain myself from punching for his terrible follow up after surgery - said that it seems that the Y90 is working though they have to redo the scans in three months to be sure keeping in mind that I always have to be open minded about doing it all over again if more mets popped up but that's the good news.
The bad news is as I feared the cancer has become more active in the bones.. they can't tell definitively if it was because I didn't take my meds regularly or simply the tumor is not responding to them. No new areas but five big spots became bigger.. two of them are in the spine which can put me at a risk of further fracture or if they got really worse they can press on the spinal cord or even infiltrate the spinal fluid and I don't want to even think about that!!
Not sure what to do .. I can continue my same medication and hoping it will work if I take it regularly, I can change medication and play that game all over again or I can treat the spine with local radiation or kyphoplasty, a new surgical procedure with it's own set of risks and side effects.
What would you do?
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