Liver mets: resection, ablation, SBRT, Y-90, anything else?
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Thanks ladies. I'm still on cloud nine with my good news. Hopefully, someday it will work for many of you, too. 💞
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well Texas just opened back up to medical diagnostics etc so I can go to MDACC in May, but do I want to? It is a 2 hour direct flight with my hubby going too
I can get the scans here at home but MDACC prefers theirs. I will miss the IR check up after y90 and getting my tour of the clinical trial facility. But I need the scans before I can be accepted anyway.
Any thoughts from my BC friends? stay home and stay safer or go and get the scans and plans in Texas like usual at 3 months since I started my new line. (My clinic is actually in League City- brand new and not crowded at all)
If I don’t go, I'm sure my Texas MO will video or call me with a plan after their radiologists look at the cd- she calls me frequently to answer questions.
stupid cancer, stupid covid, blessed I'm feeling good.
Dee
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Wow, tough decision Dee. What kind of flight rules has your country implemented? In Canada plane/train/ferry etc operators are screening passengers, will refuse boarding to people who appear ill, require everyone to wear a mask, and they're trying to seat people apart when possible. Plus extra cleaning for the cabin, hand sanitizers etc and the unions have provisions so any crew who feels ill calls in sick with no penalties. I think if you have similar measures, and can get N95 masks for your flight then I'd consider going.... (the other masks are more for protecting others, they don't protect you as much....)
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cross posting because I’m so excited that my local therapy worked and for the first time my systemic therapy seems to be working. (got my scans at home)
MY Great news! 🙌🏻 RESPONSE AND SHRINKAGE of current liver tumors and they did not light up on PET which means they are not active. These are the ones that had Y-90 and bland embolization. 1 small lung nodule weakly lit up that was seen on previous MRI- we will be watching it.
Home MO recommends staying on current medications. Afinitor/Faslodex/Sandostatin.So good to be able to say that for the first time! 😉We will need labs to watch WBC and ANC, probably weekly.
Sending scans to MD Anderson and will have video call with her after she reviews them. Their reports are much more detailed than my home clinic. So I am hoping those diffuse small mets that were previously reported on MRI andCT are just plain gone since nothing lit up Or showed beside the one in the lung.
Next scans in 3 months. Hopefully in TX but we will be smart.
PRAISE GOD. This is a such a joy to report to you all.
💃🏻💃🏻💃🏻💃🏻💃🏻💃🏻HAPPY DANCE
Now COVID has to go so I can see my kids and grandbaby again.
Dee
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Dee, posted reply to your wonderful news on the other thread, but just want to add I hope you get to see those kids & grands very soon! Congratulations!
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Dee we are in the same boat, doesn't it feel awesome? Both systematic land local working at the same time. Happy words indeed.
Faslodex is keeping my lung mets and mediastinal node under control and shrinking them. I'm not sure when my next PET will be, possibly late June. My TX has no SE except weight gain. I'm sure you probably have weight loss with Affinator. Hoping for continuing success for both of us.
Yes ,Covid, go away! I need to to see my kids and grandkids, too. I hope I get to see them for mother's day, even if it's just in my front yard. 💞
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I know this thread is for local treatment of liver mets, but I couldn’t find one here for local treatment of lung mets. Can anyone share their experience or point me to the right thread here?
I will be pursuing SBRT or cryoablation for the small upper left lobelung met.
I learned here about the "whack a mole" plan. Put out the poison (systemic treatment medicine for the whole body) and shoot the little buggers that pop up(local treatment like y- 90 or SBRT radiation, cryoablation.) In it to win it. 😉
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Dee,
I have no info to provide to you but in response to your "whack a mole" theory, I'm on board. I'd like to add to that -- get consults with the best people who you can. I know you've been working with MD Anderson. Today I had a video consult with Dr. Massimo Cristofanilli, previously of MDA, and he was just wonderful and offered such a more open, creative output than I've experienced in my cancer journey so far. Like you, I'm looking for what I can do to hold things back. I told him that, and he laughed but agreed with me. It's refreshing.
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BevJen, where is Dr Cristofanilla now? Sloan?
You mentioned that Fulvestrant/Ibrance did not work. Do you also have the FGFR1 amplification? You said negative for ESR1, which puzzled me as I thought that Ful/Ib combo would have worked.
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SandiBeach,
Dr. Cristofanilli is at Northwestern University Hospital in Chicago. He happens to be in the same department as Dr. Robert Lewandoski, the interventional radiologist who has written so much about local liver treatment for metastasis (and who I consulted last year prior to my microwave ablation of my largest liver tumor.) Both of these docs were so very caring and helpful. It's just, as I said, so refreshing.
So, Cristofanilli actually thinks that the I/F IS working, at least for the most part. It's a long explanation, but he said to hold on that treatment right now. I do not have the ESR1 mutation, but what I do have is two different mutations of ERBB2, which is, as I understand it, an amplification of the HER2 gene (not sure if I'm using the word "gene" correctly there). This, too, can cause people to develop resistance to estrogen-targeted treatment, just like ESR1. That may be what's going on with me (my tumor markers have been climbing) but we are not positive. Anyway, Dr. C wants me to have a Gardant liquid biopsy because he says that it should more clearly show which mutation is directing my cancer right now, thus enabling doctors to more precisely pinpoint my next treatment. It was really fascinating to listen to him. In 40 minutes, he just offered a ton of info.
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BevJen, that’s great that you had a productive and encouraging consult with Dr. C. I’m sure he was pleased with how informed you are as well.
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BevJen, thank you. I happy that you have the best looking advising you. 40 minutes! wow.
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Hello to all! I don’t post much but wanted to share my experience with Y90 treatment to the liver. At the end of February, I received an ablative dose of Y90 to a 13-14cm tumor in my right lobe. Overall, the SE’s were not bad. I experienced mild fevers, chills, lack of appetite, and fatigue for about one month. The SE’s would come and go but seemed worse in the late afternoon and evening. I received a second Y90 treatment in mid April, targeting two tumors in the left lobe, both about 3-4cm. I received a standard dose in the left lobe. SE’s after second Y90 were much more tolerable. Same type of SE’s but only experienced for 10 days.
I’m happy to report that my May 11th CT showed decrease in all three liver tumors. 13-14cm is down to 7-8cm and other two in left lobe are now at approx 2cm. Very close to a 50% reduction in size for all 3. I stayed on Xeloda the entire time I received Y90, 3000mg, 7 on/7 off schedule. My Y90 procedures were done at City of Hope in Duarte CA and I received excellent care. I’m currently a Kaiser patient but did receive an approved referral (Kaiser/Medicare) to have the treatment at City of Hope. I’m 46 years old and three years into this journey. I cannot recommend this treatment enough. This is the first decrease in the size of liver Mets that I’ve had since diagnosis. Y90 is much easier than the TC IV chemo I had in the beginning.
I’m thrilled with my results from Y90 and wish you all a wonderful day!
~KC
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KC great news! I feel the same as you y-90 was the first treatment to get shrinkage for me!
RO approved me for SBRT for a Single lung lesion. Getting a blessing from my MO today. So glad for local treatment options
Dee
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Yay for local treatments! I had my three month MRI of my liver and abdomen yesterday, as well as a nuclear bone scan. Last week had a CT scan. Waiting for reports of the two from yesterday, but got copies of the films from all -- plan on probably sending those back to Dr. Lewandoski at Northwestern to see what he says at this point in time about the liver. I had a single microwave ablation last summer to a 2.1 cm lesion in my right lobe, but still anticipate that one more of about a centimeter is showing up (it did on my CT) and want to see what he recommends. If my IR at Hopkins won't treat it with a local treatment, I will most likely head to Northwestern and have it treated there.
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KC..wonderful.
I am not a candidate..not yet! But taking notes..
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KC, congrats! So glad to hear your news that Y90 is working so well. Sometimes Y90 can be the only thing to make one feel like they are not constantly being chased down by liver mets. Y90 can take 5-6 months to fully work so perhaps you will end up having even more shrinkage!
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Thank you for your support! I'm def hoping for more shrinkage!!! It's been about a year of slow but steady progression. I feel like I can finally take a breath. Whew! I hope you all are experiencing your own victories fighting this disease! Stay safe!
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bevjen. Have I ever told you that I was Dr C’s patient at MDA in 2000-2002. He is, by far, my favorite MO on the planet. I really believe he saved my life back then. Sounds like he’s just as good and smart as when I saw him almost 20 years ago.
Glad you’re getting the very best advice.
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Grannax,
Oh, no, I didn't know that!!! I've read a lot of his stuff, and when I had my appointment with him, even though our appointment was video, his warmth just came through. He seemed like a very nice man and a very skilled practitioner. I am waiting for his report (it was sent to my MO) and then I'm going to keep in touch with him as my consulting physician. He just seemed so on top of everything when we talked.
I'm so glad to know that he was your doc, too. Wow!
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hello everyone , I don’t post frequently but I read this thread a lot . So my mon post diagnosis of liver Mets she took capecitabine which showed shrinkage Of 5 cm lesion and disappearing of other small discrete ones but within 3 months its stopped working and did massive progression to 16cm that her entire left lobe is now lit up on pet scan and she is stuck in India due to COVID travel ban but MDA docs had a video conference her pet was sent to them they started Ibrance and aramidix (I am getting the same company drugs in India for her much cheaper) she currently started on her third cycle
So question is she is been feeling dizzy lately , happened thrice , the first time she had a fall . She is diabetic too on metformin but her blood sugars are very much under control ..
Did anyone else witness such symptoms of dizziness ?
Concerned da
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Faripari,
First, you will probably get more responses on the Ibrance thread -- so try there too.
I had a strange response to Ibrance that I think was related to my blood pressure meds. At the beginning (and occasionally but not often now) I felt a bit "weak" -- I'm not sure that I was dizzy, but I don't know. My primary care doc had me cut my BP meds in half and that solved the problem. I am back to my full dose of BP meds. So it's possible that the Ibrance could be causing some more intensity in other meds that she is on?
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Excellent news!!! In time, hope you see even more shrinkage. Celebrate!!!
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great news KC
Good news on my front. I had a brain scan because of some light headedness. I think they may just make it an annual thing. Anyway- all clear! Probably the Afinitor and some BP fluctuations
So I’m on track to have the SBRT to the one lung lesion that lit up. The RO thinks it will be therapeutic and has very few side effects. but both MOs were ambivalent since I have other new lung lesions that are tiny and did not light up. BUT, I read about the abscopal effect of treating one lesion and others shrink too so I’m hoping for that!
So thankful for fighting for myself. Even if the OSR is not affected by SBRT, I feel like I am fighting the cancer with a real tool (wack-a-mole) and the mental benefits are worth it (even the RO said that is a valid consideration and benefit)
And my CA15-3 went down several points I’m riding high on these good reports
Blessings to all
Dee
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Dee,
Good for you for fighting for yourself, especially if that helps mentally. I've also read about the abscopal effect and think that is something to it. When I had a single liver met ablated last year, the others they could see also shrank a little bit. I just read an article (didn't keep the citation) in the Journal of Interventional Radiology that supported the abscopal effect. So good for you!
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Has anyone had TACE done? If so how big were the tumors and where? > were any near colon wall?
Also has anyone had NANOknife???
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Nicole,
Nanoknife was discussed on the LBBC videos from the conference during the bone mets segment with Dr. Brufsky. I have not heard that discussed with the liver, but only with bone or with brain cancer -- not sure it's used for brain metastases?
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Uh, our MO prescribed and half year full body routine CT scan yesterday and unexpectedly there was a vacant place, so Sandra got it for today. We see no signs (blood, ultrasounds two months ago) something could be happening but as always... who knows. Scanxiety suddenly kickin' in. Let's pray all is good... Hugs to everyone, Saulius
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Great news Dee! Will be saying prayers for strength and the best possible outcomes!!!
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With regards to liver mets only ....Can anyone tell me why TACE would be better or worse than Y90 or vice versa...also what about SBRT compared to TACE or y90?? Thoughts ???
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