Liver mets: resection, ablation, SBRT, Y-90, anything else?
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That's so good to hear. Thank you. I am very scared of laparoscopy, I got an abscess when I had a surgery done that way. It was horrible. A big needle is fine. I love this thread so much , I can calm my fears without having to call my doc.
He did say I will be under general for this one. That's fine with me.
I'm going today to ITS A s💞o that they can draw blood for my liquid BX for Tempus
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Grannax,
S3K5 had a microwave ablation the same day as I did under general. She had hers done at Memorial Sloan Kettering, and her IR simply preferred to do it that way. Maybe she will weigh in or you can ask her for some more info about her procedure.
Are you doing both a tissue biopsy and a blood biopsy? That's interesting. Is the tissue biopsy also through Tempus? I'm still waiting for my tissue biopsy report from Tempus from 10/19 -- I'm wondering if my MO didn't send it right in. She told me it would be 5-7 days, and still no report over two weeks after the biopsy.
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Hi, All,
and hi BevJen
I am new to the group. I have three tumors on my liver, 0.7, 0.7 and 0.4 cm, from last month's MRI. IR doctor just called me, he can do TACE on them, instead of microwave ablation, because my tumors are small, but there are many of them. If tumor is big but only a few, then microwave ablation is better.
I forget ask him if I can have a biopsy while doing the procedure, still like in a bad dream.
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Cyn,
Hi, there. I'm glad that the IR doc at Hopkins has a plan for you.
You can ask him about a biopsy still, prior to scheduling your procedure (or even if you have). You should check with your oncologist and see if she even wants him to try. But I suspect that he may not be able to see the lesions well enough to biopsy -- so first, check with your MO. Then, check with the IR.
I think that with a plan, you will feel better as time goes on.
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Grannax,
I've had two microwave ablations in the last 2 months. The first was of a single lesion that was over 3cm. The second was of three smaller lesions. I was under general anesthesia both times and my IR used CT during the procedure. My recovery was really easy both times… a little sore in the rib area and low energy for a couple of days. I went home the same day both times.
I'm on Enhertu (DESTINY Breast04 trial for HER2 low patients) which is an infusion every 3 weeks. Each time I had the microwave ablation 7 days after the infusion, then waited the normal 2 weeks before the next infusion. They looked at my liver function tests 2 weeks after ablation to make sure that I was good for Enhertu. After the first microwave ablation, my ALK rose somewhat, but still in the normal range. My liver function tests rose more after the 2nd ablation(out of normal range), but still not high enough to delay treatment.
Why does your IR prefer microwave ablation for you this time?
Very best wishes!
Theresa
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cynmaryland welcome...im ci fused yiu mentioned that you have 3 tumors which are very tiny but then yiu said yiu have many???
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Grannax,
I had microwave ablation on 19th Oct at MSK. I was under general anesthesia for the procedure and stayed overnight since the IR preferred it that way. She wanted to ensure there was no adverse effect later. I had one lesion (2.8 cm) ablated which was not responding to Piqray. This was located in the right lobe, under the rib cage. So the IR had to go through the lower part of the ribs.
I was told to expect some pain but the recovery was easier than I had anticipated. I took one week off work, though I could have probably worked after a couple of days. I took some pain medicines and it was pretty tolerable. My MO suggested that I skip Piqray the night before the procedure and on the night of the procedure (2 days).
As others have said earlier, I did not see the actual device used for the ablation. There were a couple of small incisions which were covered with a Band-Aid but there was some bruising around these incisions. This healed up quickly.
I am still waiting for the genetic profile report from MSK (IMPACT report), which will determine the next path forward for my treatment, since I am now triple negative.
Hope everything goes well with your procedure. When are you scheduled to have this done?
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Thanks, ladies. So much good info here.
My lipiodol procedure is on Monday at my IR s office. The MW is on Wednesday in the hospital. I think both will be CT guided. My BX was Tuesday. I think he wanted to do it separately because my MO wanted it back ASAP. Yes, UTSW is doing both tissue and liquid. Both are being sent to Tempus. I don't know when my MO will get the results. She said she would call Tempus to get the results faster. The tissue should already be there. The blood was taken today for the liquid BX.
SK35 Sounds like we will have a similar experience. I am having two 3cm done on Wednesday.. I have three in the right lobe and one in the left lobe that he wants to get. I actually don't know which two he's going to do in this procedure. If you only had bandaids, I'm sure it was done with a needle. Laparoscopy incisions are much bigger.
Theresa. Great information. You have relieved some of my fears, too. Thanks.
Welcome, Cyn. Sorry you have to be in our club but so glad you have a good IR and access to local TX.
Bev Jen. Maybe your MO already has the results and hasn't called you yet. I think the hospital you had your procedures in sends the tissue to the Tempus or wherever your MO wants it sent. The actual hospital keeps all the actual biopsy tissue. That's why my MO wanted to know exactly where and when I was having my BX.
I am feeling more upbeat today. Got several errands done today so I can have next week free.💞
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NicoleRod
My MO told me I have three measurable tumors in the liver, but there are multiple that are not measurable. Today the IR doctor also said the same thing. Maybe they saw more little ones on their high resolution monitor.
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Grannax,
So glad to hear you sounding more upbeat. That's great. I had bandaids as well, BTW, if that helps. Good luck with all of this. Next week will be busy. My MO does not have the report yet -- I was there on Tuesday and they checked while I was there (well, they didn't have it as of Tuesday, anyway.)
CynMaryland,
When will you have your procedure done? Good luck.
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Theresa. How
Far apart were your procedures? I don't remember him telling me that part so I'm curious. I guess I'll find out tomorrow.
My IR said if he tried to do a third y90 it would overwhelm my liver and I would go into liver failure. I have multiple new and, enlarging lesions in both lobes and diffuse mets. He actually said 100 but I don't think he counted them. There is a lifetime maximum of how much yittrium that can be used.
My liver numbers are perfect right now, actually all of my labs are very good.
JFL Do you have diffuse mets in your, liver, too. I'm finding that word scary.
I'm doing the countdown. Tomorrow is the lopiodol procedure. I know it's done intravenously so it shouldn't cause me any pain. I'm getting mild sedation. 💞
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Grannax - My two microwave ablation procedures were about 8 weeks apart (8/21 and 10/21). My IR was going to do them closer together, but my trial preferred that I wait until after the next CT scan for their measurements. I believe that as long as your liver function tests show that your liver has recovered enough from the first procedure, you can schedule the next procedure. My liver function tests hardly budged after the first microwave ablation (slight rise in ALK). After the second ablation, my numbers increased a little more to just above the normal ranges. It's great that your liver numbers are perfect now. One warning... my insurance initially denied the second liver ablation and part of the reasoning for the denial was having less than 6 months since the last microwave ablation. I hope that your microwave ablations will go smoothly and that Halaven will clean up the rest. Hugs and prayers! Theresa
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thinking of you Grannex.
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Thanks LFF. It was a breeze. No pain no problems yesterday for the Lipodol procedure. Tomorrow is the MW. The lopiodol makes the tumors light up on the CT so he has no trouble finding the two he wants. He's doing two in my left lobe tomorrow. Then in about two weeks he will do the same procedures on two in my right lobe.
Theresa I'm curious about your insurance. You live in Canada, right? Did you have your MWA there? That's awesome that you were approved. It seems to me that several ladies on this thread from Canada have not been able to get any local procedures, y90, etc approved. I'm sure they would love to hear about how you made that happen.
Anyone heard about a new study that is about no dairy products making a big difference for breast cancer patients? Supposedly, 40% reduction in cases. I'm sceptical until I read the whole article. Wondering where it was done and how many patients etc.
Looks like I will be staying overnight tomorrow in the hospital. My daughter will be able to stay all night with me. PTL. We were worrying about COVI D rules. We're good to go. 💞.
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Grannax,
Glad that yesterday's procedure went well. Yay! Now you have that one done.
Good luck tomorrow. I'm sure it will go smoothly. I think it's good that you are staying overnight, and that your daughter can stay with you. My center has eased the Covid restrictions a bit, too -- if I had had to stay overnight, my DH could have stayed in the room with me.
You will do great tomorrow!
Bev
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Thanks BevJen I'm sure you are right. I don't even have much anxiety about it. He did say that the two he wants to MW in my right lobe are closer to the surface and may cause more pain. I guess the left lobe two are deeper. I won't have the right lobe done until late November.💞
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grannax2
Hoping all goes well tomorrow.
Whack-a-mole!!!
Dee
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Grannax good luck
Tanya
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Grannax, I hope everything goes well tomorrow and that you are comfortable andfeeling well when you go home on Thursday. Your doctor is wise to keep you in the hospital overnight so you will be well taken care of. I am glad that your daughter will be able to stay with you.
Hug andprayers from, lynne
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Grannax, Very best wishes for your microwave ablation tomorrow! I'm in northern California and am treated at Stanford. I have an Anthem Blue Cross PPO plan through my husband's employer. The second microwave ablation was the first time that we had a denial for anything, and the issue was having two microwave ablations within 6 months. Thankfully, it was overturned through a peer-to-peer with my interventional radiologist. Hopefully you will not have a problem with insurance coverage.
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Grannax..best wishes for a smooth sailing procedure tomorrow.
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Best of luck tomorrow, Grannax 🌺
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Grannax - Good luck tomorrow! I'm so glad you're daughter will be able to stay with you.
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Thanks, ladies. It means so much to me to have your support.💞
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Grannax- best of luck on the procedure. Saying prayers.
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I've posted on the liver mets thread.
The left lobe two are done but I am, wiped out. Lots of pain especially when I move, breathe, cough, basically anything. Last night the spasms started. Ouch. They are no fun at all. Feels like my muscles and liver tighten up and get hard, then let lose. Grrrr Repeatedly all night. My nerves feel on fire plus I'm very constipated from the IV meds for pain in the PACU.
It's got to get better than this. I had it on Wednesday. How many more days I wonder. Sorry, to complain but here I am complaining.
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Grannax you never had this kind of hard recovery with the Y90? When you had Y90 what were the size of the tumors? What are they now for the MA?
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No, this is the worst SE from anything I've had from VM. The y90's had a few other SE but they were later not the first day. I'll do better next time because ill be more prepared. I won't let them give me any Zofra, etc. I'm so glad to have some relief from the frequency of the spasms. 💞 Thanks for your help.
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My IR told me that there is no way to compare y90 to MW. It would be a apples to baseball kind of comparison. He said with MW it's mostly about location. Evidently, there's a capsule covering the liver. The nerves are in the capsule. So, that's why it felt as if all the nerves in my abdomen were on fire. The left lobe ones were very close to the capsule. The right lobe ones are not. They are deep and under my ribs.
He also thinks I had postablation syndrome. Look it up, it's a real deal and sounds exactly like what I have. Basically, my body had an inflammatory response to the dead and dying tumor cells. It is a flu like response with fever etc.It usually happens on day 2 or 3, just like mine did.
I sure hope I don't have it the next time too. It seems to depend on the volume of dead cancer cells. Mine were 3 cm each in left lobe and the same size on the right side.
I'll soon find out. My next MW is December 2 💞
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Cross posting here so if you read the liver mets board, don't read this twice!
Okay, people, SH --. Just got off the phone with my interventional radiologist. I had posted that I thought there was an error in the MRI report that was posted, and I was hopeful that all would be okay when I talked to my IR. NOT. He apologized profusely but he says he missed a little bit of the tumor that they were ablating, and that it might be growing. He gave me two options -- go back in and re-ablate or watch and wait. I am not going to watch and wait when he says that it's already growing. (And he knew that I would say that.) So I have to go through this again whenever they can schedule me for it.
Not happy about having to go through with it again but he says that the rest of my liver (my biggest concern) looks good so I want to keep it that way.
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