Liver mets: resection, ablation, SBRT, Y-90, anything else?
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JFL- the liver specialists at U if W are great. Trusted them to take out part of my liver but had the option of having them do the ablation. Worth looking into.
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Thanks, Left. I had no idea so many people were getting liver resections. Not an option for me . . . . but an interesting observation. I was very impressed when I read about UW's program. Also, I would have a chance to see my family/friends and my parents could help with my 2 year old if I did it there.
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JFL, it just occurred to me that the doctor whom I had a consult with here in Ohio who does the Y90 and whom I thought was excellent (recommended by my excellent MO as well), just moved to Florida. I got a letter a couple weeks ago. Not sure if the letter stated exactly where he was going and I didn't save it but the move was to be closer to family. I will look through my stuff to find his name and get back with you. Don't let me forget.
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Can anyone tell me their experience with liver ablation? Do you know if the limit on tumors they can ablate is 2 or 3? I thought I had heard is was 2.
Thanks,
Robin
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My Y90 procedure was done in Marietta, Georgia-right outside of Atlanta. My IR was Dr Roger Williams. If you can not find some one in Florida, I would highly recommend him.
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Kaayborg, if you find his name please tell me!
BabyRuth, I am going to look into your IR. It is easy to travel back and forth from Miami - Atlanta.
I was recently reading about chemoembolizaton with doxorubicin beads (DEDBOX) for liver-dominant metastatic breast cancer. It seems to be HIGHLY effective in liver mets for breast cancer patients. I was reading a study where the median progression free survival was 26 months and median overall survival was 47 months. Liver mets patients, with the liver cancer being at least 50% of disease load. Many of whom have had many treatments before doing this one. What?! I have never heard stats like this with any other medication.
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JFL the name is Evan J Wuthrick. Goggling has him still at OSU which I really don't think is true. I recommend trying to call radiation oncology at OSU 614 293 8415 or 3244...same starting digits to see where he is or when he's going there or hopefully not to find out my brain is really chemo fried and I'm all mixed up.
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Kaayborg, it looks like he is at Moffitt in Tampa. Thank you! Moffitt is somewhere else I was looking into today, as it is the #1 ranked cancer center in FL and #9 ranked in the country (by US News).
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Kayboorg, JFL and Leftfootforward thanks for your post and information on this. It's something I've been interested in exploring ever since I first heard about it since my mets currently are only in my liver, at least that's all they had found.
Leftfoot I'm in Northern California and it would be pretty easy to fly to Seattle for a consult at UW. Are the doctors you saw intervention radiologists who specialize in the liver?
Kayboorg I read on another post that your new treatment is working so glad to hear that.
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So glad you found him JFL.
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This question is for anyone who has done Y90 or SIRT. Did you radiologist discuss the chance of liver failure that could happen months after the procedure. My MO is not on my side about the Y90 and she told me one of her patients had liver failure 3 months after the procedure. MY IR said it can happen but it is a low percentage. I am just really worried about this possibility.
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Hi!
Radioembolization 2 weeks ago and I am still struggling with nausea, my MO is all over it, but my liver function has plummeted and my TM's have sky rocket it!
Has anyone had the same experience? I understand the tumour flare in the hope the tumours are dying off, it's the liver function that is freaking me out...... along with how enlarged my liver was!
I had scans a month ago and despite the disappointment of liver progression, my widespread bone mets were resolved.... but this past week I have lower back and pelvic pain with that is just horrible
With the fail of Xeloda I have not been on treatment due to the procedure for 4 weeks, staring back on Zolodex last week and Aromasin/Afinitor today
I was hoping it was Zoledex behind the back and pelvis pain, as my ovaries had started to work, but my MO has booked an MRI to rule out the cancer has progressed in the bones once again.....
Anyone had pain with Zolidex?!?
Thanks in advance xx
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Emily Louise. It's so good to hear from you. No, I did not have nausea for two weeks after my y90. I have no idea if my TM went up because my MO does not think they are reliable enough to do them. My liver function numbers have always been in the normal range, before and after. Sorry I'm no help on this for you. I'm glad your MO and IR are watching you carefully.
Rpoole. Yes, i had y90 in April and May. The biggest risk I read about was if one of the y90spheres got out of the liver and into another organ. Also, if IR did both lobes at the same time, it could cause liver failure. But, to my knowledge, no one does that anymore. Maybe you could research a different IR who has done more of these procedures. And has had lots of success. Mine was so successful, August PET showed no uptake.
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Grannax2, that is so awesome to hear that your August PET showed no uptake. My IR said he has been doing Y90 for years and has never had a problem. Its just the fact that liver failure can and does happen. It is just so darn scary. I am glad you had such great success. How many liver tumors did you have?
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Rpoole. I had about 8 tumors. They were in both lobes. There was a cluster in the area where both lobes meet . My IR said those were the hardest to get, but he did. Sounds like you have a good one too.
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liwi- it was a board is liver specialists who met at the U of W. I ended up speaking with the liver surgeon as they found that the more appropriate way to go. It was a few years ago but I would guess that is how it would be approached for your case; tumor board followed by meeting the specialist they felt was most appropriate for you.
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Grannax2,
I have 3 liver tumors that are 1.5 cm and the biggest is 2.5 cm. What kind of treatment can you do right after the Y90 procedure? I know you can't do chemo and I would assume anything that effects the liver. Just curious, as I don't want to be off treatment.
Thanks,
Robin
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Emily-louis,
When I was on AA is raised my liver enzymes and my TM's tripled. I know you just started AA, but I just wanted you to be on the lookout.
I pray you get a full response with your Y90 and I hope you start to feel better soon.
Robin
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I was able to stay on Ibrance femara during the time I had y 90's. I don't know what trreatment you are on. Recovery isn't that long, maybe 2 weeks.will they have to do both lobes? If so, that will be two separate procedures.
I hope you do well and have as much success as i did. rpoole
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Emily-Louise- it took me 6 weeks to recover from the Y90. I had severe nausea and was exhausted. We did not check my TM's during that time but I had a scan just one month later and one of the tumors was completely gone and the other had shrunk. My liver enzymes were really high but my IR had told me that was to be expected as the tumors continue to die off. I hope that you get relief soon.
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Emily-Louise- it took me 6 weeks to recover from the Y90. I had severe nausea and was exhausted. We did not check my TM's during that time but I had a scan just one month later and one of the tumors was completely gone and the other had shrunk. My liver enzymes were really high but my IR had told me that was to be expected as the tumors continue to die off. I hope that you get relief soon.
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mom. Just wondering how Dani is today. I think she is having y90 mapping today.
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I had SBRT in April to my three liver mets. It is targeted so it really was easy...just some fatigue. I still managed to push myself and exercised. I was able to stay on Herceptin and Perjeta and anastrozole. I have had two “no evidence af new or residual disease.” CT scans since. With SBRT you can have it again if needed and there it a 95% local control rate for liver cancer patients...it’s newer for breast cancer patients.
Feeling hopeful and grateful that my MO referred me and my IR agreed to do it as the breast clinical trial was for no more than two mets
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Bstein - Very interesting. My onc's first reaction was that SBRT would not work on the liver as it would irritate the liver and just cause problem. Rads to the liver mets dropped in priority and my efforts have been focused on pondering zapping only bone mets. Very interesting. Please keep us updated on your progress ...
I am going to have to head to UTSW when I get back and get a consultation ...
>Z<
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Has anyone heard from mom since Dani's procedure yesterday? I'd love to know how shes doing.
Z. If you come to UTSW in Dallas, let me know. I live in Garland, just 30 minutes from UTSW.
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Mom posted on liver mets thread. Sounds like she did get the mapping and is a candidate for y90. Good news. I think the y90 will be done on the third of November. Meanwhile, she's having rads done to orbitals. Her post is on the how are people doing with liver mets? Thread.
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Grannax. Interesting. Remind me where you got your y90 done ... was it UTSW?
>Z<
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Z no not at UTSW. Dr Van Meter did mine at a specialty hospital on Greenville and Walnut hill. I can't remember the name but it closed/ went bankrupt in June 2017. I was really surprised. I know he's still working, possibly at Methodist Hospital. Travis Van Meter, MD try looking him up.
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I was wondering if anyone had Y90 without continuing a systemic treatment at the same time. If so, how long were you without systemic treatment to complete the process?
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Kaayborg. It was almost two months for me to get all three procedures done and recover. So, I assume that's how long you'd need to be off treatment. As you know I was able to continue w Ibrance and femara, so I'm just giving an educated guess.
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