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Topic: Liver mets: resection, ablation, SBRT, Y-90, anything else?

Forum: Stage IV/Metastatic Breast Cancer ONLY —

Please respect that this forum is for members with stage IV/metastatic breast cancer only. There is a separate forum for caregivers and friends: Caring for Someone with Stage 4 or Mets.

Posted on: Jun 19, 2015 06:49PM

Trish03 wrote:

I'm interested in who has had local treatment for liver mets and what was your experience and outcome. I've been talking about this with my onc, and he seems a little hesitant. I have my regular appt. for a 2-mth MRI of brain and followup with rad onc. I plan to ask him about the possibilities. I think that some of the procedures must be done by an interventional radiologist. I assume that's a different person. Do most teams contain an interventional radiologist separate from the rad onc?

I would appreciate if you would share your experience with any procedures. I always like to hear first-hand experience.

All the best to everyone. Hugs, Trish

Dx 09/03, ILC, Stage IIIa, 7 cm, 4/18+ nodes, ER+/PR+, Her2-, 11/05 BL DIEP, 5/13 Stage IV, dx mets to liver Dx 9/15/2003, ILC, 6cm+, Stage IIIA, 4/18 nodes, ER+/PR+, HER2- Surgery 9/30/2003 Mastectomy: Right Chemotherapy 10/14/2003 AC + T (Taxol) Hormonal Therapy 4/14/2004 Arimidex (anastrozole) Radiation Therapy 4/14/2004 Breast Surgery 11/16/2005 Prophylactic mastectomy: Left; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap Dx 5/27/2013, ILC, 6cm+, Stage IV, ER+/PR+, HER2+ Targeted Therapy 6/23/2013 Herceptin (trastuzumab) Targeted Therapy 6/23/2013 Perjeta (pertuzumab) Chemotherapy 6/23/2013 Taxotere (docetaxel)
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Oct 24, 2021 08:15AM BevJen wrote:

Terri,

Just curious -- how many lesions? And what were their size(s)?

Hope you continue to feel better and better.


Microwave Ablations,Liver 3x ;Radiation Therapy to Femur (Both) April 2021; total hip replacement (R) and placement of rod (L) to stabilize femur both sides; immunotherapy (single agent - keytruda) Dx 11/2003, ILC, Left, Stage IIIC, 13/18 nodes, ER+/PR+, HER2- Dx 6/2006, ILC, Stage IV, metastasized to other, ER+, HER2- Dx 5/2019, ILC, Stage IV, metastasized to liver, ER+/PR+, HER2- Surgery 7/5/2019 Targeted Therapy 7/31/2019 Ibrance (palbociclib) Immunotherapy Keytruda (pembrolizumab) Surgery Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Chemotherapy TAC Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal; Mastectomy; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Radiation Therapy
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Oct 29, 2021 04:38AM terri-c wrote:

BevJen, there were 4 that were between 1cm and 2cm, and a whole bunch of little ones (under 1cm), far too many to count.

Dx 7/7/2011, IDC, <1cm, Stage I, Grade 1, 0/9 nodes, ER+/PR+, HER2- Dx 4/7/2014, IDC, Right, <1cm, Stage IV, metastasized to bone/liver/lungs/other, Grade 2, 0/9 nodes, mets, ER+/PR+, HER2-
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Oct 29, 2021 05:56AM BevJen wrote:

Thanks, Terri.

I hope you are back to feeling better now -- on your last post you were still in a lot of pain.

Microwave Ablations,Liver 3x ;Radiation Therapy to Femur (Both) April 2021; total hip replacement (R) and placement of rod (L) to stabilize femur both sides; immunotherapy (single agent - keytruda) Dx 11/2003, ILC, Left, Stage IIIC, 13/18 nodes, ER+/PR+, HER2- Dx 6/2006, ILC, Stage IV, metastasized to other, ER+, HER2- Dx 5/2019, ILC, Stage IV, metastasized to liver, ER+/PR+, HER2- Surgery 7/5/2019 Targeted Therapy 7/31/2019 Ibrance (palbociclib) Immunotherapy Keytruda (pembrolizumab) Surgery Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Chemotherapy TAC Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal; Mastectomy; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Radiation Therapy
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Oct 31, 2021 05:09AM terri-c wrote:

Doing much better BevJen, thanks :)

Dx 7/7/2011, IDC, <1cm, Stage I, Grade 1, 0/9 nodes, ER+/PR+, HER2- Dx 4/7/2014, IDC, Right, <1cm, Stage IV, metastasized to bone/liver/lungs/other, Grade 2, 0/9 nodes, mets, ER+/PR+, HER2-
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Nov 3, 2021 04:09AM - edited Nov 3, 2021 04:10AM by SandiBeach57

Hi. Y90 on both lobes are done and I will have MRI and CT 12 weeks post the 1st Y90 on Nov 15.

To alleviate radiation fibrosis (SBRT caused radiation recall on back), I have been in a hyperbaric oxygen chamber. So far, 11 out of 30 treatments. I see improvement, but will always have the fibrotic tissue, which adheres to rib lining and surrounding tissue. Just an inconvenience.

I am still on Taxol, although reduced amount and on a week on/ week off schedule. If progression is noted (mets in my liver grow fast), I have no idea the next treatment, possibly Afinitor/Aromasin. Always looking for trials that don't exclude me!

Meanwhile, I am deconditioned and will start back my walking and biking.

Wear your jewelry. See my Biography for treatment history.
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Nov 5, 2021 06:59AM - edited Nov 5, 2021 07:00AM by SandiBeach57

Hi AlabamaDee. I live on the east coast. I looked at ARV471, but I haven't had a 2nd antiestrogen in a metastatic setting. I think you had to have failed on two..

I am negative for PCK3, ESRI, PDL1 and androgen receptor. My last 2 liver biopsies showed ATM and FGFR1amp mutations. Not sure if mutation(s) caused the progression while I was on Ibrance/Letrozole. My cancer has not seen a mTOR inhibitor yet.

Taxol is holding me steady, but I have a gut feeling that there is new liver met growth while healing from the two Y90s. That happened with the SBRT..killed the tumor, but had new lesions grow before the 3 month MRI. Grrr.

Not only do we have to worry when treatment fails, but have to plan ahead for the next treatment. Then you have to be mindful you are not excluded from clinical trials with the new treatments after progression.

It is so very tiring.


Wear your jewelry. See my Biography for treatment history.
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Jan 15, 2022 05:57AM SandiBeach57 wrote:

The Y90 with Taxol caused a side effect which I do not think I will recover from the damage.

I developed cirrhosis on parts of my liver, causing enough irritation to have ascites fluid. I get drained once/week. There was hope the ascites would clear, but doubt it now.

The extra fluid is painful and hard to find clothes to mask it.

I am sad and sleep a lot. Have not been on treatment for 2 months. I am starting afinitor and aromasin next week. MRI this Sunday and CT scan on Wednesday. It will be interesting to see if I have cancer growth.

P.S. I have 4 more weeks of hyperbaric chamber to help the healing of radiation recall wound. This was caused by SBRT.

I guess radiation and me do not get along.

Wear your jewelry. See my Biography for treatment history.
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Jan 15, 2022 06:23AM BevJen wrote:

SandiBeach,

Good to see you posting, but I am so sorry about these developments. I think you are correct when you say that radiation and you do not get along.

I am hopeful for you that the A/A treatment will work for you, and that you have no new cancer growth.

We are pulling for you.

Microwave Ablations,Liver 3x ;Radiation Therapy to Femur (Both) April 2021; total hip replacement (R) and placement of rod (L) to stabilize femur both sides; immunotherapy (single agent - keytruda) Dx 11/2003, ILC, Left, Stage IIIC, 13/18 nodes, ER+/PR+, HER2- Dx 6/2006, ILC, Stage IV, metastasized to other, ER+, HER2- Dx 5/2019, ILC, Stage IV, metastasized to liver, ER+/PR+, HER2- Surgery 7/5/2019 Targeted Therapy 7/31/2019 Ibrance (palbociclib) Immunotherapy Keytruda (pembrolizumab) Surgery Lymph node removal: Left, Sentinel; Mastectomy: Left, Right; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Chemotherapy TAC Hormonal Therapy Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery Lymph node removal; Mastectomy; Reconstruction (left): Pedicled TRAM flap; Reconstruction (right): Pedicled TRAM flap Hormonal Therapy Faslodex (fulvestrant) Hormonal Therapy Femara (letrozole) Radiation Therapy
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Jan 15, 2022 09:49AM NicoleRod wrote:

Sandi..I am so sorry about this...What do you mean the Y90 and Taxol?? When I did Y90 I had to be off all chemo for 2 weeks prior and 2 weeks post.... If you were off for the 2 weeks prior and post in what say do you feel the Taxol effected the Y90 and your developing ascites? Just because it was too much stress on the liver? How many leisions did you have Y90'd? Also were any located near colon? Also when did you have the Y90 done and then when did you develop the ascites?

Dx 12/14 Stage 0, Grade 3, ER+/PR, HER2- (FISH),Dx 04/19, Stage IV mets to bone/liver, Hormonal Therapy 04/19 - 10/19 Ibrance/let/faslodex 10/19 **TNBC AUG 2021 Dec 2019-May 2020 Xeloda Failed May-July 2020 - Doxil Failed Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/28/2019 Surgery Chemotherapy Doxil (doxorubicin) Chemotherapy Xeloda (capecitabine) Radiation Therapy Surgery Mastectomy: Left, Right
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Jan 15, 2022 10:10AM SandiBeach57 wrote:

Nicole, I was on Taxol concurrently with Y90.

1st was 8/25/21 R, 2nd was 10/6/21 L. I had several liver lesions.

I developed Ascites 2 months ago..thought was severe constipation -approx 11/6/21

It was not near colon, but did take a PPI every morning, starting 2 weeks prior to 1st Y90.

Wear your jewelry. See my Biography for treatment history.
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Jan 15, 2022 10:15AM NicoleRod wrote:

Sandi...so your IR never told you to stop the Taxol 2 weeks prior to the Y90 and 2 weeks post??? That is NOT good. Also...why did the IR agree to do Y90 only 2 months after Rads to your liver??? That is A LOT of stress on the liver....

Dx 12/14 Stage 0, Grade 3, ER+/PR, HER2- (FISH),Dx 04/19, Stage IV mets to bone/liver, Hormonal Therapy 04/19 - 10/19 Ibrance/let/faslodex 10/19 **TNBC AUG 2021 Dec 2019-May 2020 Xeloda Failed May-July 2020 - Doxil Failed Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/28/2019 Surgery Chemotherapy Doxil (doxorubicin) Chemotherapy Xeloda (capecitabine) Radiation Therapy Surgery Mastectomy: Left, Right
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Jan 15, 2022 10:24AM SandiBeach57 wrote:

Nicole, the SBRT killed my liver met , but while waiting for scans, I grew more and then later developed radiation recall. While I was healing, Y90 was discussed. Taxol was to address the growing mets as I was taken off Xeloda.

Seems like everything happened at once. I hope my liver heals. I start A/A next week. My cancer has not seen mTOR inhibitor. Just want more time.

Thanks for the interest as it may help others to ask the right questions before proceeding.

S

Wear your jewelry. See my Biography for treatment history.
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Jan 15, 2022 12:58PM NicoleRod wrote:

Sorry Sandi..I have to say I definitely think your IR should NOT have given you Y90 and an RO should not have given radiation while on chemo..(they should have taken you off all treatment 2 weeks prior and 2 weeks after).... Im pretty sure my IR would not have touched my liver if I had just had rads and /or was on treatment continuously. :(

I defintely think all that over loaded your poor liver. I hope the issue clears up for you...look into TUDCA....its very good for the liver.

Dx 12/14 Stage 0, Grade 3, ER+/PR, HER2- (FISH),Dx 04/19, Stage IV mets to bone/liver, Hormonal Therapy 04/19 - 10/19 Ibrance/let/faslodex 10/19 **TNBC AUG 2021 Dec 2019-May 2020 Xeloda Failed May-July 2020 - Doxil Failed Dx 12/19/2014, DCIS, Right, Stage 0, Grade 3, ER+/PR+, HER2- (FISH) Dx 2/5/2019, IDC, Right, Stage IIA, Grade 3, ER+/PR-, HER2- Dx 3/2019, Stage IV, metastasized to bone/liver, Grade 3, ER+/PR-, HER2- Hormonal Therapy 4/28/2019 Surgery Chemotherapy Doxil (doxorubicin) Chemotherapy Xeloda (capecitabine) Radiation Therapy Surgery Mastectomy: Left, Right

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