Anyone with Stage IVa just do Xelolda or 5-fu?

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Re: Anyone with Stage IVa just do Xelolda or 5-fu?

Postby mpbser » Sat Jan 13, 2018 4:16 pm

My husband's words:

So the news from Mass General is not as great as we hoped it would be... at the same time, it was nowhere near as catastrophic as it could have been.

The Chemo did exactly what the oncologist wanted it to - arrested the growth of the existing spots on the liver, and prevented it from spreading elsewhere in the body. That is TWO MRIs in a row that show no new spots, and shrinkage in the main spot. Good news!

We are going to do surgery at the end of the month and remove the spots that remain. The confidence level of a CURE is extremely HIGH! So we are thrilled.

My words:

We got MRI results yesterday. The MRI was done only a few hours before our appointment with the doctors. They did not have much time to analyze the results. I do not have the radiology report yet. According to the liver surgeon, the left lobe mass has "nearly disappeared" and is almost impossible to see. The right lobe mass's size remained essentially the same. The liver surgeon said that he wants to go ahead with open surgery to do the resection. He did not explain, this time around, how much will need to be removed. I have notes about that in my records from a previous visit.

We are home now. I have looked at the records and I notice that the left lobe mass is the one that the previous radiology report had an impression that this one was consistent with metastasis. The right lobe mass is the one that the radiologist identified as demonstrating features most consistent with a benign etiology such as a sclerosed hemangioma. This means, in my lay opinion, that the left lobe tumor, being cancerous with rapidly dividing cells, responded very well to the chemo. The right lobe mass, consisting not of rapidly dividing cells, did not respond to the chemo because it is not cancerous.

I tried to address this with the liver surgeon but he was of the opinion that it would be better to be safe and have it removed and to do so with open surgery. This is very strange to me because when my husband was undergoing the first attempt at the liver surgery, the plan was for laparoscopy. The reason it was aborted was the proximity of the left lobe mass to a blood vessel. There was no concern at the time about the location and morphological features of the right lobe mass. Then again, the surgeon did not get that far. Because there was the colectomy to be done at the same time, laparoscopically, the surgeons did not convert to open surgery to do both as it would just be too much on the body all at once.

I guess my confusion lies with the fact that when we last met, the plan was to see if chemo would shrink this left lobe mass to the point where it could be removed safely laparoscopically. Now that it has worked, why the surgeon recommends open surgery is a mystery to me. What the heck???
Wife 4/17 Dx age 45
5/17 - Lap left hemi
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm width T1 N0
CEA: 1.4 Pre-op; 2.1 2 days Post-op
Lynch no; KRAS wild
Immunohistochemsistry: Normal expression of MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53

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