Well I met with Dr D'Angelica and he does not feel that surgery is the right course for me right now. He reviewed my scans from today and said that I have had a tremendous response to the liver directed chemo. Because it is impossible to determine whether all of the micrometatases have been killed by the liver directed chemo (which he said does happen for some patients) he doesn't want to go in for surgery only to end up in the same position as we were the last time a liver resection was attempted. He thinks that the better plan is to continue on with the liver directed chemo through the HAI pump and then at some point to stop it and see if any of the tumors that remain visible on the ct scans grow or not. He said in some cases the HAI pump actually kills all of the rumors in the liver and that patients are off chemo for years with nothing growing back. He said this doesn't happen a lot but it does happen and that he has seen it here at MSKCC. in the event that in my case certain tumors start to grow after i am off chemo then we would have s better idea about what would need to be surgically resected and could come up with a plan then. But right now he just doesn't feel that surgery is the right thing.
I met with Dr L immediately after Dr D'Angelica and she seemed a bit disappointed in the decision not to move forward with surgery. She obviously supports Dr D'Angelica's decision but feels that the HAI pump has killed the micro metastasis and thinks it is worth trying to get rid of what is left of the larger tumors. She wants to revisit in the future. She did note that my CT shows a large cystic spot on my left ovary again . (My Sept scan showed s lesion on my left ovary....which an ultrasound found to be a cyst.). This time the "cyst" is larger so she is concerned. She said that mets have a way of looking cystic in the ovaries. I need to have another ultrasound at home this week. I am worried about this now.
I am disappointed overall...thank you all for the love and prayers.
Mommy to Jack (8) now (16) and Katie (4) now (12)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new mets lymph nodes lung:
05/18: Keytruda (MSS w/Intermediate TMB): CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8, .8, 1.1, 1.1, .7
7/18; 9/18; 11/18; 2/19 Clear CT scans