What Dr D'Angelica Said

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Jack&KatiesMommy
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Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

What Dr D'Angelica Said

Postby Jack&KatiesMommy » Mon Dec 10, 2012 3:36 pm

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.

Cynthia
Cynthia
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

janklo
Posts: 1566
Joined: Wed Mar 03, 2010 11:10 pm
Facebook Username: JanetKlostermann

Re: What Dr D'Angelica Said

Postby janklo » Mon Dec 10, 2012 3:49 pm

I'm sorry that you didn't hear what you wanted. But the good news is that the chemo is working. And you know a ton of people have screwy things that show on their ovaries. So just forget about it and enjoy your holiday with your two beautiful children. :D
Mom to 28 yo daughter
colectomy 2/22/10, stage 3C, signet cell
7/2011 peritoneal mets
HIPEC September 2012, difficult recovery
Hospice 10/31/2012, Died 11/16/2012

gfpiv
Posts: 156
Joined: Tue May 25, 2010 9:24 pm

Re: What Dr D'Angelica Said

Postby gfpiv » Mon Dec 10, 2012 4:29 pm

Glad to hear you've had a good response, and hope Dr. D is right. He's a great doc - did my HAI, and my general onc regularly consults with him on my scans. I was maybe in a similar boat to you - major shrinkage in liver tumors from systemic chemo, then calcification of much of what was left via HAI. But still my liver was swiss cheese with so many spots on it, and Dr D recommended against any attempt at resection. I stayed on HAI as long as they would let me (maybe longer than I should have), and quit when my liver counts got very high. However, ever since that forced break in chemo, all the spots have stayed completely stable, and I'm now going on 8 months without any chemo whatsoever. Of course things could become active again any day, but am thankful for the extra time I've been given. Anyway, just wanted to provide you a little hope that there is some sense to what Dr D is suggesting, even if the odds aren't great (but then again, we stage IV-ers know about long odds). Hopefully you will have as good or even better results with your treatment.

-Chip
Chip
DX stage IV CC Jan '10, numerous unresectable liver mets
FOLFOX + Avastin Feb-Jul '10
Colon resection, HAI install Aug '10
Systemic FOLFIRI and hepatic FUDR Dec'10-May'12
Chemo break May'12-pres (tumors calcified & stable, knock on wood)
Billiary bypass surgery and SBRT on pesky liver met in 2015

Mona
Posts: 910
Joined: Wed Jan 19, 2011 10:27 am
Facebook Username: maria kucharek
Location: NY

Re: What Dr D'Angelica Said

Postby Mona » Mon Dec 10, 2012 4:29 pm

Cynthia, can you take 2 more Fudor treatments and be scan again? This time go for liver resection. You can say that you want it to give try. He did not said no, he said in the future.
As for cysts in your ovary, keep an eye on it. I have two small ones and I would like to get rid of them. I made appointment at Sloan for April 2013 with Dr.
At age 46 DX 7/21/10 Stage 4 colon cancer with mets to the liver.
8/10 Folfox 6 tx
11/10 Colon/liver resection 1/29 nodes
12/10 Folfox 6 tx, NED
3/11 chemo done
11/11 recurance liver
12/11 liver resection/Hai pump
01/12-07/12 Fudor/Folfiri

Angiemarie2000
Posts: 573
Joined: Sat Jul 14, 2012 6:29 pm
Facebook Username: Angela.boles
Location: Eden Prairie, MN

Re: What Dr D'Angelica Said

Postby Angiemarie2000 » Mon Dec 10, 2012 5:41 pm

Cynthia,

I know it's disappointing. We want this crap to be a long past memory and to be moving forward with our lives healthy. But remember this is not a sprint and you got good news. So keep fighting and you will get there.

One day at a time

Angie
5/12- @ 37 DX IV KRASmt
5/12- R. Hemi
6/12- Folfox/avastin-(Bad Reaction)
6/12- xeliri-7rds
CEA-DX @ 80 then 11,10,7,14,25,210,340,540,900
12/12-R. Ovary removed
01/13- folfox 4 rounds
03/13- folfox failed, in liver failure, starting regorafebin.

usopen
Posts: 188
Joined: Mon Jul 18, 2011 12:37 pm

Re: What Dr D'Angelica Said

Postby usopen » Mon Dec 10, 2012 6:15 pm

Cynthia,
I feel that I had liver resection too early (it was last Jan.). I had the other surgeon (on the 5th floor).
When I met the surgeon on the very first consult, he said "no" to surgery, only suggested the pump. Had about 15+ tumors.
Had the pump implanted, but I only got to use the pump twice (liver enzymes elevated). But I kept using systemic for about 6 more times.
I was thinking I would have to use the pump at least a couple of more times, if not longer, but Dr. K presented a scan to the surgeon, and now all of a sudden I was ready for resection? I had a gut feeling it was too early. But, I didn't question it, I was getting anxious.

Had the rt. lobe taken out, and 3 sections of the left. One section didn't have clear margins.....ugh. So now I am back to where I started, but I am glad to have the pump, and we're going to get more aggressive.
I hope to get to the place where Chip is at, where the tumors are inactive or calcified, and can get off chemo. It shows it is possible.
Also, the good response that you have had is really good news....and may it continue. I know that it is disappointing, and I'm praying the ovary is nothing to worry about, but just another thing to have checked out and more inconvenience.

Joan

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Jack&KatiesMommy
Posts: 589
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: What Dr D'Angelica Said

Postby Jack&KatiesMommy » Mon Dec 10, 2012 7:06 pm

I love all of you. Having a bad day.....you all sure know how to make someone few better. Thank you, friends.
Cynthia
Cynthia
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

done
Posts: 197
Joined: Sat Jul 21, 2012 10:31 pm

Re: What Dr D'Angelica Said

Postby done » Mon Dec 10, 2012 7:37 pm

Cynthia,
I'm so sorry you didn't get better news. I hope you can find peace until you can regroup. It does sound like you have good docs on your team that are really pulling for you. And how great that your onc says your response has been really great so far!
With all best wishes,
Theresa

dianne052506
Posts: 1651
Joined: Sun Nov 02, 2008 11:57 pm
Location: North Carolina

Re: What Dr D'Angelica Said

Postby dianne052506 » Mon Dec 10, 2012 8:19 pm

Cynthia,
I'm sorry it wasn't better news. I hope you can take some encouragement from the response your liver tumors have had to chemo.

I hope the ovary really does prove to be a cyst and you can have some peace of mind for the holidays with those beautiful children. (Love the avatar, but when do we get to see a picture of Jack?)

Dianne
May 06 Stage IV CC: liver,ovarian mets
Oct 07 inoperable lung mets
Feb 08 - Apr'12 chemo
allergic to oxaliplatin, irinotecan
Aug '12-Feb'14 Genentech PD-L1/Avastin trial
Mar '14 -radiation to largest lung nodule
still recovering; looking at trials again

jens22
Posts: 1006
Joined: Wed Jun 09, 2010 9:26 am
Facebook Username: jspirio
Location: Long Island, NY

Re: What Dr D'Angelica Said

Postby jens22 » Tue Dec 11, 2012 8:11 pm

My Friend,
I know this is an increadibily rough time of year for you and this news didn't make it any better. It's hard when you have so many doctors and each one feels differently about the surgery. Waiting, watching and going through more chemo is so hard. If you can give it a few more months you should be out of cold and flu season. Not the best time to recover from a liver resection. Maybe you'll be one of the ones who chemo works for. I think of you all the time. I had a 'Cyst in the Ovary' which grew at times and when down at other. My GYN said is was part of Pre Menapausal ovulation. Still you've got to get it checked. I loved to see you. PM me, Call text, Whatever. I'll hang out with you at 53rd!!
Colonoscopy 3/10 for ? hemmorrhoid.
Diag Colon Cancer 3 days later
Colon Ressection 3/30/10
Stage 3B 5/14 Nodes positive.
Power Port and 7 months of Chemo
Port removed 11/11
8 negative Cat Scans..... 7 years cancer free and Discharged from Sloane Kett!!
Diag age 47 , now 54 Mom of 3 boys.

Seriously, WTF?
Posts: 602
Joined: Wed Nov 17, 2010 10:48 pm

Re: What Dr D'Angelica Said

Postby Seriously, WTF? » Tue Dec 11, 2012 9:10 pm

Xoxoxo
ALWAYS IN MY HEART!
5/7/2013


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