Views needed please

[Girl111]

The liver met in my dad's liver is now 4 cm. in august 2014 it was only 1.5cm

It had obv grown as the irinotecan did not work !as some of you are aware, he also has a lymph node and a sub pleural nodule . Both are small.

Here's the confusion .... His old onco said ablating this is pointless due to ther areas as have chemo ,

The interventional radiologist says it should be ablated as the bigger it gets the worse it is . Obviously the ablation would be done private .

As chemo already has not worked , there's no guarantee it will
Shrink the met and it can grow more.

What option would you guys suggest :

1, chemo first
2, ablate the met and then chemo again

Thanks all

[TheLadySkye]

If the tumor is resectable, I would get it out of there. A lot of folks have had luck with surgical removal. Sometimes they will try to shrink it with chemo first if it's responsive or near a major blood vessel, but the general rule seems to be surgery as soon as possible.

[KWT]

Option two sounds the best.
For some strange reason the oncs have no problem with giving us chemo ( that may not work) but have a problem with ablations/resections that may not work. Myself I think I'd rather go in for weekly ablations than chemo.

[Cb75]

My view, reduce the tumor burden as much as possible by surgery/radiation then hit it with chemo. In your dad's case, chemo isn't doing the trick, so I'd radiate or seek surgical options. Keep on top of it, get aggressive. If you can have it surgery/radiation its the best option and more statistically significant the chemo, in my opinion.

cb

[rp1954]

Getting rid of the worst mutated mets and major load can make an old chemo work again. The first choice is always surgery. The big question is what is the mildest chemo that can keep you clear or at least stable. I would take a very hard look at how and when to use cimetidine and celecoxib.

[Girl111]

Thx all
RP1954, he's KRAS mutant so can't use Celebrex .

Will look into the other one you suggested . The worry is both xeloda n irinotecan failed so I don't know if he may be is chemo resistant .

[Voxx66]

I could be wrong but I haven't heard that Celebrex was ineffective with KRAS mutants.

[lpas]

RP1954, he's KRAS mutant so can't use Celebrex .

While it appears that those with the PiK3 mutation are the best responders to ADAPT, Dr. Lin (pioneer of the ADAPT protocol) has reportedly indicated that KRAS mutants do just fine. See the discussion here:

http://coloncancersupport.colonclub.com/viewtopic.php?f=1&t=48774&p=371128&hilit=lin+kras#p371128

[Lee]

Has your Dad tried FOXFOX (5FU and oxyplatin) yet? Avastin??

I agree with others, getting the tumor out is his best chance for NED

Lee

[Girl111]

I've realised , that Celebrex if the arthritis drug, I got it mixed up for the cetuximub !

Lee, no none of those have been tried . Therefore we have fought a sec opinion
And have been told about oxyplatin .

[Lee]

Lee, no none of those have been tried . Therefore we have fought a sec opinion
And have been told about oxyplatin .

Glad to hear about the 2nd opinion. I was diagnosed a stage III, and was put on 6 month of FOLFOX. Was going to use Avastin if I went to stage IV. When I was diagnosed almost 11 yrs ago, these were brand new drugs on the market. In fact FOLFOX was only available to stage IV folks at that time (2004-2005), but my Onc was able to get me on board before the FDA approved it for stage II & III colon cancer folks.

Lee

PS Oxyplatin is part of the FOLFOX cocktail.

[Nik Colon]

As mentioned, you could ask about chemo options, there are many so just because 1 doesn't work does not mean others wont. I am one of those who is getting chemo then surgery then more chemo. I will have my 4th tx without oxi because of the side effects I was having, not sure how chemo is doing as I have to wait for my ct which will hopefully be in a about a month.

[Cherie]

Great point Kenny

For some strange reason the oncs have no problem with giving us chemo ( that may not work) but have a problem with ablations/resections that may not work. Myself I think I'd rather go in for weekly ablations than chemo.