Dang 1cm Liver Met!

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teacher2017
Posts: 191
Joined: Sat Sep 09, 2017 1:18 pm
Facebook Username: Lydia Clark

Re: Dang 1cm Liver Met!

Postby teacher2017 » Fri Aug 17, 2018 9:21 pm

heiders33 wrote:Hey teacher, I met with the surgeon today, although my appointment left much to be desired for several reasons and I will be getting a second opinion at MSK. Just want to mention that she said there are different schools of thought on chemo in this situation, and she recommends a short chemo regime prior to surgery, but she did not mention the HAI pump. I have only ever heard of people using the HAI pump when there is more than one met, but then I’m not as educated on this stuff.



I’d love to hear what MSK says to you. They may offer it. If so, would you do it? I don’t know. They say that it’s a 70% chance of it reoccurring again and there is a chance of spread. But I really do not want another thing inside me.
48 year old female- mom of 2 (12,15)
DX stage 3c - 12/17 LN. T3
8" sigmoid resection Sept 22 2017
6.1cm tumor size
chemo -folfox 11/8/17-4/18
CEA level- 1.4 11/8/17
Colonoscopy- 5/30/18 - CLEAR!
Cea level- 1.8 6/1/18
Cea level- 2.1. 8/4/18
Sh$t has hit the fan- 8/10/18 Stage 4
1cm met in seg.8 liver
Liver resection- 9/12/18

DarknessEmbraced
Posts: 3115
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Dang 1cm Liver Met!

Postby DarknessEmbraced » Sat Aug 18, 2018 8:52 am

I'm sorry it wasn't better news!*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

heiders33
Posts: 277
Joined: Sat Nov 04, 2017 11:08 am

Re: Dang 1cm Liver Met!

Postby heiders33 » Sat Aug 18, 2018 5:47 pm

teacher2017 wrote:
heiders33 wrote:Hey teacher, I met with the surgeon today, although my appointment left much to be desired for several reasons and I will be getting a second opinion at MSK. Just want to mention that she said there are different schools of thought on chemo in this situation, and she recommends a short chemo regime prior to surgery, but she did not mention the HAI pump. I have only ever heard of people using the HAI pump when there is more than one met, but then I’m not as educated on this stuff.



I’d love to hear what MSK says to you. They may offer it. If so, would you do it? I don’t know. They say that it’s a 70% chance of it reoccurring again and there is a chance of spread. But I really do not want another thing inside me.


I’ll let you know what they say. It may be a little while before I have an appointment. I don’t know that they would offer because I had only one involved lymph node. However, I still don’t know if this thing is cancer, so I need to figure that out first.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR surgery with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump

teacher2017
Posts: 191
Joined: Sat Sep 09, 2017 1:18 pm
Facebook Username: Lydia Clark

Re: Dang 1cm Liver Met!

Postby teacher2017 » Sun Aug 19, 2018 12:18 pm

Everyone raves about this Kemeny dr. And Dr. D’Angelo??? I don’t have them. I see Dr. Jarnagin who is a liver surgeon at MSK.

I’m absolutely sick over the stats for stage 4. Is this really my life???
48 year old female- mom of 2 (12,15)
DX stage 3c - 12/17 LN. T3
8" sigmoid resection Sept 22 2017
6.1cm tumor size
chemo -folfox 11/8/17-4/18
CEA level- 1.4 11/8/17
Colonoscopy- 5/30/18 - CLEAR!
Cea level- 1.8 6/1/18
Cea level- 2.1. 8/4/18
Sh$t has hit the fan- 8/10/18 Stage 4
1cm met in seg.8 liver
Liver resection- 9/12/18

heiders33
Posts: 277
Joined: Sat Nov 04, 2017 11:08 am

Re: Dang 1cm Liver Met!

Postby heiders33 » Fri Aug 24, 2018 2:18 pm

Hey teacher, I saw my original liver surgeon today and learned that my spot is indeed cancerous. She recommends 2 months of Folfiri and then rescanning, with potential for surgery after. She said it can be taken out any time, but chemo will kill any circulating cancer cells. I’m getting a second opinion at MSK (Dr Kingham) on Monday. She said MSK tends to push the pump, but I’m not a good candidate for it because it’s just one spot. So we’ll see what Dr Kingham’s opinion is. Hope that helps.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR surgery with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump

hiker
Posts: 41
Joined: Thu Aug 09, 2018 10:15 am

Re: Dang 1cm Liver Met!

Postby hiker » Fri Aug 24, 2018 3:21 pm

teacher2017 wrote:Ok I met with surgeon. He said it would be laparoscopic unless there was a need to open me up. He would resection it. But he did offer the pump which would have to be done during open surgery. Nothing is guaranteed and would require some maintenance and 6 months of chemo. I could also just do this resection and see if there is another reoccurrence...and if so then get the open surgery and the pump. I don’t know what to choose! Any suggestions?

Teacher, if you've been offered the HAI pump - my opinion is take it! I had my liver resection July 2017 at which time the HAI pump was implanted. I did 5 rounds of chemo via the pump which had no side effects. From what I understand, there is generally a 70% chance of recurrence; however that drops to somewhere between 30-50% with the pump. That was too much of a benefit for me to pass it up.

My doctors are Dr. Kemeny and Dr. D'Angelica - and I too am here to rave about them. They are incredible at what they do. But that's not to say other doctors aren't qualified. The fact that you're at MSK is comforting - that is one professional organization.

hiker
Colonoscopy 2/17, 5cm tumor descending
Diagnosed stage iv, liver mets 3/17
Colon resection 3/17
Told surgery not an option, get my affairs in order
Meet w/MSK team 5/01/17
Folfox(3rds) 5/17-6/17
Liver resection/implant HAI pump 7/17
HAI pump chemo(5rds) 8/17-2/18
Folfiri+Vectibix(11rds) 8/17-2/18
Spot on chest CT 10/17
Lung biopsy (that was fun) 11/17
Nocardia bacterial infection w/spread to brain (this is serious) 11/17
IV antibiotics 12/17-2/18
Oral antibiotics 3/18-present
Clear of cancer since surgery

AppleTree
Posts: 218
Joined: Fri Mar 18, 2016 8:16 am

Re: Dang 1cm Liver Met!

Postby AppleTree » Fri Aug 24, 2018 10:04 pm

Teacher...I hope your recovery is going well after your surgery. I never had a pump. My met surgery was in my lungs and I had a VAT last summer. Then Folfox August through the end of April. My oncologist wants me to keep my port for a year. My June CT was questionable, but July PET looked good. I am now scheduled for a 2nd PET mid October. If everything is still fine, I still get 2 more 3 month scans before graduating to 6 month scans.
Diag Feb 5, 2016 Age 45
3 cm tumor 5 cm from verge
Radiation + Xeloda pills - 3000mg 5x week
3/14 - 4/16 - 25 sessions
Shrank just over 50% L nodes 0/13
Remove rectum with temp Ileo 6/17
Reversal 7/20 due to infection
Acute hepatitis August. Chemo cancelled
June to September 2016 - 58 days in hospital

2017
6/16, MRI shadow in lung
Pet - 6.6mm Met in Upper right lobe
7/30 VAT surgery Mass General/Boston
8/24 port
8/30 - 4/28 Folfox. 12 rounds
2018
June CT shows new lung Mets.
July PET...CLEAR!

teacher2017
Posts: 191
Joined: Sat Sep 09, 2017 1:18 pm
Facebook Username: Lydia Clark

Re: Dang 1cm Liver Met!

Postby teacher2017 » Sat Aug 25, 2018 11:27 am

hiker wrote:
teacher2017 wrote:Ok I met with surgeon. He said it would be laparoscopic unless there was a need to open me up. He would resection it. But he did offer the pump which would have to be done during open surgery. Nothing is guaranteed and would require some maintenance and 6 months of chemo. I could also just do this resection and see if there is another reoccurrence...and if so then get the open surgery and the pump. I don’t know what to choose! Any suggestions?

Teacher, if you've been offered the HAI pump - my opinion is take it! I had my liver resection July 2017 at which time the HAI pump was implanted. I did 5 rounds of chemo via the pump which had no side effects. From what I understand, there is generally a 70% chance of recurrence; however that drops to somewhere between 30-50% with the pump. That was too much of a benefit for me to pass it up.

My doctors are Dr. Kemeny and Dr. D'Angelica - and I too am here to rave about them. They are incredible at what they do. But that's not to say other doctors aren't qualified. The fact that you're at MSK is comforting - that is one professional organization.

hiker


Thank you. I’m aware of the stats but I can’t get my head around the fact that one liver met under 2cm would constitute a pump. It could totally blow out my liver too.
48 year old female- mom of 2 (12,15)
DX stage 3c - 12/17 LN. T3
8" sigmoid resection Sept 22 2017
6.1cm tumor size
chemo -folfox 11/8/17-4/18
CEA level- 1.4 11/8/17
Colonoscopy- 5/30/18 - CLEAR!
Cea level- 1.8 6/1/18
Cea level- 2.1. 8/4/18
Sh$t has hit the fan- 8/10/18 Stage 4
1cm met in seg.8 liver
Liver resection- 9/12/18

hiker
Posts: 41
Joined: Thu Aug 09, 2018 10:15 am

Re: Dang 1cm Liver Met!

Postby hiker » Sat Aug 25, 2018 5:40 pm

teacher 2017 wrote:
Thank you. I’m aware of the stats but I can’t get my head around the fact that one liver met under 2cm would constitute a pump. It could totally blow out my liver too.


Teacher, the pump really isn't for the 2cm met that's already there. It's to knock out the cancer cells that are still floating around or mets that are too small to be detected by a CT or MRI. Chemo directed straight to the liver is incredibly powerful and can kill cancer cells that systemic just can't. I won't deny that there are risks with the pump. However, the doctors at MSK are skilled and will review your labs every one to two weeks to make sure everything is okay. If not, they adjust the dosage.

hiker
Colonoscopy 2/17, 5cm tumor descending
Diagnosed stage iv, liver mets 3/17
Colon resection 3/17
Told surgery not an option, get my affairs in order
Meet w/MSK team 5/01/17
Folfox(3rds) 5/17-6/17
Liver resection/implant HAI pump 7/17
HAI pump chemo(5rds) 8/17-2/18
Folfiri+Vectibix(11rds) 8/17-2/18
Spot on chest CT 10/17
Lung biopsy (that was fun) 11/17
Nocardia bacterial infection w/spread to brain (this is serious) 11/17
IV antibiotics 12/17-2/18
Oral antibiotics 3/18-present
Clear of cancer since surgery

Lee
Posts: 5666
Joined: Sun Apr 16, 2006 4:09 pm

Re: Dang 1cm Liver Met!

Postby Lee » Sat Aug 25, 2018 6:15 pm

teacher2017 wrote:I’m absolutely sick over the stats for stage 4. Is this really my life???


I am so sorry about this liver met. (((teacher))) Please understand a lot of the information out there on the internet can be 5-10 yrs old. There is a lot of advancement in the past 5 years. There was a time in the not to distance past, when there was nothing they could do for that 1cm liver met. Today there are many options. And yes, NEDville.

Focus on the positive,

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

boxhill
Posts: 117
Joined: Fri Apr 06, 2018 11:40 am

Re: Dang 1cm Liver Met!

Postby boxhill » Sun Aug 26, 2018 9:08 am

I have no informed opinion on the pump option, but I *do* know that the stage 4 stats out there are totally out of date, and were derived with a patient population that did not have access to many of the treatments available today. This was clearly stated by ALL of my doctors, including the expert at Dana-Farber. As the surgeon who broke the news to me said, there ARE cures. As the doctor at D-F added, it can now be managed as a chronic disease, and who knows what therapies my be available 2 years down the road. Look at Keytruda, which has been practically a miracle drug for many.

Don't read that stuff. It just isn't accurate now.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

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dianetavegia
Posts: 2685
Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia
Contact:

Re: Dang 1cm Liver Met!

Postby dianetavegia » Mon Aug 27, 2018 9:21 am

NO RADIATION! Surgery is the gold standard for a CURE!

Here's the study. https://jamanetwork.com/journals/jamasurgery/fullarticle/398409

I had a 1.4 cm liver met 3 years after my original dx and a hepatic resection with no follow up chemo needed. That was 6 years 4 1/2 months ago. All clear!
Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 6 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

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dianetavegia
Posts: 2685
Joined: Sat May 16, 2009 8:47 pm
Facebook Username: Diane Weldy Tavegia
Location: Villa Rica, Georgia
Contact:

Re: Dang 1cm Liver Met!

Postby dianetavegia » Mon Aug 27, 2018 9:25 am

CURE CHART for Stage IV after hepatic resection.


https://www.ncbi.nlm.nih.gov/pubmed/25398280
Stage IIIB cc surgery 1/7/09. 5/17 nodes. 12 tx FOLFOX
Stage IVa 2/15/12. CEA 6.4 PET = 1.5cm liver met. HR 4/11/12 No chemo

Nine years 6 months since my original dx and Six years post liver resection.
NED April 2018!
“O Lord my God, I cried out to You, And You healed me.”
Psalms 30:2

heiders33
Posts: 277
Joined: Sat Nov 04, 2017 11:08 am

Re: Dang 1cm Liver Met!

Postby heiders33 » Mon Aug 27, 2018 12:51 pm

I just met with Dr Kingham at MSK and they are recommending resection with HAI pump installation and then six months of Folfiri. They also mentioned a clinical trial that I might qualify for run by Dr Kemeny. This is an aggressive approach because I am young and healthy. They said they didn’t start recommending the pump to people with 1 spot until a couple years ago when they did a study showing survival benefit. Teacher, did you decide yet what you are going to do? I have not decided yet but am continuing to see my oncologist and Dr Kingham this week.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR surgery with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump

teacher2017
Posts: 191
Joined: Sat Sep 09, 2017 1:18 pm
Facebook Username: Lydia Clark

Re: Dang 1cm Liver Met!

Postby teacher2017 » Mon Aug 27, 2018 1:01 pm

heiders33 wrote:I just met with Dr Kingham at MSK and they are recommending resection with HAI pump installation and then six months of Folfiri. They also mentioned a clinical trial that I might qualify for run by Dr Kemeny. This is an aggressive approach because I am young and healthy. They said they didn’t start recommending the pump to people with 1 spot until a couple years ago when they did a study showing survival benefit. Teacher, did you decide yet what you are going to do? I have not decided yet but am continuing to see my oncologist and Dr Kingham this week.


Hi-
I have been researching like a crazy person. I just don’t like this pump idea for only one resectable met. It can totally blow out your liver forever! I read a lot of cases where it was not the miracle cure everyone says it is. I also do not like that other hospitals are not on board with it. Only some and many say it’s very old practices. I don’t like that MSK only did a study on their own patients. They will even remove your appendix and gall bladder during surgery and the cut is straight down your middle. Maintenance on the pump is a commitment too. People don’t remove it for 5-7 years because it cannot be put in again. It also has to be filled every two weeks with chemo and drained. Afterwards it needs glycerol every 6-8weeks. To remove it is another big surgery. Recovery will be 3 months for one liver met? I don’t like this idea. And there are no guarantees. Some people get a laparoscopic resection and no chemo and live a normal life. Read above! What are you thinking? I’m having surgery on sept 12.
48 year old female- mom of 2 (12,15)
DX stage 3c - 12/17 LN. T3
8" sigmoid resection Sept 22 2017
6.1cm tumor size
chemo -folfox 11/8/17-4/18
CEA level- 1.4 11/8/17
Colonoscopy- 5/30/18 - CLEAR!
Cea level- 1.8 6/1/18
Cea level- 2.1. 8/4/18
Sh$t has hit the fan- 8/10/18 Stage 4
1cm met in seg.8 liver
Liver resection- 9/12/18


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