I believe Dr. Kemeny is definitely worth consulting although I still have yet to meet her. I have heard many stories on here of people deemed incurable by their oncologists, with numerous liver mets, who have gone to her and are still alive and kicking.
HERE IS THE MOST LATEST UPDATE:
We went to Mass General yesterday to see husband's oncologist. We went over MRI results and saw the two spots of concern - one 1.6 cm suspicious and possible met in the caudate lobe and one 1.3 cm very likely a cancerous lesion/mass (I forget the term) in segment 6 in the right lobe. The MRI image for the caudate lobe lesion is very faint and indistinct. The oncologist couldn't see it but I spotted it out to him. He had actually even almost forgot about it when reviewing the MRI and we had to remind him of the fact that the radiologist had detected it. (Argh.)
The liver surgeon and oncologist recommended ablation of the certain 1.3 cm segment 6 met. The reasoning is that surgery is not an option at this time because it is too soon to do another liver surgery after his surgery January 28, 2018.
The 1.6 cm caudate lobe questionable spot needs a CT-guided needle biopsy, so my husband asked if everything can be done at one time: biopsy and ablate the 1.3 cm segment 6 met plus biopsy and ablate the 1.6 cm caudate lobe questionable spot. His thinking is that if they are going to take out a centimeter or so to biopsy it, why not also ablate the thing while in there? No sense in going in there to do the needle biopsy and NOT burn or freeze the lesion away. There really isn’t much risk beyond what is already being incurred from the biopsy itself.
So, the next step will be to kill-all-birds-with-one-stone, so long as the interventional radiologist, liver surgeon, and oncologist agree that this is the best course of treatment at the moment. It likely to take place ASAP after Christmas. The consensus of the oncologist and liver surgeon is we should deal with it quickly, but it’s not critical to upend our holiday with an emergency procedure.
Depending on the results of the biopsy, the ablation will most likely be followed by a chemo regimen to be determined.
In the meantime, I finally got all my husband's records to MSK late last night after we got in from Boston. Luckily we went to Boston because I don't know if the central records department maintains the particular record they needed. I had been waiting for the faxed request from the other day to get processed but who knows how long it would have taken.
We intend to go see Dr. Kemeny for a consultation assuming she agrees to see him. We want to hear what her recommendation would be, but, at the same time, we are not wasting any time moving forward at MGH to get the treatment he needs right away. From what I know about Dr. Kemeny, she is chemo-driven and I don't think that she would be recommending liver surgery right away at this time anyway, so having these ablations done as the first course of action as we sort out what chemo to do next seems to make the most sense.
Whether we switch over to MSK remains to be determined. If my husband is a good candidate for the HAI pump, then it's a no-brainer to switch. We now know that his Mass General oncologist is not chemo-aggressive, whereas MSK is. That might just be what my husband needs to nip this cancer in the bud.
Wife 4/17 Dx age 45
1st primary T3 N2b M1a
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
Lynch no; KRAS wild
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles