Anyone have ablation that worked?

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mpbser
Posts: 759
Joined: Wed Apr 19, 2017 11:52 am

Anyone have ablation that worked?

Postby mpbser » Tue Jan 08, 2019 7:26 am

Has anyone here had a percutaneous ablation (microwave, cryo, RFA, etc) that got you NED? My husband is scheduled for microwave ablation for one or two possible mets on his liver January 22nd and we still are not sure if he should do that or explore other, more likely successful, options.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

Gravelyguy
Posts: 125
Joined: Thu Jul 05, 2018 6:03 pm

Re: Anyone have ablation that worked?

Postby Gravelyguy » Tue Jan 08, 2019 10:24 am

Hi Mpbser,

At diagnosis, I had 2 mets to my liver. After 4 rounds of chemo with Vectibix, they resected one met and RFA-ed the 2nd. No recurrence so far!

I did respond very well to the chemo-Vectibix combo as in the resected tumor was dead when they biopsied it.

Hope this helps.

Dave
6/17 dx mCRC t3n1m1 very low rectal tumor 2 liver Mets 1.3 cm and .9 cm

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection cancer is out of here!
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12/18 clear scans, CEA .9 still NED!

stevieb
Posts: 402
Joined: Sat Feb 09, 2013 12:26 am

Re: Anyone have ablation that worked?

Postby stevieb » Tue Jan 08, 2019 3:30 pm

I've had 5 lung cryoablations of the past 3 years and no local reoccurrence yet.
Dx age 33
12/19/12 Stage IV liver/lung
1/14-2/28/13 Folfox
3/27/13 rectal/lung rst; temp ileo
7/11/13 liver res/ileo rev
9/30/13 - Folfox
11/13,2/21 NED
3/14 lung recur;6/16-VATS
7/14 5 bi lung mets
10&11/15 laser lung surg
2015 Colondar Model
12/15 5 lung met-folfiri
5/15 NED
11/15 2 lung mets; cryoablation
1/4/17 2 lung mets; cryoablation
NED as of 1/23/17

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LPL
Posts: 565
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Anyone have ablation that worked?

Postby LPL » Tue Jan 08, 2019 4:29 pm

Thank you stevieb, for sharing your experience, good result.
I hope you will be for ever NED !
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

User avatar
juliej
Posts: 2923
Joined: Thu Aug 05, 2010 12:59 pm

Re: Anyone have ablation that worked?

Postby juliej » Tue Jan 08, 2019 5:41 pm

I would wait for the new MRI results from MSK before committing to an ablation. Their machines can detect subcentimetric metastases. Hopefully, you'll find out they are just hemangiomas or something benign. Fingers crossed for you!

Juliej
Stage IV, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/11
LAR, liver resec, HAI pump 11/11
Double lung surgery + ileo reversal 2/12
Adjuvant Xeloda 3-9/12
VATS rt. lung 12/21/12 - benign granuloma!
NED 3/17/12 to 2/1/2019, CEA<1

mpbser
Posts: 759
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone have ablation that worked?

Postby mpbser » Wed Jan 09, 2019 7:50 am

Oh, yeah, for sure we are not going to go ahead at MGH before getting MSK MRI results. Good to know how powerful their MRIs are!

"Hopefully, you'll find out they are just hemangiomas or something benign." YES! Hoping and praying!
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

mpbser
Posts: 759
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone have ablation that worked?

Postby mpbser » Wed Jan 09, 2019 7:54 am

P.S. Last night, my husband and I finally had the time to talk through our current decision-making needs and created an algorithm for working through them. Tricky and complicated but he does not want to risk any gap in his treatment. It was really good to brainstorm because we've been on non-stop for the past few weeks.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

User avatar
juliej
Posts: 2923
Joined: Thu Aug 05, 2010 12:59 pm

Re: Anyone have ablation that worked?

Postby juliej » Wed Jan 09, 2019 7:38 pm

mpbser wrote:P.S. Last night, my husband and I finally had the time to talk through our current decision-making needs and created an algorithm for working through them. Tricky and complicated but he does not want to risk any gap in his treatment. It was really good to brainstorm because we've been on non-stop for the past few weeks.

Great idea!!! I made a 'decision tree' to help sort out the pro's and con's of my choices. One time, though, I went with my "gut" instinct instead of a rational decision. It ended up being the right thing to do, which proves I guess that we're not just analytical bots but have some instinctive feelings too.

I agree about not risking any gap in his treatment. I know too many patients who've had their cancer get out-of-control (and beyond the possibility of surgery) while they took time off to make decisions.

You're doing the right thing with your research and conversations about your upcoming decisions!

Juliej
Stage IV, liver/lung mets 8/4/2010
Xelox+Avastin 8/18/10 to 10/21/11
LAR, liver resec, HAI pump 11/11
Double lung surgery + ileo reversal 2/12
Adjuvant Xeloda 3-9/12
VATS rt. lung 12/21/12 - benign granuloma!
NED 3/17/12 to 2/1/2019, CEA<1

mpbser
Posts: 759
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone have ablation that worked?

Postby mpbser » Thu Jan 10, 2019 8:06 am

BTW, thanks for mentioning hemangiomas earlier, juliej. I had not heard of them before. I did some reading about them this morning. Very interesting stuff!
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7

mpbser
Posts: 759
Joined: Wed Apr 19, 2017 11:52 am

Re: Anyone have ablation that worked?

Postby mpbser » Thu Jan 10, 2019 8:48 am

Reading about hemangiomas, I came across this:

On MRI, the typical appearance is a well-demarcated, homogenous lesion, hypointense on T1-weighted images and hyperintense on T2-weighted images, the “cotton-wool” aspect [27]. Because both malignancy and HH are hyperintense on T2-weighted images, the differentiation is done by increasing the echo time (TE): while the signal from malignant lesions tends to decrease, the one from HH increases [28]. Diffusion-weighted images are also useful in differentiating HH from malignant lesions.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0, 2.9, 2.2
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI shows met
Resection & HAI Mar 7


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