Rock_Robster wrote:That’s great news Alexandra! Thanks for sharing. Really pleased to hear about the liver and glad you’re now prioritising a surgical opinion.
Indeed below 2cm then ablation can become an option, depending on the position of the tumour. Ablation doesn’t work so well near major blood vessels. Below 2cm, ablation has been shown to about 90% as good as surgical resection (above 3cm, it’s about 10% as good). If there are several mets in one segment then they must just prefer to do an anatomical resection of that segment, but if there is a “rogue” small lesion elsewhere, or if it is very deep (which would mean losing a lot of healthy liver too), then they may prefer to ablate. If it is near the surface then a ‘wedge’ resection is also possible to avoid losing the whole segment. Often they combine ablation with resection if there are multiple mets to try to preserve as much liver as possible. Lots of tools in the arsenal, anyway.
Enjoy the chemo break and hoping you guys get some great news from the surgeon
AlexandraZ wrote:Just checking in to mention that Jesper's new scan came in after his 12th round of FOLFIRI. His lung mets are stable (biggest met is 1cm) and his liver mets have shrunk further. At diagnosis, the biggest mets were 5-6 cm. Now they are 1.8-2cm! That's over a 60% decrease in size! We're very pleased and will definitely get a second opinion to see if there is someone who thinks his liver is resectable now.
He is getting a much-needed chemo break and during the break I'll send his scans around and see what other surgeons (and what the people at MSK) think! I think I heard something about that if tumors are under 2cm you have more treatment options. Maybe RFA or something, I don't know. Anyway, just wanted to share the good news!
rachelfromnyc wrote:Sorry to hear both you and Jesper have the flu but glad that it wasn't so severe for Jesper that he had to be hospitalized. I have a little experience in chemo delays while I was on FOLFOX over the summer so I thought I'd share. I had two one week delays. The first was for low counts. Before starting any chemo, I was already in the low end of the normal range so going into treatment #3, my counts had fallen below what's needed to move forward. The second delay was for a commitment I made pre diagnosis in which I had to go out of town. Of course, I was nervous and asked what difference a week made. My oncologist assured me that this kind of situation wasn't unusual and that one week doesn't make a difference. She did however start me on Neulasta and I have a shot each time after disconnect. Since then, I've had no issues and my treatment schedule is more predictable. So less stress there! Is the doctor recommending the same or are you just waiting for the counts to come back up naturally?
Claudine wrote:Sorry about Jesper getting sick, that sounds miserable! As far as neutropenia resulting in chemo delays, my husband has had this happening several times (3 I think?) over his 18 cycles of Folfiri/Avastin. Each time, the counts rebounded after a week break, and there was never any problems with cancer suddenly progressing because of the delay. He even had a 4 week break last summer while we were traveling abroad, without any negative consequences, so I’m sure that Jesper will be fine, too!
Rock_Robster wrote:Hi Alex,
Merry Christmas! So sorry to hear he had to spend it sick.
But yes - a week’s delay of FOLFOX is nothing. Obviously if it happened every cycle it could end up having an effect, but occasionally is fine. My onc mentioned that the impacts of oxaliplatin on the cell replication cycle continue for about 4-6 weeks after treatment, so this made me feel better too.
I have also heard that CEA flares are common early in oxaliplatin treatment, so hopefully this is the case here!
Hope you guys have a good new year.
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