RFA -Lung Tumour

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Cydni50
Posts: 8
Joined: Sun Dec 22, 2019 6:25 pm
Facebook Username: Cyndi Gilbert-den Boer

RFA -Lung Tumour

Postby Cydni50 » Fri Dec 27, 2019 2:20 am

Hi all, I am a new member though I have been on the bowel cancer journey for 4 years now with Stage 4 mets to my lungs. Three weeks ago I had a successful lung resection on my right lower lobe and in a few weeks I am having RFA on a tumour in my left lung. Has anyone had this and can advise what to expect? I have been through so much but this is unsettling me. I will put my history into my signature over the next week. Thank you in advance for any input...
Female 59 years
Dx Feb-16 Rectal Cancer - Staging T3 - NO2
Mar-16 Ileostomy + Port Inserted
Apr 16 8 cycles 5FU + 30 rds Pelvic Radiation
Jul-16 Ultra Low Anterior resection
Aug 16 FOLFOX
Dec-16 Closure Loop Ilesostomy and Port removal
Jul-17 Mets- Lungs 3 - 4 Lesions ??
Jul-17 PICC line inserted
Jul 17 5/8 cycles Irinotecan
Oct - 17 Xeloda + Avastin
Nov-19 VATS - R/Lung - 2 Lesions
Jan-20 RFA - L/Lung
Jan-20 Avastin only
April-20 Cybersknife L/Lung

Cydni50
Posts: 8
Joined: Sun Dec 22, 2019 6:25 pm
Facebook Username: Cyndi Gilbert-den Boer

Re: RFA -Lung Tumour

Postby Cydni50 » Wed Jan 01, 2020 9:19 pm

I am still trying to find anyone who has had RFA on lung tumours and can advise what to expect.
Female 59 years
Dx Feb-16 Rectal Cancer - Staging T3 - NO2
Mar-16 Ileostomy + Port Inserted
Apr 16 8 cycles 5FU + 30 rds Pelvic Radiation
Jul-16 Ultra Low Anterior resection
Aug 16 FOLFOX
Dec-16 Closure Loop Ilesostomy and Port removal
Jul-17 Mets- Lungs 3 - 4 Lesions ??
Jul-17 PICC line inserted
Jul 17 5/8 cycles Irinotecan
Oct - 17 Xeloda + Avastin
Nov-19 VATS - R/Lung - 2 Lesions
Jan-20 RFA - L/Lung
Jan-20 Avastin only
April-20 Cybersknife L/Lung

stu
Posts: 1396
Joined: Sat Aug 17, 2013 5:46 pm

Re: RFA -Lung Tumour

Postby stu » Thu Jan 02, 2020 5:03 am

Hi ,

Hope it all goes well . Not sure if it’s just a little quiet over the holiday period as there are a lot of people who have been very helpful with me regarding lung mets for my mum .

If your looking for people’s experiences you can use the search function on the top bar . They are well documented . You could PM some of the people to ask them as I found them very willing but just not always on the site .

I hope it goes well for you ,

Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

Cydni50
Posts: 8
Joined: Sun Dec 22, 2019 6:25 pm
Facebook Username: Cyndi Gilbert-den Boer

Re: RFA -Lung Tumour

Postby Cydni50 » Thu Jan 02, 2020 5:53 am

Thank you Stu for your information....
Female 59 years
Dx Feb-16 Rectal Cancer - Staging T3 - NO2
Mar-16 Ileostomy + Port Inserted
Apr 16 8 cycles 5FU + 30 rds Pelvic Radiation
Jul-16 Ultra Low Anterior resection
Aug 16 FOLFOX
Dec-16 Closure Loop Ilesostomy and Port removal
Jul-17 Mets- Lungs 3 - 4 Lesions ??
Jul-17 PICC line inserted
Jul 17 5/8 cycles Irinotecan
Oct - 17 Xeloda + Avastin
Nov-19 VATS - R/Lung - 2 Lesions
Jan-20 RFA - L/Lung
Jan-20 Avastin only
April-20 Cybersknife L/Lung

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Jack&KatiesMommy
Posts: 628
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: RFA -Lung Tumour

Postby Jack&KatiesMommy » Thu Jan 02, 2020 7:57 am

I have actually had 10 rfas to my lung mets over a period of 3 years. They are very simple procedures (one night in hospital...maybe none if you aren't flying home.) . However, what you have to remember is that RFAs do not always work the first time. The Interventional Radiologist is using a 2-dimensional image (CT) to burn out a dimensional tumor. Often it is difficult to kill every part of the tumor on the first try. My RFA's destroyed the tumors in my lungs eventually. However, I ended up with mets in several lymph nodes near my lungs afterward. I am currently on Keytruda and everything is clear so far.

Cynthia
Cynthia
Mommy to Jack (8) now (17) and Katie (4) now (13)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new lymph mets lung
05/18: Keytruda (MSS w/Intermediate TMB): NED CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8,

Cydni50
Posts: 8
Joined: Sun Dec 22, 2019 6:25 pm
Facebook Username: Cyndi Gilbert-den Boer

Re: RFA -Lung Tumour

Postby Cydni50 » Sat Jan 04, 2020 12:32 am

Thank you Cynthia. Great information..... Can I ask if you were awake or asleep for your RFA procedures? Also have you had any chemo?
Female 59 years
Dx Feb-16 Rectal Cancer - Staging T3 - NO2
Mar-16 Ileostomy + Port Inserted
Apr 16 8 cycles 5FU + 30 rds Pelvic Radiation
Jul-16 Ultra Low Anterior resection
Aug 16 FOLFOX
Dec-16 Closure Loop Ilesostomy and Port removal
Jul-17 Mets- Lungs 3 - 4 Lesions ??
Jul-17 PICC line inserted
Jul 17 5/8 cycles Irinotecan
Oct - 17 Xeloda + Avastin
Nov-19 VATS - R/Lung - 2 Lesions
Jan-20 RFA - L/Lung
Jan-20 Avastin only
April-20 Cybersknife L/Lung

AlexandraZ
Posts: 178
Joined: Fri Aug 23, 2019 8:25 am

Re: RFA -Lung Tumour

Postby AlexandraZ » Sun Jan 05, 2020 8:22 am

I am interested to know more about RFA on lung tumors too! Can you do RFA if you have many tumors? Or will they only do it if they can ablate all the tumors in one go?
Boyfriend 28yo dx February 2019, CEA 70,480
Stage 4 CRC with multiple mets to liver & lungs
KRAS, NRAS, BRAF wild type, MSS
12x FOLFIRI + Vectibix
September 2019 CEA 210, 60% reduction in size, chemo break!

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Jack&KatiesMommy
Posts: 628
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: RFA -Lung Tumour

Postby Jack&KatiesMommy » Sun Jan 05, 2020 2:43 pm

You are under general anesthesia for the RFA procedures. I had multiple mets in both lungs. They will only do one lung at a time (as occasionally, a lung will collapse during the procedure and you need at least one lung working properly). I am not sure how many mets is too many...but because the RFA kills the tumor and some of the surrounding lung tissue, they are careful about how much mass is destroyed and there would obvioulsy be a limit on the number of mets that they would ablate.
Cynthia
Mommy to Jack (8) now (17) and Katie (4) now (13)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new lymph mets lung
05/18: Keytruda (MSS w/Intermediate TMB): NED CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8,

AlexandraZ
Posts: 178
Joined: Fri Aug 23, 2019 8:25 am

Re: RFA -Lung Tumour

Postby AlexandraZ » Sun Jan 05, 2020 2:48 pm

Jack&KatiesMommy wrote:You are under general anesthesia for the RFA procedures. I had multiple mets in both lungs. They will only do one lung at a time (as occasionally, a lung will collapse during the procedure and you need at least one lung working properly). I am not sure how many mets is too many...but because the RFA kills the tumor and some of the surrounding lung tissue, they are careful about how much mass is destroyed and there would obvioulsy be a limit on the number of mets that they would ablate.


Thank you so much for the data! Do you mind me asking how many you had removed? I never know what "multiple" and "innumerable" really mean. :shock:
Boyfriend 28yo dx February 2019, CEA 70,480
Stage 4 CRC with multiple mets to liver & lungs
KRAS, NRAS, BRAF wild type, MSS
12x FOLFIRI + Vectibix
September 2019 CEA 210, 60% reduction in size, chemo break!

NHMike
Posts: 2505
Joined: Fri Jul 21, 2017 3:43 am

Re: RFA -Lung Tumour

Postby NHMike » Sun Jan 05, 2020 10:40 pm

Is this like VATS? If so, we've had some here in Europe that have had it.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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Jack&KatiesMommy
Posts: 628
Joined: Wed Dec 21, 2011 1:08 pm
Location: Columbus, OH

Re: RFA -Lung Tumour

Postby Jack&KatiesMommy » Mon Jan 06, 2020 11:22 am

It may sound funny, but I am not sure how many tumors I had RFA'd. Sometimes, it was questionable whether we were ablating a new tumor or re-ablating one that had been done before. I would guess that I had 8 or so distinct tumors that were ablated over the years.
Cynthia
Mommy to Jack (8) now (17) and Katie (4) now (13)
(My Most Precious Things)
Dx 8/11 Stage IV CRC (liver mets) CEA 2,600+
9/11 Folfiri 2/12: Failed Liver Resection
5/12 HAI pump/removed primary
4/13 Liver Resection
8/13-12/15 (10) RFAs lungs
5/17: Upper Left Lobe of lung resected.
02/18: 3 new lymph mets lung
05/18: Keytruda (MSS w/Intermediate TMB): NED CEA: 66.4, 39.2, 23.8, 13, 3.5 1.8, 1.0, 2.8 3.9, 5.0, 5.6, 1.5, .8,

Claudine
Posts: 440
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: RFA -Lung Tumour

Postby Claudine » Mon Jan 06, 2020 11:57 am

Since my husband also has lung mets, I'm also very much interested in this topic. I remember previous discussions mentioning no more than 8 mets (at one time) in the US (but I may be wrong); this article says 5: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671845/

"The 2012 Cardiovascular and Interventional Radiological Society of Europe (CIRSE) standards of practice based on expert consensus (31) state that the maximum number of lung metastases that may be ablated is not clearly defined with most centers treating patients with five or fewer metastases. Combination therapies are suggested as an option for improving chance of cure and sparing lung function including thermal ablation combined with surgery (32) or chemotherapy (33). Patients should be assessed by an interdisciplinary team and the maximum tumor diameter should not exceed 3 cm in diameter (31). A recent expert consensus document suggests that if curative ablation is intended, a tumor number cutoff of ≤3 in the case of unilateral metastases and ≤5 in the case of bilateral metastases be employed, echoing the CIRSE guidelines which suggest a cutoff of five metastases in total (31). Finally, the guideline suggests that no metastasis should be greater than 3 cm if multiple (34)."
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 58, low 3.2, now 24.1
Scan 03/19: Multiple small lung nodules, now gone
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 09/20: nothing to report

Annajane
Posts: 3
Joined: Tue Mar 12, 2019 1:52 pm

Re: RFA -Lung Tumour

Postby Annajane » Thu Jan 16, 2020 3:50 pm

Hello,

I had RFA for 8 lung mets a few months ago here in the UK. As the mets were all less than 3 cm the treatment was very successful.
I had each lung done separately. I bounced back really quickly afterwards. There was a bit of pain immediately then for a few weeks afterwards i had pains across my chest and down to my stomach. I mention this because it worried me until I found out the cause: intercostal nerves get damaged and hurt as they recover.

There was much more pain after the second procedure as the tumours were closer to the chest wall where all the nerves are. I think an intercostal nerve may have been permanently damaged as I still can't feel a patch of my tummy.

However, overall it was not a big deal in my opinion. I stayed one night in hospital after each procedure. I was back to normal activities within 48 hours easily.

Best wishes

Anna

Cydni50
Posts: 8
Joined: Sun Dec 22, 2019 6:25 pm
Facebook Username: Cyndi Gilbert-den Boer

Re: RFA -Lung Tumour

Postby Cydni50 » Fri Jan 17, 2020 12:01 am

Thank you Anna. Great information. The procedure for me is next week and fingers crossed all goes well. It will be nice to have this behind me...
Female 59 years
Dx Feb-16 Rectal Cancer - Staging T3 - NO2
Mar-16 Ileostomy + Port Inserted
Apr 16 8 cycles 5FU + 30 rds Pelvic Radiation
Jul-16 Ultra Low Anterior resection
Aug 16 FOLFOX
Dec-16 Closure Loop Ilesostomy and Port removal
Jul-17 Mets- Lungs 3 - 4 Lesions ??
Jul-17 PICC line inserted
Jul 17 5/8 cycles Irinotecan
Oct - 17 Xeloda + Avastin
Nov-19 VATS - R/Lung - 2 Lesions
Jan-20 RFA - L/Lung
Jan-20 Avastin only
April-20 Cybersknife L/Lung

kandj
Posts: 301
Joined: Sun Sep 27, 2015 11:29 am

Re: RFA -Lung Tumour

Postby kandj » Tue Jan 21, 2020 1:33 pm

Dh had an RFA procedure done in 2018. They ended up aborting the procedure as the IR doctor felt he could not visualize the tumor well enough and didn't want to kill health tissue. They ended up doing a VATS the next day. Other than them not being able to see the tumor well enough (it was small, about a 1cm, and the bottom of the lung) the procedure was pretty simple. General anesthesia and a small puncture site.
wife to DH, dx 8/15 stage IV @36, numerous unresectable liver Mets
resection and HAI placed 12/15
Liver resection 5/19/2016 15-20 mets removed (surgeon lost count, but it hopeful he got it all!)
Recurrence 7/2017 4 Liver mets and one possible lung met
Radiation on liver Mets 12/17
Lung met 10/18
VATS on lung met 11/18 started xeloda
Chemo break 6/19-11/19 lung/adrenal gland recurrence 11/19
Adrenal ablation2/20 Robotic Assisted VATS 3/20 Xeloda again


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