The best chance at getting rid of any of these tumors permanently is surgical removal. While some doctors will "write off" patients with both liver and lung mets, many are coming around to the idea that this can be dealt with. Information about a lot of the procedures below is new but promising.
A treatment plan may mean one of many things - it all depends on how many mets there are, how big they are, exactly where they are located, etc. I think that the key is to find a doctor who is well-versed in the possibilities of all of the options and finding a combination plan to move forward with treatment, if that is what your friend wants to do.
I would specifically ask the doctor about:
- systemic chemo to try to shrink all tumors
- radiofrequency ablation (RFA) for either or both liver and lungs (it is done on both)
- chemoembolization or hepatic pump to the liver
- SirSpheres to the liver (as someone already mentioned, this should not be ruled out without specific information about location/size of the tumors, and possible testing of the blood vessels in the liveer)
I would urge your friend to find a doctor who will look at all of these options with the end goal being to shrink the tumors in both locations until they are surgically resectable. That may mean RFA (radiofrequency ablation) to the lung mets and then systemic chemo to shrink the liver mets until they can be removed surgically. It may mean chemoembolization and/or SirSpheres to the liver (which sometimes can be done after Avastin, though it can complicate things) and RFA to the lungs. There are a lot of options and again, it all depends on the specific situation AND of course what the doctor is willing to try.
If the doctor is saying that your friend isn't a candidate for any of these procedures, there should be specific reasons for that. If the doctor is unaware of any of these procedures, find someone who is. If your friend wants to move forward with treatment and the doctor is unable or unwilling to make a plan, get a new doctor.
Good luck and keep us updated.
Hannah K. Vogler
Co-Founder, The Colon Club
cousin of Amanda Sherwood Roberts
dx 1/99 Stage III at age 24
died January 1, 2002 at age 27