Local chemo - TACE?

[AlexandraZ]

Hi everyone,

I really hope some of you have some input for me and my boyfriend. We are in Germany now to see Dr. Vogl, who is an interventional radiologist. We were hoping he could ablate some of Jesper's tumors, but he says he doesn't dare to at this point. Since Jesper has 800-1000 small mets in his lungs, he says it's too risky. If everything goes fine it would be okay, but he says in case of infection or complications we'll have "lost the race". So he recommends local chemo (TACE - transarterial chemoembolization) , first to the right lung, then the liver, and then the left lung (in sequence of the condition of his organs - his right lung is the worst off). He says the side effects are a lot less than with systemic chemo, while achieving a much higher concentration of chemo in the organ. That sounds good, but I haven't heard much about this treatment before. People come here from all over the world, as it's apparently not accessible in many places.

Ablation may be an option later on, but first he wants us to do local chemo to shrink the tumors.

A lot of you are so knowledgeable in all things cancer. We find it so difficult to navigate this jungle, as doctors tend to claim that their way is the only way. It's hard to get an objective response. We are still going to MSK, as a note, but we haven't heard back from them yet, and I don't want to delay treatment further! What would you guys do?

[NHMike]

I have never heard of this before so I had a look for articles and found this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6315076/

It's not completely descriptive of how the procedure(s) are done but it gives you an idea of the mechanism and how it works.

[stu]

A previous poster many years ago went to Germany and I think it might have been the same Doctor . He certainly used TACE but not in isolation . He used many different components and to be honest I could not quite unpack the approach as he had various doctors and several plans . He had a lot of wins along the way and treated the disease for a long time . Now I think he may just have been ahead of his time . He was gracious in the face of criticism and unstoppable in his pursuits of a cure . Many of them were in their infancy .
As I said I can’t remember in isolation how he did with TACE . It was years ago . However if you wish to try and unpack it to see if it’s the same treatment and Doctor he blogged under the name
Petelostatsea . I remember from his blog that he was possibly dyslexic and it was evident in his writings but his content was well recorded . He would have loved it to come to the aid of someone else . I say that as a fellow dyslexic and mean no criticism.
Be interesting to see how some of his treatments have developed over time . We had another man who insisted the immune system was the solution . Now with the advent of immunotherapy I think of him often .
All the very best with the treatment .
Stu

[Rock_Robster]

Hi Alex,

Good you saw Dr Vogl and great to hear hear he had a proposal for Jesper. TACE to the liver is fairly common; I’m not sure though how the local control/response rates compare to something like HAI or Y90. I don’t see it being so commonly offered in the major centres (unlike these other two) so this does make me wonder. Some research needed there I guess (esp if MSK is offering HAI).

I have never heard of TACE being done for CRC mets to the lungs; nor could I find any info online. It does seem to have had some success with primary lung cancer however. I wonder if it’s worth asking Dr Vogl if he has any data supporting the effectiveness of this? I guess if it’s safe and the only option on the table for the lungs then perhaps worth trying.

Sounds like in any case the sequencing between the liver and lungs is going to be important. Just personally and overall I think if I were given the option of HAI I would take this over liver TACE, but I realise this doesn’t address the lung issue so a combination may be needed.

Cheers
Rob

[CRguy]

he blogged under the name Petelostatsea

You can check for Peter Trayhurn's posts on CTalk under the username pete43lost_at_sea although he also posted on a number of other forums with variants of that name.

We had another man who insisted the immune system was the solution . Now with the advent of immunotherapy I think of him often .

I believe Marc is who you are referring to, known here as lohidoc

We had many off forum conversations and contacts with local researchers who were trying to follow up on his ideas concerning
Dr. William Coley's so-named Coley's toxins

His blog marcdu4 Cancer and other things remains online, and should be considered essential reading for anyone who wishes to "know" an incredible human being

[stu]

That’s the one I was thinking off ! Thanks .

Hope everything is going well in Germany .
Stu