Liver mets: resection, ablation, SBRT, Y-90, anything else?

NicoleRod —Here is my situation

I had multiple liver mets before I had chemo( taxol+carboplatin), after 4 cycles, only 2 left (1.2 cm and 0.6 cm), I then have another 5 cycles of Carboplatin only, the 2 old ones are stable, no SUV uptake, but 2 new ones popped up (2.5 cm and 0.8 cm). I keep postponing the chemo due to the low platelet side effects from carboplatin . Up until today I am already off carboplatin for 4weeks, the platelets are growing up slowly(67), but still not enough for me to get another cycle of Carboplatin. It’s time for new treatment regimen.

My next regimen is olarparib, not chemo. My MO just prescribe the drug yesterday so I am still waiting to get the new drug.

I also have multiple bone Mets, they are continue healing. I had double mastectomy 10 years ago so I don’t have any mets in my breast.

All my other liver numbers AST/ALT/….are good.

Hope I explained everything clearly, yesterday I was so frustrated, but today I feel better. I should have ask my MO what data she is taking about. She is so busy every day, I feel I don’t have enough time taking science with her. Maybe I asked too much.

Thanks NicoleRod. Your input matched my research. Since cancer masses are in both lobes, will ask if I can do worst lobe 1st, then chemo, then 2nd lobe. Probably too risky.

I don't have solid lesions, they are heterogenous masses. That is why they had to take multiple cores as some might not show cancer.

Just want to eek out more life like the rest of us.

How are you, by the way? When is next scan to see if A/F is working?

Yes, they can still hurt if you are stable Nicole.

I will assume microwave ablation is the same as RFA, Radio Frequency Ablation? I know when I was considering this 20 years ago they had been training surgeons at the Cleveland Clinic but very little research was being done into this approach, especially for MBC. The surgeons that were trained in RFA recommended it, the surgeons who did liver surgery recommended the surgery (one immediately made an appointment for me). The RFA doc had me wait a while to see if systemics would work, and it did and then I didn't need the RFA . I finally had surgery 15 years later, a blend of RFA and surgery, whatever it took to get ride of the two mets, and 2 cysts along the way. 4 years later mets came back to the liver but disappeared with Xeloda for the past year.

SandiBeach

I understand your concern. So glad you are approved for y90. My questions would be

• how soon can I get y90
• a how soon after can I start systemic
• If I try systemic first and the tumors grow larger am I still eligible for y90- what is the cut off criteria

I was already having some diffuse micro mets when we did y-90. But the goal was to whack a mole and kill the 3 fast growing larger ones to give me time to find the next systemic.

It is great that your team is getting together. Love the communication. I would want to be on that call asking questions!!😉

Dee

I decided on weekly Taxol. I have not been on a working tx since March. While I was healing from successful SBRT for a 2cm liver met, my liver grew a new crop of diffuse lesions. So although the mapping for Y90 went smoothly (no coils needed for potential leakage to gastro/entero, lung), I can't afford to hold off chemo for another 8 weeks. If I need Y90 in near future, I do not need to redo the mapping part.

Sandibesch- weekly taxol took care of my liver Mets. May it do the same for you.

Very interesting, Dee. Thx for posting!

Is there a tumor size limit for Y90.

Nicole

🙏🏻🙏🏻🙏🏻

Dee

Nicole, wishing you a smooth procedure and super fast easy recovery! This time will be golden!

Nicole,

Hope that your procedure goes smoothly tomorrow. We will all be thinking of you and hoping it is a successful procedure with quick healing!

Nicolerod, I will be with you in my heart during the Y90 and your recovery.

Nicole

Thinking of you tonight. I hope all went well and you are home resting.

Dee

Thanks ladies!!!! That means so much. So far so good side effects from Y90 should kick in for 3 -5 days they said...but the Esphogitis from the rads to spine kicked in yesterday...(which was the exact day my RO said they would)...it hurts to swollow even water..feels like swallowing glass...but I am using throat coat tea and cough drops and this pink stuff that numbs the esphogus (I take that before eating).