Hi all,
I'm relatively new here. This sure seems to be a kind and knowledgeable group of people.

I'm wondering what experience you all have with liver resection. My liver was clear in November. I was dx with stage III n2 rectal cancer in Dec. 05. Did concurrent chemo and rad followed by rectal resection in late March. In April they found three lesions in my liver.

At that time my oncologist informed me that my condition was terminal. This was confirmed by a second oncologist at a prominent local cancer facility. Both said that the presence of lesions in both lobes of my liver make it unresectable.

I recently "happened" upon a new neighbor, a cancer surgeon who has just transferred here from M.D. Anderson. He told me that they are being very aggressive with liver resection these days. I read a very informative article on M.D. Anderson's web site. I am eagerly awaiting an appointment with my neighbor to review my medical records and determine if I'm a possible candidate for liver resection.

Just wondering if anyone here has had liver resection with multiple liver lesions. I've also been looking into Y-90 implants and RF Ablation. Any experience or success stories would be greatly appreciated.

Thanks!

You can remove over 80% of the liver and have it fully regenerate within a few weeks. MD Anderson is the best cancer treatment center so you are going in the right direction. Ablation is a very viable option. I know one guy who is a 9 year liver cancer survivor. Hepatocellular carcinoma, which is one of the deadliest cancers. He currently has numerous tumors in his lungs but he is still fighting, going for 10 years. His liver is now clear. I think he goes to John Hopkins in Baltimore and Mass General in Boston. The ablation may be able to clear one of your lobes or both and allow for resection. There is always hope, explore all options. The y-90 is pretty new I think but I don't know a whole lot about it. Best of luck. :)

Hi Life2short

If you read some of my earlier posts you will find details of my husbands liver resection. But i'll post some details here for you now ....... sorry if im boring some of the oldies.

Husband diag April 03 at stage 4 already (he was 43 y/old at the time). Had colon resection and before leaving hospital was told (by one of the oncology team) that the liver was inoperable due to size and locations of the multiple tumors and lessions. However, they referred him to a LIVER SPECIALIST in a different hospital (here in the UK we have cancer networks of different hospitals). This specialist (Dr Ashley Denison) is considered one of the best in Europe and operates out of a teaching university hospital.

He confirmed that he would consider the liver inoperable at that time but considered that he should try oxaliplatin chemo to shrink the size. Husband had 3 months chemo and this shrunk them down to an operable state.

Both his lobes were affected with deep tumors and was left with only about 30% of his liver...... this grows back again. It was a very difficult operation and it took longer than anticipated to recover.

He then had a month of radio therapy followed by another 3 months chemo. His last treatment was in May (?) 2004.

He has had clear scans from thereon :blob_fire

I hope this gives you some encouragement. It is important to find a liver specialist who can work with the oncologists. From what we were told, we had to work quite quickly as husbands liver was heading towards being overwhelmed by the tumors. I would also urge you to do the same.

Good luck and keep us posted with how you are doing. Please also feel free to ask any questions. I'll do my best to answer them for you.

Regards
ktee_uk

I am with the gang here. There are so many articles by drs now that talk about how they are re-thinking the resection thing, and finding that many more people than they once believed are eligible for resection -- they might need to be treated first, to get those lesions subdued, but that MD Anderson article should point you in the right direction.

Someone with liver expertise should be involved, too.

Please let us know how you doing in your pursuit of this --

Jeni

Thanks for the responses. I was able to visit with my new neighbor, the oncology surgeon in his office today. He was wonderful. He sat me in front of his PC and reviewed my most recent CT scan. He said that I am very much a resection candidate. I will first do Folfox / Avastin in hopes of shrinking the tumors and making the surgery less invasive. But even if I don't respond to chemo, he thinks I am likely still resectable.

This is amazing news. I'm totally blown away. I was told in April that my cancer is terminal - no hope except to enjoy the months or possibly couple years that I still have. I have two small children, the thought of leaving them without a mom has been absolutely heartbreaking. I now have hope. I will begin chemo tomorrow morning. I've been dreading it, but now look on it as just part of the road to a possible cure.

I feel as if an angel dropped into my life. Devine intervention? An answer to so many who have prayed for me? Dumb luck? Informed luck? All of the above? It's amazing what a bit of hope will do for the phyche!!

Life2short, things are changing for our type of cancer, esp for stage 4. We are finally getting some traction on some new treatments, and so forth.

This also shows me the power of a 2nd opinion.

Chemo is your friend. It sorta reminds of the old movies where the police chief has to make a deal with the mob boss to defeat a larger enemy - chemo is the mob boss. Tough, rugged but effective. You get that chemo going, shrink those tumors, and get a resection pronto.

Just watch, the next 5 years, which I am convinced you will be here to see will yield even greater things for our cancer. I am not just whistling in the dark, this is the truth. And nearly all the research and development is aimed at advanced cancer.

Love to you - fight on

Jeni

Life2short, if its not too much trouble, I do have a few questions for you.

I read in one of your earlier posts about radiation, and how hard it was for you to heal from it. I completed my own radiation a week ago Monday.

Did I read it right, did your drs find a mass in your pelvis that they did not remove at surgery, even tho they thought it was cancerous, because of radiation damage ? Did your drs have any idea that your tissues would be that damaged prior to the surgery ? What did they do about the mass, were they just going to deal with it w/chemo ?

And if I read it right, they extended the radiation in order to get some swollen nodes that were not reducing ? Was the radiation successful in doing that ? Did the drs regret doing the radiation for so long, all in all, or did they still think it was necessary to do it as long as they did ?

How long was it from the time you ended radiation until your surgery ? My surgery will be exactly 6 weeks after the last radiation treatment.

Thanks for letting me pry -

Jeni

Jeni,
During surgery, my doctor saw a lymph node and mass that was well away the rectal area. The lymph node looked suspiciuos so he removed it and sent it for biopsy. He / we did not know about this mass prior to surgery and radiation. When he removed the lymph node there was a lot of bleeding and the area was badly irradiated, so he did not dare remove any additional tissue.

Seems my radiologist made all the call regarding radiation treatment, and just kept my surgeon in the loop.

As for the lymph nodes in the groin - they were my first indication of cancer. Though highly suspicious, nobody really wanted to mess with them - I guess it's got a bit to do with the possibility of causing lymphadema to my leg if those lymph nodes were missing. They just kept hoping that the nodes were merely "reactive" and would go away when the cancer was gone.

After eight weeks of radiation, with the last three focused only on the nodes, they still hadn't shrunk and the radiologist finally called it quits. My surgeon agreed that he would look at the nodes during surgery and likely remove them and biopsy them. They both came back positive for cancer. In retrospect, I wish they'd been surgically removed before all the radiation - though the surgery is tricky, the trauma was not huge because they were so close to the surface of my skin. I think my entire healthcare team would have had a better idea of the level of metastasis that had already taken place if they had first biopsied the nodes. Of course, hindsight is always 20/20. I regret the extra three weeks of radiation for the damage it did and the extra time that my cancer spread while I was waiting to heal for surgery.

My rectal incision also became infected post surgery - also because irradiated tissue does not heal well. They had to open the incision and let it heal from the inside out. It was very painful. I was unable to sit for approximately six weeks after surgery. Six month later the wound is still open and drains a bit from time to time. Just yesterday I had a bit of a flare up and had to have some silver oxide put on the open area of the incision.

I was exactly four weeks from end of radiation to surgery. However, the last three weeks were very targeted on the lymph nodes, so the skin in my rectal and vaginal area had begun to heal during those last three weeks of radiation.

I wonder if more time would've helped. I recently posted a question about the timing of my surgery - set for exactly 6 weeks after my last radiation zap - and the gang here said less than 6 weeks was unusual, that radiation keeps working after the last zap.

I guess there is a real balance between what is affective for cancer and what makes surgery do-able.

I do find it chilling that you have not adequately healed from all that radiation. I won't kid you, it makes me anxious, what with my rectal cancer surgery on Nov 13th.

I meet with my surgeon on the 17th of this month, get my 2nd opinion at the Univ of WA on the 24th.

Please keep us posted, you have had good news recently and much to hope for. Thanks for being willing to share.

Jeni

Life2short,
I don't have enough knowledge for your current situation. I just want to give my best wish for your life. Good luck!
Alex