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Old 04-20-2009, 08:48 AM   #19
jml
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Join Date: Dec 2006
Posts: 415
Similar Dx...did RFA, did Liver Resect - liver NED since 12/05

Hi Lori~
First & foremost, I'm sorry you're wrestling with a stubborn liver met. I know how disheartening it is to deal with the recurrence.
I have a similar story to yours & I hope my experience & my journey is helpful to you.
I was dx'd Stage IV @primary dx too (5/02). I had single liver met, but after failing navelbine+herceptin, the disease progressed to "innumerable, immeasurable" lesions. Fortunately, Taxol+Herceptin cleaned up my liver & I was NED for a year!
In 9/04, a single lesion recurred. We did short cycles of TH & the lesion would resolve, I'd go off chemo, but then it would pop back up.
I researched RFA & consulted with an Interventional Rad.When the lesion recurred in 1/05, I had RFA. But it was only partially successful because the lesion was located adjacent & very close to the main portal vein. The proximity to the vein creates a "heat sink" effect - carrying the heat from the RFA away from the lesion during the procedure & preventing the lesion from heating up sufficiently to kill off all the cells. So, while some of the tumor was blasted away, it did leave a crescent shape of viable cells that eventually just grew back.

So back on chemo - Abraxane
+ Herceptin, but no response.Then TCH & complete response again.
In the meantime, I started consulting with a liver surgeon.He followed me through the year, then in 11/05 when the lesion recurred again, he said he felt confident a liver resection would be curative, unlike the RFA. (Incidentally, he said that he would have never expected the RFA to be completely successful/curative because of the location & heat sink effect. He suggested the IR should have known this & should have been completely honest with me about the best potential outcome. He's right, the IR never stressed the importance of the heatsink...)
In 12/05, I had a right partial hepatectomy - they removed the R lobe of my liver, which is 55% of the organ. My surgeon did a full exploratory internal sonogram of the liver while I was in surgery to make sure there was in fact only a single lesion. He said if he found small lesions he could RFA them internally, but if there were too many, he would have had to abandon the procedure.
By the grace of God, there was in fact, only 1 lesion. They removed the R lobe. I was in ICU overnight, then on the regular floor the next day. Believe it or not, I was up & walking (thanks to the epidural) & dc'd from the hospital after only 4 days.
I don't mean to imply that the surgery was easy -b/c it wasn't. I have a big incision that runs 1" below my sternum to 1" above my bellybutton. And the 1st few weeks post-op were tough - incision pain, really weak. Taking a shower was exhausting.
BUT with each passing week, I could feel myself getting stronger.By week 3, I was able to travel to LA to be with my family.
The good news is, the liver resection was curative and my liver has been NED ever since.

Unfortunately, I have wrestled with recurrences in the supraclav nodes (2x) & mediastinal nodes(1x) since, but that's the unfortunate cirucmstance of a Stage IV'er. As far as I'm concerned, a recurrence in a lymph node is less threatening compared to a vital organ.

I'll mark 7years as a Stage IV'er in a couple of weeks. Surviving this disease, through all the surgeries, radiation & 105 chemos-to-date is definitely worth celebrating.
Now I have the "7 Year Itch" & I wish, hope & pray to move past this disease. But ultimately, if I have to live with this disease, I will do so vigilantly, but peacefully.

Sorry this is soo long, but, I do hope the info is helpful to you. Most of all, I urge you to get as much info as you can about RFA, you candidacy for a Liver Resect, and consult w/an IR and a Surg Onc & always get 2nd opinions!

Please feel free to send me a note via pm & if I can be additional help.
Successful treatment for any one of us is a victory for all of us. We will help you find yours too!

Keep the Faith, Lori~
Jessica
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