Time for a chemo break?

Lauriesh · 01-12-2011, 05:29 AM

Hi everyone,

I was diagnosed stage 4 in July, 2010, with mets to my liver.

I have done 8 rounds of TCH and have had an excellent response. One liver lesion is gone, and the other has shrunk from 11 cm to 3 cm.

My onc mentioned taking a break, and switching to just Herceptin and tykerb. I am doing ok on the chemo, just some neuropathy and fatigue.

My first reaction is to continue until I am NED , or it stops working, but just wanted to get others opinions. Is there any benefit to taking a break at this point?

Thanks,

Laurie

Lori R · 01-12-2011, 06:08 AM

Laurie,
It is wonderful news that the TCH has had such dramatic results on beating back the liver mets!!! I too have had to deal with liver mets and almost 4 years out, I continue to win the war.

As you can see from my post, I've used a combination of cryosurgery + chemo to allow for an occasional chemo break. (which is nice)

That said.....chemo's do a number on my WBC so I don't think I held up as well as you. Could you talk to your Onc about staying on TCH as long as the remaining tumor continues to shrink? If it stops shrinking then move to a different option?

Now that the 11 cm tumor is down to 3 cm you might want to consider quickly zapping the sucker with cryoablation. The drawback is that at that point, you can't measure it and know for sure if the chemo of choice is working. Cryoablation might be worth asking about with your Onc.

One more random thought.....I believe TCH is a powerful combo that I doubt your Onc will want to keep you on indefinately. Once the big guns eliminate the final met, you could go on Herceptin + Tykerb as insurance???

Many positive choices, which is such good news.

Again, so glad that the chemo has made such a big difference for you...Keep us posted...Lori

michka · 01-12-2011, 07:01 AM

Hi Laurie. Good news the TCH is working! I agree with Lori that if it is working I would try to go to NED unless you have bad side effects in which case you could have the remaining part of the met zapped. How often do you check the progress? After each round? Did the progress stop? Maybe your onc can tell you what he is worried about?
I am going to discuss chemo with my onc on friday and this result with TCH is interesting although I am not sure I can take 8 rounds of TCH. Are you ER+ or not?
I hope you will be Ned soon. You seem to be on the right road Michka

Lauriesh · 01-12-2011, 09:22 AM

Thanks for the responses Lori and Michka,

I saw one Dr. already, who told me that my lesion was not in a good spot to have it zapped. I have a second opinion this fri, as I did not like the first Dr. I am hoping I get better news. I would love to have rfa or cyroablation done.

I am er/pr - . I have had two scans since July. The last one was in Dec. , which still showed the tumor shrinking since the scan in Oct. The Dr. I am seeing on Fri mentioned that they might want an MRI to get a better look at the lesion. I hope they decide to do one, as it would be nice to see if it has shrunk again in this last month.

I will definitely be on Herceptin and tykerb once this liver tumor is gone.

I didn't ask my onc why he wants me to take a break, I will have to ask him next time. It could be that my nueropathy is getting worse, and he knows that I won't say I need a break until I am NED.

Laurie

Joan M · 01-12-2011, 12:20 PM

Laurie,

I would agree with Lori and Michka about the RFA and the cryoablation alternative. It would be best to speak directly to an interventional radiologist. That is the doctor who performs these procedures, and they would know whether it can be done. Avoid asking a surgeon. Many of them feel that these procedures are not worthwhile and plug surgery.

A second opinion is good. A had a lung RFA. The first doctor said the lesion was in an awkward place, but the second one said he had enough room and did the procedure.

RFAs and cryoablation are preformed frequently in the liver for both primary and secondary lesions. A lung RFA is a newer procedure.

Joan