Cryosurgery Procedure

[Lori R]

Hi all,
Below are some details of the cryosurgery procedure I had in May of this year (2009) and the short term results. (which were good)

BACKGROUND:
Upon my initial diagnosis in Oct 2007, I had a single liver met. Unfortunately, approximately 1 year after completing Taxotere the met returned. The "new" met was measured at 2.8 CM.

PROCESS - DETERMINATION TO USE CRYOSURGERY
Upon discovery of the Met , my Oncologist referred me to an interventional radiologist. I was thrilled with the interventional radiologist as he answered EVERY question I had. As always, make sure that you are comfortable with any Dr. performing a procedure. He explained that a couple of years ago he used Radio Frequency Ablation (RFA - heating) to destory liver mets but has been using cryosurgery much more frequently. He informed me that the healing time was shorter with the cryo (freezing) and during the procedure it was much easier for him to see where he had treated. He felt this visibility allowed him to be more precise and feel more confident about an appropriate margin.

Unfortunately there are some limitations to the procedure that I am not 100% certain I have the facts, so I encourage you to investigate this procedure with a Dr. My radiologist informed me that he felt the effectiveness diminished at anything over 3 CM. So...I felt lucky to have just made it under the wire at 2.8 CM. He did not indicate that he would not perform the procedure if over 3 CM but he was expressing some caution. I also understand there are locations next to critical veins (?) that limit the use of this procedure. I am not certain about using the procedure on multiple mets.

PROCEDURE DESCRIPTION
Short answer - very manageable. Long answer - see below
First of all, the procedure is performed laproscopically so the time in the hospital is minimal - outpatient. The recovery was amazingly quick.
I checked in at 8 a.m. (the usual pre-hospital blood draw, insurance paperwork etc. etc.)
The procedure was performed in a room containing a CT machine, ultrasound equipment and the cryo equipment which involves a big tank of gas (nitrogen?) and the rods that are inserted into your liver to freeze the tumor. These rods are about the size of your small finger.
This is the amazing and encouraging part.....I was given "twlight" gas so I remained fully awake. They numbed my stomach which I don't even remember them doing. The radiologist made 2 small slits and inserted the freezing rods. He would freeze and then move me about a foot into the CT machine, check the margins, pull me out and then freeze some more. I only felt pressure on a couple of occasions. OK....a little freeky...kind of like going to the dentist and being numb but when they push on your tooth you sort of feel like it hurts but doesn't really.

The procedure with lots of back and forth into the CT machine was complete in 2 hours. I was rolled into recovery and walked about with my husband at 5 p.m. (ok...the anesthesia made me sick..that was THE worst part) Only "stitches were little tape like tabs over 1/8 inch slits.

Thursday (day after procedure) I felt crummy, again a result of the anesthesia but showered by noon and felt much better. No need for any pain medication. (I think I was provided some but didn't need it)

Friday - Drove to the grocery store, picked up a few items for dinner and made dinner.

Saturday - cleaned out my garage.

Monday - back at work

I respect both my oncologist and interventional radiologist as they did not want me to assume I was "cured". As we all know, those pesky tumors can have long tenticals that exceed a reasonable margin. So, to be on the safe side the cryosurgery is usually followed up with a round of Chemo. We let the liver recover for about 3 weeks and then I started on Abraxane for 6 cycles.

THE SHORT TERM RESULTS:
After 3 cycles of Abraxane my PET/CT showed no evidence of disease!!!

LONG TERM RESULTS:
I will continue to add to this thread as time marches on. It is my understanding that this procedure can be used on multiple occasions.

For now....I'll take the victory provided by this minimally invasive procedure.

My sincere hugs and best wishes for anyone considering this treatment approach.