Liver Mets - Cryo vs Radiation vs Surgery

[Lori R]

Hi my liver mets friends. My PET/CT in mid-February revealed a return appearance of my nemesis the liver met. Same time, same place. (but he is getting bigger 4+ cm in just 4 months....he is going on a diet) Seriously though, I do have a single liver met that presents itself in the same location. To date, I have no other known disease.

So...we've had many a debate as to an ablation technique vs targeted radiation vs surgery. I thought I would fill you in on 2 very, very busy weeks of Dr. appointments trying to determine the next step.

Short answer - Surgery - Liver resection of the left lobe.

Long answer below:

Cryoablation - as many of you know, I was so hopeful this technique would get rid of the bugger. I tried 2 times and when it returned a 3rd, the interventional radiologist very much encouraged me to consider a different alternative. I am not certain he would have tried again even if I had pressed him.

Targeted Radiation - This was very seriously considered as it is a very non-invasive procedure. We ultimately ruled this out because the tumor is high in the left lobe and is close enough to the heart that the dose would need to be reduced. Thus, making the procedure less effective. Also, the chubby tumor was a little large for radiation. However, I was quoted progression free rates of 90% for 1 year and 80% for 2 years. I will be keeping this on my list as a back up procedure.

Surgery: All involved called this the "gold standard". The surgeon that will ultimately perform the resection jokingly said that I must have "proved myself" to finally get the OK for a resection. So....I am getting one more 2nd opinion to make sure I choose the best possible combination of surgeon +hospital and then will get this met removed within a couple of weeks. (at least that is what I am hoping for) Due to the small amount of BC patients with liver resections there weren't a lot of stats that he could quote. So he gave me the more common colon cancer stat which is 60% without progression in 5 years. WOW!!! I'd be thrilled. Not banking on it. I would love another 4 years to get my daughter out of college. (she graduates from high school in 3 months!!)

In other posts I had detailed the cryoablation procedure (freeky but manageable). When I am done with the liver resection, I'll give the gory details of that procedure as well.

I am disappointed to not have the chance to be a cryo cheerleader. I was so hoping that would put the end to this nonsense. So....OK....I will be a liver resection cheerleader. That will be OK too.

Lots of love to all, hope this info is of some value to anyone pondering the various liver met treatment options.

Lori