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Old 08-12-2021, 09:12 AM   #1
Donna H
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radio-embolization

Hi-

So I am done with traditional chemo but still getting Perjeta and Herceptin every 3 weeks. My last pet scan showed the live tumor still active and its size remains unchanged. So my med onc sent me to a surgical onc to discuss liver direct therapy. Surgical onc recommends radio-embolization but I need to get a liver mri and more bloodwork to determine if I am a candidate for this. Has anyone heard of it, gone through it? I asked about removing the tumor on the liver but was told that isnt an option. Apparently the liver tumor is the doctors biggest concern right now.
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Old 09-06-2021, 06:38 AM   #2
Joan M
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Re: radio-embolization

Check out this 6-minute video. It mentions radio-embolization, when radioactive particles are delivered directly to a tumor. The video also explains other potential procedures.
The video about guided techniques appears at the bottom of the page:

https://www.mskcc.org/cancer-care/do...tephen-solomon

Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 09-06-2021, 06:51 AM   #3
Joan M
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Re: radio-embolization

Check out this 6-minute video, which mentions the delivery of radioactive beads directly to a tumor. The video about guided techniques such as radio-embolization appears at the bottom of the page.

https://www.mskcc.org/cancer-care/do...tephen-solomon

Best,
Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 09-08-2021, 07:43 AM   #4
Donna H
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Re: radio-embolization

Thanks. I have a consult with the radiology specialist next week. I hope this, or chemo embolization is an option for me. The large liver tumor grew slightly since the previous scan in February - this while I was getting chemo. This is one stubborn tumor.
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Old 09-13-2021, 06:59 AM   #5
Joan M
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Re: radio-embolization

Best of luck with your appointment. In the least we have potential options. Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 09-23-2021, 01:20 PM   #6
Donna H
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Re: radio-embolization

Met with the interventional radiologist on Monday. If my insurance approves the procedure, then I will go ahead and start the process. There's a mapping procedure done prior to the actual placement of the radioactive beads. So now we wait for the insurance to rule. Joy.
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Old 09-23-2021, 05:07 PM   #7
Joan M
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Re: radio-embolization

Very glad to hear that you have this option, and keeping my fingers crossed that the procedure will be covered by your insurance.
Joan
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 10-01-2021, 01:32 PM   #8
Donna H
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Re: radio-embolization

Still waiting to hear from insurance. Gotta love 'em. I'll call the specialist's office Monday and see if they have heard back and if not if there is anything I can do to facilitate an answer. Monday will be 2 weeks since the specialist's office put in the request.
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Old 10-01-2021, 03:09 PM   #9
Joan M
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Re: radio-embolization

Ugh! I’m hoping your insurance responds soon. Not any of us like waiting that long.
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Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 10-04-2021, 11:28 AM   #10
Donna H
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Re: radio-embolization

Mapping procedure is scheduled for the 14th. Any thoughts on taking the risk of the actual procedure (assuming I am a candidate)? My husband and friends all think I should absolutely do it. But as the one who could end up with a wicked ulcer as a result, I can't help but wonder. The odds are very low (4%) that anything bad can happen. And would appreciate any and all opinions from other HER2+ people.
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Old 10-17-2021, 07:06 AM   #11
Joan M
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Re: radio-embolization

My lung collapsed during the RFA but there was a 40% chance of that happening. I think each of us decides on the risk we are willing to take.
__________________
Diagnosed stage 2b in July 2003 (2.3 cm, HER2+, ER-/PR-, 7+ nodes). Treated with mastectomy (with immediate DIEP flap reconstruction), AC + T/Herceptin (off label). Cancer advanced to lung in Jan. 2007 (1 cm nodule). Started Herceptin every 3 weeks. Lung wedge resection April 2007. Cancer recurred in lung April 2008. RFA of lung in August 2008. 2nd annual brain MRI in Oct. 2008 discovered 2.6 cm cystic tumor in left frontal lobe. Craniotomy Oct. 2008 (ER-/PR-/HER2-) followed by targeted radiation (IMRT). Coughing up blood Feb. 2009. Thoractomy July 2009 to cut out fungal ball of common soil fungus (aspergillus) that grew in the RFA cavity (most likely inhaled while gardening). No cancer, only fungus. Removal of tiny melanoma from upper left arm, plus sentinel lymph node biopsy in Feb. 2016. Guardant Health liquid biopsy in Feb. 2016 showed mutations in 4 subtypes of TP53. Repeat of Guardant Health biopsy in Jana. 2021 showed 3 TP53 mutations, BRCA1 mutation and CHEK2 mutation. Invitae genetic testing showed negative for all of these. Living with MBC since 2007. Stopped Herceptin Hylecta (injection) treatment in March 2020. Recent 2021 annual CT of chest, abdomen and pelvis and annual brain MRI showed NED. Praying for NED forever!!
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Old 10-27-2021, 09:08 AM   #12
Donna H
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Re: radio-embolization

The procedure is scheduled for Tuesday. During the mapping procedure, the onc discovered 2 new tumors on my liver. So if the first procedure goes well, I will need a second to take care of the 2 new tumors. Apparently the blood supply is different so it can't be done all at once. And now that I have had progression while on Herceptin and Perjeta, my oncologist wants to switch my regular treatment. Can't wait - ugh. I was just getting used to the Perjeta side effects! The good news is - there are options to try. I am grateful for that.
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Old 11-05-2021, 07:49 AM   #13
Donna H
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Re: radio-embolization

I had the Y90 treatment on Tuesday. SO far so good - although Tuesday night and Wednesday morning were rough. Strange thing, on the doctors report of the procedure said the 2 new tumors he saw during the mapping procedure were no longer evident. Of course, I didnt get to talk to the doctor after the procedure. I see my oncologist next Friday so hopefully she can address this. I sure hope this means I can stay on Herceptin and Perjeta and that I wont need another Y90 treatment. I can't help but feel like a walking science experiment. And we won't know if this treatment ate away at the liver tumor for a few weeks. But I like to believe it is!
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Old 11-08-2021, 12:59 PM   #14
Pamelamary
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Re: radio-embolization

Good luck Donna!
Best wishes.....Pam
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