Topic: The latest "Plan of Attack"

Hello. Since I was diagnosed with CC the Oncologist's "Plan of Attack" (my words not his) has changed. Initially I started chemo, Gemzar, in Jan. The regimen was 1 treatment per week for 3 weeks then a week off. There were  no major side effects, although I did start to become anemic during the Feb. cycle, crit down to 31% vprc. At the beginning of Feb. I was referred to a Radiation Oncologist at Wilmot Cancer Center at Strong Memorial Hosp in Rochester, NY. He posed that I undergo tomotherapy. I also was referred to a Surgical Oncologist at Wilmot. His proposal was to resect my liver. My tumors are almost totally within the right lobe. I feel that this is the best option. My Oncologist agrees.
  Resection is an involved process. This Wednesday 3/11, I will have a volumetric CT scan to update the CC's progress and provide a baseline. Next Wed. I will undergo an embolization of my right portal vein. This will somewhat starve the right lobe but it's primary purpose is to promote growth in my left lobe. After about 2 months, 5/6, I will have a followup volumetric CT. If there has been sufficient growth of healthy liver tissue in the left lobe I will have the resection surgery on 5/18. Recovery is expected to take 6 weeks or so.
  At the present time I am still healthy enough to work full time. I am an electronic technician for the US Postal Service. I have lost 5 more pounds, 25 total since Aug 2008. I will keep updating this thread as time allows. I would also like to say that I find each and every story on this site very moving and pray for all. Peace.

Re: The latest "Plan of Attack"

That all sounds very good. Even though this turns one's world upside down and inside out it is somewhat comforting to at least know you have a plan. We will be sending good luck and prayers your way. Please keep us posted.

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: The latest "Plan of Attack"

I am sending good luck vibes to you!!  Please keep us posted and know that we are praying for you also!!

Smiles through tears,
Patsy

Re: The latest "Plan of Attack"

Good luck! Be thankful that you have a physician who is really trying and willing to change course if needed.

5 (edited by marions Mon, 09 Mar 2009 15:54:42)

Re: The latest "Plan of Attack"

Welcome for joining us and thank you so much for sharing your

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER

Re: The latest "Plan of Attack"

Good luck to you. I will be hoping for the very best. Keep us informed as to how you are doing.

Peace,
Darla

"One Day At A Time"

All of my comments and suggestions are just my opinions and are not a substitute for professional medical advice.   You should always seek the advice of your physician or other qualified health care providers.

Re: The latest "Plan of Attack"

I am so so happy for you. I hope this plan of attack kicks some cancer butt and you have a wonderful success with it. Please keep us informed. There are so many posts about helpful hints and what to expect so please look at them.

Best of luck.

Kris

Cancer is a word, not a sentence.

36 year old patient with buckets of hope

8 (edited by JimGall Thu, 12 Mar 2009 08:52:40)

Re: The latest "Plan of Attack"

David  Nice :

I  find  your  progress  encouraging... I too   live  in  Rochester  &  am  working  with  the  staff  @  Wilmot.   I've  undergone  Tomotherapy  already  ( 15  straight  days )  &  just  completed  my  2nd  round  of  Gemzar  &  Xeloda.  I'm  scheduled  for  a  CT  scan  next  week  to  determine  if  I'm  resectable.  My  case  sounds  almost  identical  to  yours..
11cm  tumor  on  right  lobe  ( hopefully  now  shrunk ).

Re: The latest "Plan of Attack"

My "Plan of Attack" was changed for the very worst last week. First on Wednesday a we were driving to the hospital for the embolization procedure the cell phone rang and it was the Special Procedures nurse informing us that the procedure was canceled. A phone call from the Surgical Oncologist explained that the embolization was canceled because the CT from the week before revealed that my tumors had grown too large for a successful resection. An appointment with a Radiation Oncologist on Friday had the same outcome; My tumors were too large for tomotherapy. I have an appointment with my Oncologist to work out a Chemo regimen. It doesn't seem promising. Peace

Re: The latest "Plan of Attack"

David,
sorry  to  hear  of  your  disappointing  turn  of  events...
I  too  had  some  disappointing  news  yesterday....  Oncologist  indicated  that  last  C-scan  indicated  no  shrinkage  on  tumor  despite  the  3  weeks  of  radiation  &  into  3rd  round  of  chemo.  He  did  indicate  that  my  CA-19  had  come  down  to  within  normal  range...  anyone  that  can  explain  how  tumor  is  still  large  ( 11 cm )  &  yet  this  enzyme  marker  has  dropped  ?

Re: The latest "Plan of Attack"

Dnice

I understand the size of the tumor can be reason to cancel surgery, but I don't understand why they would cancel the chemoemoblization. Was there another reason than size? My father has an 11x14 cm tumor and never has size been mentioned as a reason for not doing chemo embolization.

I defer to others with more experience, but one thing I have learned is not to take the first no as an answer.

Peace!

Re: The latest "Plan of Attack"

Hey David, sorry to hear about the news you received this week. My Dad was told by 9 out of 10 docs that his cc was unresectable & that chemo was the only option. A doctor, just down the road from you- in Sayre PA (at the Robert-Packer Guthrie) said that he'd be willing to try to resect if they could reduce the size of the tumor just a bit. So they were pursuing chemo & planning radiation via brachytherapy (8 out of 10 others also said no to radiation). Both the radiologist & the surgeon on his cc team are fairly new to the Guthrie. I believe Dad's tumor was somewhere between 2.5 & 4 at that point. The nurse told us that this doc was not afraid to attempt such surgery, as was not the case with all surgeons.  His name was Dr. Douglas Trostle, General Surgeon, Phone: 570-882-2388.  Just thought I'd pass that on in case you were interested in locating a second opinion.  Best to you as you move forward with plan B.

Jim, the doc told my Dad that three key diagnostic tools that he was looking at, when assessing the overall state of the progression of the cc, was the CA-19 tumor marker, the CT scan showing the size of tumor and the bilirubin level. He indicated to Dad that while the chemo had halted the growth of the tumor, the assessment was not favorable because the other two factors were not in his favor - noting that the bili level & CA-19 were on the rise. The docs interpreted this to mean that the cc was progressing. But Dad's levels were high, bili levels were up near 22 & his CA-19 fluctuated between 9,000 and 27,000.  Wishing you the best Jim.

-Tess

Re: The latest "Plan of Attack"

Tess, Jim:

Was the AFP mentioned? I have copies of my father's labs and haven't seen the CA 19 on there and I am wondering if it goes by something else. AFP is the only of my dad's numbers that are a tip off for liver trouble, that and, oh yeah, he has a mass as big as his hand....

I found this informative on CA19

http://www.labtestsonline.org/understan … /test.html

Re: The latest "Plan of Attack"

Dnicetry,

Keep focusing on the positive and get a second opinion. If you are still healthy enough to work then I think another doc might be willing to go for it. My mother was resected even though she had a pacemaker/defibrillator and was still smoking.

Patty

Re: The latest "Plan of Attack"

Hi Walk, the CA19 was the only one Mom mentioned. She never said anything about the AFP. They appear to both reflect cancer diagnostic tests. Good point though, different docs likely have their own sets of diagnostic tools that they monitor.

-Tess

Re: The latest "Plan of Attack"

Hello, Last month I had an appt. with Dr Fong at Memorial Sloan Kettering. He said that the growth of tumors in the left lobe of my liver along with the large tumor in the right lobe leaves resection out as treatment. However, I have an appt. on June 1st with Dr Kemeny at MSK to evaluate suitability for the implantation of a chemo pump that feeds directly into the hepatic artery. This allows for a much stronger concentration of a derivative of 5-FU. Dr Fong would do the surgical implantation. There is data that shows very good results with tumor shrinkage. The people I met at MSK were very helpful and friendly. Here's hoping.
Peace

Re: The latest "Plan of Attack"

Sounds like a great plan. Hoping for the best results!

Teddy ~In our hearts forever~ATTITUDE is EVERYTHING
Any suggestion I offer is intended as friendly advice based solely on my own experience. Please consult your doctor for professional guidance.

Re: The latest "Plan of Attack"

Dnicetry....Dr. Fong has much experience with CC and I would feel very comfortable with him as I would with Dr. Kemeny.   I am very interested in their possible approach of implanting a pump to deliver the chemotherapy and would love to know more about it.  The events sure have taken on a different turn for you but, indeed the contemplated  approach sounds very promising.  Keep up your spirits.   This cancer likes to throw curveballs at us but, we don

THIS INFORMATION IS NOT INTENDED NOR IMPLIED TO BE A SUBSTITUTE FOR PROFESSIONAL MEDICAL ADVICE. YOU SHOULD ALWAYS SEEK THE ADVICE OF YOUR PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROVIDER