Topic: possible resection/liver surgeons? dealing with ascites?

My dad has been repeatedly turned down for a liver resection; however, he has been responsive to the chemo (a combination of Gemzar, Taxotere, Xeloda, and Avastin) which he has been on since Feb. of this year. The chemo, however, has been very hard on him.
I was wondering if anybody has had a successful liver resection of a large tumor, who the surgeon was, and where the surgery was conducted. Both University of Pittsburgh, Sloane Kettering, and the Mayo Clinic in Rochester, have turned my dad down for surgery, in part because he also has ascites. So, I was also wondering if anybody else knew how to deal with ascites. Currently, my Dad get parascentesis twice a week and the doctors have advised not putting a shunt in because of in the possibility of infection. My dad just turned 49. His tumor started out as 13 cm but has shrunk. We are thinking about seeking an opinion from Stanford and MD Anderson. I would be very greatful to hear of any aggressive liver surgeons out there who have had a lot of experince. Thank you- C. Smith

Re: possible resection/liver surgeons? dealing with ascites?

Hi cmsmith,

  My husband had his resection at Stanford by Dr Esquivel (head of the liver transplant team).  When they went in, they did not expect to see what they found.  He had a softball size tumor with 2 daughter tumors.  Dr. Esquivel came out after about 7 hours and told me that they almost closed Ken up and let him go but because of his age, 45 years, they decided to go ahead with it.  I would absolutely recommend Stanford as a place to go for anyone needing a specialist.

Terri

Re: possible resection/liver surgeons? dealing with ascites?

Hello cmsmith,

I believe in gathering as many opinions as possible in order to make informed decisions.

This is one more liver transplant surgeon with extensive experience.
Dr. Jenkins at the Lahey Clinic in Boston.  I assume you have records on hand such as any abdominal imaging reports & CD (or films),  Hospital records, pathology, operative reports, labs, doctor

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: possible resection/liver surgeons? dealing with ascites?

I just found this on another site, It can't hurt to contact the doctor who performed this surgery and get his opinion for your dad.  http://www.curedoflivercancer.com/
Colleen

Re: possible resection/liver surgeons? dealing with ascites?

Hi, my husband age 52 also repeatedly turned down for liver resection since being diagnosed in May of this year. They are still so young.  Sounds like these two have some things in common.  Our 2 children are 16 and 19 and I can tell by your writing, you're probably older??  I'm glad your Dad was responsive to the chemo. Charlie was also, but towards the end of 2nd cycle, it was very hard on him too.  He was on Gemzar alone and the tumors are stable, no shrinkage, no growth.  Desperately researching other options, I'm sure you all have been too.  Univ. Pittsburgh also turned my husband down.  We've never been given a cm measurement, but the whole left lobe of Charlie's liver is full of tumors.  E-mailed UNC about Cyberknife, got a call from Dr. Morris that his tumors were too big for that, but referred me on to Dr. Hanna Sanoff for consultation.  She also said no possible resection.  We were looking in to SIR spheres at Wake Oncology when we got a call from UNC that his case had been presented to the tumor board and a surgeon was interested. Laparoscopy performed by Dr. Ben Calvo to see as much as he could before proceeding.  After many trips to Chapel Hill, we met with Dr. Mauro for chemoembolization consult and this should be performed within a week or 2.  He is going to specifically target a small amount of tumor that is bulging out into the good lobe and try to shrink that. In 4 to 6 weeks, if all goes well, will perform complete left lobectomy which is major surgery.  There's a tiny bit of tumor in the right lobe also.  Possibly this can be more well managed after left lobe of tumors removed or maybe small enough for Cyberknife?? I don't know why Charlie's case caught Dr. Calvo's eye.  We just thank God for it.  What does it take?  Someone willing to take a risk, someone more skilled...I just don't know.  All this came about because of a simple e-mail about Cyberknife at UNC and went from there.  Are there not that many skilled surgeons out there willing to try things?  We have told every doctor we've met with from the beginning that even a few more years is better than the standard 6 months, so please try something.  It drives me crazy.  I think about all the people suffering from this and wonder if a surgeon somewhere would just take a chance...go a little further before saying No.  We're so grateful that UNC is willing to try this.  Sometimes I feel like they turn us down too quickly thinking the tumors are too big or there's cancer in both lobes or it's going to recur anyway and you'll only get a couple more years.  Well, we'll gladly take those couple of years. 

I guess that's why I don't post more often because I vent my frustrations (and it felt good) as I know you and your family are also frustrated. 

More opinions are always good.  I'm not sure where you live, but our experience at UNC so far has been great.  I also know that each person is a totally different case with size of tumors, where they are, etc., etc. so must be looked at individually.  It seems that each case of cc is so different!

My best wishes for your Dad, you and your family.

Carol

Re: possible resection/liver surgeons? dealing with ascites?

Dawn had her resection done at Rush University Hospital Chicago. Dr Stanton Dodson, a liver transplant specialist that did over 200 Liver transplants in 2005. Another respected gastro surgeon in this area is Dr. Kevin Rogin at the University Of Chicago Hospitals. We have met him and he did some exploratory surgery for Dawn about six month ago

Re: possible resection/liver surgeons? dealing with ascites?

If have been turned down for resection, if your doctors say there is now hope, if you want to live, go to www.curedoflivercancer.com!