If I were you ,unless your tumors sizes shrinked enough to allow surgical resectionn BOTH lobes--which I really doubt at this point that resection is the choice before you have the radioembo treatment.I do not know how the surgeon can resect both lobes in your situation since your disease state involved both lobes. So logically ,I will have the radioembo treatment first; the surgical consult at this point before radioembo may not provide you any addition info with regard to resection possibility for you now. Your have one big one on one lobe and some small ones on the other. and I think radioembo is currently the best treatment options for you besides the clinical trials that you have now,
BTW may I ask are you stiil on that clinical trial and what is the result of the most current scans showed about your tumors?What % of the shrinkage of the tumors?Are the little ones COMPLETELY gone? if so you may ask the surgeon to get rid of that one by resection first and leave the big one for radioembo later; But it does not make senses to me to do so. I still believe radioembo for treating both lobe is a good choice for you now unless contraindicated.
It will not hurt to have a base line(MRI or CAt scan) now or withing 4 weeks before your radioembo to compare with the later scans;anyway if I understand correctly, you may need to be off the chemo for 4 weeks before you can have the radioembo.
Resection after radioembo may not be needed depends on your condition.But if you are healthy enough ;you may consider it too but if the CCA recur,for myself,I will re-radioembo or RFA or have SBRT before consider surgery as it is easier to take . I will only explore resection if it is the only option available .
Re-radioembo maybe the choice of treatment if the location of the tumor,the state of your health(ECOG scale 0-1)and the size of the recurrence tumor
(eg</=25%) is in your favor ; it can provide a long term survival .
As you know ,even you can have surgery for the CCA ;you know that CCA can come back even after you have a good and clear margin . I have clear margin(1.5cm) after resection but the CCA came back after 14 month of Gemzar and 6 month off chemo.
Please keep me inform, we are actually in the same boat but just different in timing of boarding ;and if I may say so,my friend , under the available current medical advancement ,it is not how soon we can go abord with a cure on hand ,but it is how much we can do while the boat is still floating .
Do I make any sense to you? good luck and
Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.