Need Advice! RadioEmbo and Resection…
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Eli,
That does make sense. We were wondering why they couldn’t just do a blood vessel bypass and cut out the damaged tissue, but the Dr said something to the effect that there wouldn’t be any appropriate tissue to reattach the healthy part of the portal vein to at the left lobe of the liver (the left lobe of the liver has no tumors).They could have done the resection right off the bat, before the tumor grew into the left branch of the portal vein, but he said it was likely that “cancer seed cells” may have been carried into the left “healthy” lobe of the liver already since the tumor was within a blood vessel. The goal of chemo was to kill these seed cells as well as to shrink the tumor thrombus away from the left branch of the portal vein. I think the surgeon wanted to preserve the left branch of the portal vein along with the left lobe of the liver. Now they say that won’t be an option. We are really, really disappointed (that’s an understatement!).
No blood thinners. No talk of blood clots (though I can see why thinning the blood may help if the vessel is narrowed, just to improve flow).
She is only on the standard Gem/Cis and the meds they give concurrent with that:
IV Zofran day of chemo, a neulasta shot day after chemo, ativan.She’s had chemo every other week. Chemo has definitely caused low blood counts from the very first tx (wbc’s early on and platelets last week) which have deferred chemo a couple times.
She hasn’t had problems with severe nausea or vomiting, so hasn’t had to take the meds given for home use for that.
This is just a guess and I may be completely wrong:
Radioembolization delivers a very high dose of radiation to a small area. Radiation damages the body tissues. The tissues become “dry” and brittle. It is possible that the damage to the surrounding tissues is bad enough that the surgeon might not be able to make the new surgical connections.
My wife had external beam radiation after her surgery. Compared to radioembolization, external beam radiation delivers a much smaller dose to a much larger area. I don’t recall who told us this – either radiation oncologist or the surgeon – but the message was that any subsequent surgery would be very difficult technically due to radiation damage.
Hi,
Is your sister on any anticoagulant like Coumadin, Lovenox ?
What other meds she is on now beside GEM/CIS?
God bless.Percy,
Thanks for sharing your experience. We really wish they gave her a choice of chemoembo rather than radioembo. My sister just turned 50 and has a young child and so much to live for. I do hope she will come through and be able to maintain much like Maria in Sweden has!Hi,
At this point just based on the info. from the message board your put up,
I think chemoembo is safer to use .
Radioembo,based on the last three members that I had close contact with,is not proven its value in treating cholangiocarcinoma. All of them passed away within 6months due to various reasons.
However all of those three patients are older than 50 years ; and it seems younger patients can be of more benefit than the older patients. My guess is that the younger patients can withstand the radiation better and have enough liver vitality to recover after radiation.
God bless.from that article:
“Tumor in the portal vein may have an appearance identical to that of thrombosis, but this appearance is far less common than others. Tumor in the portal vein is most frequently related to hepatocellular carcinoma. The thrombus may be partial or complete. It may be mixed with bland thrombus as well.”
Willow, sorry I cannot be of any help here, just wanted to let you know I am praying and cheering for your Sister!
Article on medscape about Portal Vein Tumor thrombosis
http://emedicine.medscape.com/article/373009-overview
Percy,
Sorry, I don’t have the report, but I did ask my sister for it. She said she would mail (snail mail) me a copy. I will send it to you via private email (rather than the blog), with her blessing. Percy, thank you so much just for caring enough to think about this one! Bless you, WillowHi,
is it possible for you to send me the CT scan report; (the impression section or the findings) through here or my email.?
I still not get the complete picture.(PS as you know ,I am not a doctor) but the reports is easier and more specific for me to understand .
God bless.it’s in the portal vein. Started in the right branch, very near the junction to the main portal vein. Grew into that junction and up into the left branch, all right at the Y (where the main portal vein splits into the left and right portal veins).
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