Oncology have come up with a new plan for me. There’s a bit of reluctance on both their part (and on mine too) to rush me back into systemic treatment. The two lesions in my liver are small and relatively stable following the Pembrolizumab. There’s no other evidence of disease. I have had a pretty rough ride since my immunotherapy related adverse event in September, am still weaning from the steroids, and still have some consequences in terms of kidney and lung function, and nerve pain. So I am being referred back to the interventional radiologist who ablated my first liver lesion in November 22, to see if either or both of the lesions are suitable for ablation.
So it’s yet another liver MRI so that he can look at the detail. Size matters, but also so does the proximity of the lesions to major blood vessels, bile ducts etc.
i have mixed feelings about this. The previous attempt didn’t buy as much time as I had hoped - by the time I was scanned 3 months after the procedure, the first lesion had reformed and I had a second one in another area of the liver. There’s obviously no guarantee it will work any better this time around - although the cancer is not growing so aggressively at the moment thanks to the pembro. It’s also a general anaesthetic on lungs that aren’t wholly well following the IRAE. It’s 2 days in hospital and a lot of stiffness and bruising. When I look back at my notes, it was 3 or 4 days of a lot of pain, stiffness and general difficulty moving around; a couple of weeks before I was pain free; and about a month before I had my energy back. On the other hand it might be more effective this time and it will at least delay decisions about more systemic treatment. That’s of course assuming the lesions are suitable. But probably my best plan.
