Test of time

Hi Star74

I really don’t quite know what to say ! My mum did have an immediate recurrence but it all depends on perspective as it greatly reduced the tumour burden in her liver and the recurrence was significantly smaller that time . She had an extended procedure taking away 73% of her liver the second time  . She also had a significant spread at the start of treatment but no one suggested it was not a criteria for proceeding to surgery . Yes the recurrence was a disappointment but we always viewed it as a few steps to NED!

Her first liver resection was carried out at a large teaching hospital in the city ! The second one she moved over to a centre of excellence for the liver . Most of them do liver transplants. I think there is around seven of them in the U.K. . My mum’s oncologist at the time was not supportive of a resection so it really helped us to hear directly from them what they could achieve . I am not saying it was easy to listen to but I left with complete  trust and felt she had been fully informed in it’s entirety. The decision was her’s at the end of the day to make but it was a very informative consultation ,

My own opinion is if you still have unanswered questions then it’s important that you see what your options are . Could you chat it through with your oncologist again ?

take care ,

Court 

Thank you courtI must admit I was surprised, I presumed that good shrinkage would result in surgery.  My oncologist said its shrinking beautifully and the scan pictures are amazing. I'm happy to stay on the treatment and am coping well with it but feel a bit in limbo.  What if it grows during this break, does that mean he'll refuse to operate?! 

I will have a think and process the information from today but I'm tempted to ask for a second opinion.

It is certainly a new one to me too! Your oncologist sounds helpful and you could certainly chat through the benefits of a second opinion with her !

There was a young breast cancer patient who had to prove stability. I have never encountered it before on the bowel forum but it may be current practice I honestly don’t know but your oncologist would know ! I also think that is  a relevant question . You could email that to the surgeon to see if that is the case ! 
These are such difficult situations stage 4 patients are faced with but the positive is your oncologist sounds very good and could help you navigate this . 
Take care ,

Court 

Hi Star74

Another thing has been playing on my mind since you posted and after a bit of thought I think I am going to say it ! My mum had two lots of chemo over two years . Six cycles each . I credit as a contributing factor to her longevity. However after the second year the liver surgeon said there was a window of opportunity to do the surgery as there was some evidence that her liver was starting to show signs of having had chemo . He wanted to do it before that increased ! Not that she would not be able to have years more of chemo but there was a tipping point for surgery ! Again I don’t know how important that was but it was part of the decision my mum had to make at that point in time.  Given this has not been mentioned to you it may be that it is not at all relevant to your situation. My mum was 69 which could be part of the reason to proceed at that juncture ! My mum was a top responder to chemo and we could see why the oncologist wanted to keep her on it ! We got it ! But we also wanted to see what the surgical team was considering .

You have time to Wade through this and you are in a strong position being so chemo responsive ! Also good to have options ! But thought I would share this aspect so you could just check it out with your oncologist . 
Take care and whilst you are in a strong position responding it does being other headaches with it but in a good way !

Court 

Hi court

Thank you so much for sharing this, it's an important point and one I hadn't considered.  I will certainly bring it up with my oncologist.  

I definitely get the impression she disagrees with the surgeon, she has said in the past as soon as we get enough shrinkage she will get me straight in for surgery.  She also made it clear that the break is the surgeons suggestion and she seemed pleased that it will be discussed further with the liver team.

If the result is the same following the discussion I will ask her if we can get a second opinion.  

Actually, do I need to arrange a second opinion or is it something my Onc will arrange?

Thank you again for your insight, such useful information, as always!

Best wishes,

Michelle 

Hi Star74

Your oncologist should be happy to help arrange a second opinion , if not your GP will. 
I was concerned to raise it as it may have been a factor that was only relevant to my mum but given the circumstances I thought it might be better for you to enquire just to be sure !

I think you will get more information from the liver team that will resolve this !

Your oncologist sounds very supportive and that’s wonderful. I really do think there are some complex clinical decisions but I get the feeling you will only head in a direction when you are confident it’s the right one for you and that’s a great way to be . Getting all your information together to make an informed choice . 

Also to put your mind at rest a bit . There was around a two month delay from my mum finishing chemo , gathering scans and eventually getting a surgery date ! She was still able to have surgery ! 

Have a good day !

Court