Ablation vs chemo for liver tumour

Can anyone advise me if they have been in same position.  I had bowel cancer with 2 tumours in liver.  Stage 3.  All was taken out in surgery last year - 148 lymph nodes clear then i started the belts and braces chemo of oxyplatine and capecetimine bills for six months.   Under 11 months post chemo a 16mm lesion has appeared on my liver.  Petscan reveals nothing anywhere else.  I have both a private surgeon and nhs .  The private surgeon recommends ablation and chemo x 3 months.  NHS want to just go with chemo - and after 2 months scan me again.  My big concern/confusion is why would they not want to ablate either it hasn't really been explained to me clearly and the cynic in me thinks it boils down to money.  The key thing is the tumour is small enough only over next 3 weeks to be ablated so i have a small window to make my mind up.  I can start chemo next week and hope it kills off current lesion and of course any pending cells.  But was going to do chemo anyway after ablation at least that way forward i know that particular lesion has been targetted and killed pre chemo.  Any advise for anyone who has had this dilemma vey welcome.

  • Hello there and thanks for posting,

    I am sorry to hear about your situation and appreciate making a decision about which route to take must be a difficult one.

    Every patient is different and decisions about treatment are made by a team of specialists in an MDT (multi disciplinary team) rather than by just one person. These decisions are based on the patient's circumstances and what the best treatment is for them.

    There are many factors taken into account when considering the treatment options and whilst cost is involved in the approval of treatments within the NHS, so is the clinical evidence available, about the effectiveness of a treatment. There are NICE guidelines about metastatic colorectal cancer in the liver, and the management of this, and they do mention that RFA may or may not be useful, with or without liver resection surgery. In producing these guidelines, it demonstrates that there isn't currently a lot of published data, or many available previous published medical studies to draw from. So, there is a somewhat lack of firm evidence either way for RFA use with or without surgery, or chemotherapy. So, it isn't a clear clinical picture. Clinicians do try and steer a treatment course, based on their patient's individual circumstances and best interests. 

    I hope you are able to get a better understanding soon so you can make the decision for yourself.

    All the best,

    Naomi