Hello  Lexi9,

                      pleasing to read from a different post that husbands bowel op went well. 

l think you may be unduly upsetting yourself with the news that your liver consultant feels able to treat liver mets by chemotherapy. Personally speaking l would have considered this a result without the need to resort to invasive surgery.

Given that the results from the chemo treatment will be carefully monitored to ensure it is having the desired effect, any shortfall would be picked up quickly and then surgical intervention could be considered. Also given that surgery has proceeded without pre chemo, it would seem prudent to knock out any stray cells before going into more major surgery, which may prove not to be required.Should the worst case scenario occur and the liver spread continue, at least things would have been damped down allowing surgery to take place.

Reading your earlier posts it would seem that the cancer was caught early on, and suggestive of a slow moving version that has not deeply embedded within the liver. Biopsy of the bowel tumour and monitoring of the liver would confirm this.

l also think it is correct to say that chemo can take out early stage cancers on the liver without resorting to surgery, and lead to a permanant cure. 

l think it is a good idea to raise specific questions to the consultant via writing to his secretary which l am sure he would answer in detail to put your mind at rest.

What you perceive to be a negative,. l would very much hold the opposite view and feel things would be much more serious and closer to the edge if surgery was required. Having been under knife with all the subsequent challenges arising from that, avoidance to get to the same result of successfully crossing the finishing line seems like a real bonus.

Good luck to your other half as he navigates chemo as it goes to work doing its worst to both good and bad without fear or favour,and all unwanted guests are duly evicted in the major spring clean,

                                                best wishes,

                                                                         David

Hi David. 

We finally managed to speak to someone and have a better idea of the plan 

They explainwd that it is standard practice for secondary liver cancer to do surgery first to deal with the primary tumour  (which has now been done) then chemotherapy to ensure that if there are any cells lingering that don’t show up on a scan that they get them first rather than moving to surgery and then doing chemo as by the time that starts with time to recover then if there was anything there it might have started to grow a tumour in another place and that wouldn’t be great obviously.
 

So, they do chemo and what that will do is either 1. shrink the tumours 2. stay the same size 3. get rid of them completely (because they are so small that may well happen) or you don’t respond to that chemo at all and they get bigger (but hopefully that wouldnt be the case).

If 1 or 2 happens they then move to surgery after. If 3 happens they hope that will be it and they won’t return. They say this can happen and cure but sometimes they do return - just can’t be They will then at that stage probably monitor him to make sure they don’t return but if they do then maybe surgery happens then - in all likelihood they would come back in the same place but the hope would be they wouldn’t ever come back.

The tumours are at this moment in a place where surgery is possible. One tumour is near a vain that if it got too big they wouldn’t be able to operate but they don’t think that will happen as chemo should start to do one of the 3 things I mentioned above.

I think in our heads we would like them to shrink but maybe not to nothing as surgery would be the best way of knowing that we def got it all. They said that even if a spec of an amount is left they can operate but if they can’t see anything then they obviously can’t operate as they can’t be sure of the area they are resecting.

The type of chemo and when it starts will depend upon the biopsy results that come back from the tumour that was removed and we expect that to be discussed on the 23rd March, so we won’t know anymore info until then. The hope is that it’s not an aggressive form and in the meantime those tumours haven’t grown or any others cropped up anywhere else! 

We feel much better knowing this plan but just want him to get started on chemo ASAP so we can make sure those tumours don’t grow or anymore pop up anywhere else

Thanks so much for coming back to my post! 

Hello Lexi9,

                   its good to hear that you are now clear in your own mind of the reasons and options of your treatment plan.Although it does not seem so at first, it is reassurring to know your MDT are all over your case.

l sympathise with your desire to get on with chemo asap, but a little time off for good behavior to rest and recover from surgery before getting a hammering seems reasonable. l would have thought by 6 weeks all  being well. Remember the need not to get dragged down too hard too soon in case further surgery gets pulled forward.The good news is that your care team will be monitoring this to give the best possible journey through the treatment.

It seems that you have made a good start, little steps that keep moving forward is the key, and the biggest impact you can have is to try to keep the stress to a minimum to allow the body to concentrate on the healing process, l cannot overstate the importance of this, l found focusing on the what can be, and forgetting the what if's worked well

tread softly and be gentle with yourselves,

                                                                       David

Hi David. Hospital rang with pathology results. 6 out of the 17 lymph nodes that were removed from the colon have signs of cancer. 1 of them is towards the end of where they cut out and rejoined so even if it had not spread to liver he would be suggesting chemo to make sure it's not spread beyond that point as they can't be sure. It’s also shown up in the blood vessel. I'm assuming that's the one to the liver?! We have an appointment with the oncologist on Thursday at 12.30 to discuss treatment plans, what it all means and next steps. Not sure what to think really. Not great re lymph nodes as we thought might have spread via blood vessel to liver? Now worrying about where else it might have spread as in the nodes but that's probably something we will never know unless if materialises! Was there any cancer found in your nearby nodes on removal of tumour? Do they ever know how the cancer got to the liver? By nodes or blood, or do they just never know that? Should be able to ask all these questions next week hopefully! The rollercoaster continues... 

Hello lexi9,

                    the rollercoaster goes on but at least you are getting more information as you travel.

             l had one infected node next to the tumour and goodly few removed at surgery. As for spread to the liver the biggest suspect would be via the blood given the large bloodflow interchange from the bowel. The node was noted as inflamed at the initial colonoscopy on christmas eve. l then had 6 weeks of chemo and radio through jan-march.Bowel surgery scheduled for june, but pre surgery tests picked up something on the previously clear liver. l was rushed to a super scanner that confirmed spread, and had surgery switched to liver first which the consultant pointed out that given the rapidity of spread and siting within the liver,left for a few more weeks would have made surgical intervention impossible. So the spread through the lymph system was slow and limited in my case,but the chemo/radio may well have been responsible for that.As in all things, its the little things and timing that can make such a difference to the end result.

One thing l would advise is to write down all your questions to take to your consultation, things have a tendency to get missed as your minds spin as you struggle to cope with all the new information coming at you. A printed itemised sheet to hand to the consultant at the end will quickly allow him to cover any points not previously addressed

It will be a weight off your minds to know your options going forward, you can cope with anything apart from the uncertainty,

   Hopefully your other half continues to improve from the effects of surgery,

                                                                                                                             David                                                                 

Hi David, I thought I'd give an update on things here. Last round of chemo started today and Matt has coped really well with the side effects! He has had neuropathy and upset tummy but has managed to continue working and doing DIY at home! I'm in awe of him. Things have been tough emotionally on and off and we are quite anxious about the scans and oncology appointments in July but keeping positive everything has gone as should have. They did mention half way through that his cea markers were at 2 but we have no idea what that means as don't know what they were before. Did you get yours checked? He has managed to have no delays and kept healthy throughout. Baby due on Sunday. Hopefully we can move to liver surgery next and then surveillance scans! Hope you are keeping well.

Also, mri and ct scans are 3rd July but last round of chemo doesn't finish until 14 July (last tablet 7 July then 7 day break) is it oddor a bad sign they want to scan him before end of treatment?