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liver Mets 5 lesions
john75
Posted: Friday, January 09, 2009 5:47 AM
Joined: 1/9/2009
Posts: 3


Dear Doctor

My dad is 71 fit and well and live in the UK.Had his bowel cancer resected in 2006 and had 3 lines of chemotherapy. He is on his last NHS chemotherapy before there is no further treatements unles he goes private to have monoclonal antibodies.He has 5 lesions only in the liver,1 lesion is about 2cmx2cm,2 are about 3cmx4cm and last one is 4cmx6cm. The oncologist said surgery is not possible are the lesions are too spread out and ablation requires the lesions to be <5cm. I have read about cyberknife and was wondering whether it could be an alternative.

I have heard there is one in London and is new. We are willing to travel

Does it matter where you go? If we went to the US which is the best center for my dads condition. If CK is not suitable can they still use it to shrink the lesions to enable him to have more time with his loved ones? otherwise will monoclonal antibodies help to shrink it further before CK if there are too many lesions for CK?

Does the cost vary between countries?Whats the appropriate cost?

Thanks

 


radsrus
Posted: Friday, January 09, 2009 2:21 PM
Joined: 10/10/2008
Posts: 4435


That is a lot of tumors. I think we would be willing to treat such a person but not all centers would. Even for us, it would require a great deal of consideration and planning to be sure it could be done safely and that it had a chance of being effective. Another option might be radiolabelled spheres.


 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


john75
Posted: Saturday, January 10, 2009 12:48 AM
Joined: 1/9/2009
Posts: 3


Thanks for the quick reply. I was a little put off with Germany saying that there is too many lesions and UK saying it may not be an option.Those measurements I gave your of the 5 lesions were at the start of 3rd line chemotherapy in October 2008 after 6 months no chemotherapy!His is due to finish his 6th cycle at then end of January 2009 and will be scanned so the lesion sizes will be updated hopefully smaller.
What kind of sizes are other centres confortable with?The UK say 1-4cm is possible but any larger CK may not be an option but then again they are a new centre.
I will be seeing our oncologist in Mid February how should he contact you?via letter/phone?
Also what is radiolabelled spheres,what does that involve? 

radsrus
Posted: Saturday, January 10, 2009 6:38 AM
Joined: 10/10/2008
Posts: 4435


We don't have  a definite limit on size, just a judgment as to the chance of success and the risk.

Radiolabelled spheres have either glass or plastic spheres containing a radioactive material that are injected into the hepatic artery and go to the tumors and irradiate them from the inside.


 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


john75
Posted: Sunday, January 11, 2009 5:47 AM
Joined: 1/9/2009
Posts: 3


Thanks for your quick reply again

Gayle Ferraro
Posted: Sunday, March 08, 2009 10:24 AM
Joined: 3/8/2009
Posts: 1


My  husband has 5mm liver met Talked to a RFA Dr. and he was not a candidate for it.  Was told to close to vital organs a 5mm liver met was to close to a biliary duct. also a 4cm in adrenal bed  a 1cm near pancreas a 1cm near remaning left kidney.  Has Kidney cancer  clear cell.  Did Sutent ,did not work.  Now they want him to try Nexavar  Trying to avoid drugs.  Before Sutent only 1, 3cm met in adrenal bed. after 3month  we now have 4. Thank you
radsrus
Posted: Sunday, March 08, 2009 11:17 AM
Joined: 10/10/2008
Posts: 4435


Any of those things could be treated but I would question whether it makes sense there is is almost certainly othr disease we don't know about. If something becomes symptomatic, then I think treatment would be very reasonable. I certainly would not treat a 5 mm liver metastasis when there is a 4 cm adrenal mass that is much more likely to become symptomatic.

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


chandra51
Posted: Friday, May 29, 2009 2:19 PM
Joined: 5/29/2009
Posts: 1


My friend has liver metastatis in the liver with the largest size about 9,5cm. The site of the primary is unknown. Is he a sutable candidate for the Cybnerknife. Pl. replæy.

Thanks & regards from SWEDEN



 


radsrus
Posted: Friday, May 29, 2009 3:20 PM
Joined: 10/10/2008
Posts: 4435


That is a very large tumor. Chemotherapy might shrink it somewhat and allow for safer treatment. Also, it is important ot know how many there are. What did the biopsy show?

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Kart
Posted: Tuesday, September 29, 2009 8:14 AM
Joined: 8/26/2009
Posts: 3


Hi, Which are hospitals having Radiolabelled spheres treatment in india ?
radsrus
Posted: Tuesday, September 29, 2009 8:48 AM
Joined: 10/10/2008
Posts: 4435


Sorry, but I don't have any way of knowing that.


 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


antonwong
Posted: Thursday, March 31, 2011 2:55 AM
Joined: 3/31/2011
Posts: 4




Anton
antonwong
Posted: Friday, April 01, 2011 1:07 AM
Joined: 3/31/2011
Posts: 4




Anton
antonwong
Posted: Friday, April 01, 2011 1:15 AM
Joined: 3/31/2011
Posts: 4


Dear Doctor, My mother was diagnosed with colon cancer in May 2010. She had a successful colon resection the same month but already had liver mets and a few small nodules on the lungs. 9 months of Chemo (Folfox with Avastin) showed some reduction in the liver but the most recent scan shows some progression in the liver. Currently on Avastin only. The last scan showed 4 lesions- Left lobe measures 2.1 x 2.3 x 1.7cm in segment 3, two lesions in segment 6 measure 4.5 x5.4 x 4.7cm and 3.5 x3.8 x 3.3cm and the lesion in segment 5 measures 3.0 x 2.8 x 2.4cm. I would be grateful if you could advise if CK is an option as my mothers general health is excellent and she can travel to secure treatment at the most appropriate facility. Many thanks in anticipation. Anton

Anton
radsrus
Posted: Friday, April 01, 2011 3:21 AM
Joined: 10/10/2008
Posts: 4435


She might be better treated with radiolabelled spheres because of the number of mets and the presence of lung mets

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


Dr. J
Posted: Friday, April 01, 2011 3:30 AM
Joined: 10/11/2008
Posts: 1070


I also would not advise CK in this situation.

 

Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828

 

Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717


antonwong
Posted: Friday, April 01, 2011 6:23 PM
Joined: 3/31/2011
Posts: 4


Thank you for your prompt reply. We are in Australia and already have an apppointment with a Doctor who uses them. Should the spheres help in reducing the size of the liver tumors would CK then still be an option?

Anton
radsrus
Posted: Saturday, April 02, 2011 4:35 AM
Joined: 10/10/2008
Posts: 4435


It would depend on the details of the lung tumors - number, size, locations etc

 

Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org

Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102

 


 

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