Boris

Some of you may not be aware but I have been dealing with metastasized breast cancer during this past two years.  After my mastectomy in 2009 I had a tumor discovered on my S1 vertebrae within 9 months of finishing chemo and radiation for my breast cancer.  It was radiated and left a hole in the bone, but not enough to compromise the structure of the vertebrae (it was 4.4 cm big).  This happened in May of 2010.  Then in February 2011 I had emergency gallbladder surgery and the surgeon discovered a couple of tumors on my liver.  Fortunately he took a biopsy of the tumor and it was confirmed to be breast cancer cells on my liver.  This is good as breast cancer is easier to treat than liver cancer.   After another PET scan (which I now get every 3 - 4 months) there seemed to be only two tumors on my liver.  In June 2011 I had a second PET Scan and we were surprised to find that my S1 vertebrae lit up and they could see a third, but microscopic, tumor on my liver.  Below is the conversation I shared with my family this last week on what we think is going on with Boris.

My oncologist had the opportunity to sit with the radiologist and compare my last two PET scans and discuss them.  He called me last night to share with me what they observed and his opinion on the situation.   It appears that the third microscopic lesion that was discovered on my PET this month was probably in the PET Scan I took in March.  It looks as if there was swelling from my gallbladder surgery and that the microscopic lesion was not visible in March, but was probably there.  Since the other two lesions that were visible did not grow, they are assuming that nothing has changed since my last PET Scan.  This is really good news.  The tumors are not growing, but they are not shrinking either.

My S1 vertebrae did have enough contrast on my June PET Scan that showed up which appeared that there was some metabolic activity in the lesion where I had the tumor.  That said, about 7 weeks ago I had a really hard fall at home in my bedroom and my tailbone and lumbar region has been so sore that it was painful to sit on my bed or even the couch for a month.  Yes, I fell directly on my rear.  I know you are laughing.  The hardest part was telling my oncologist how this happened.  LOL Anyhow, with this knowledge, the radiologist and my oncologist agreed that the fall could have aggravated the region to cause this activity to show up on the PET Scan.  The concern was that the tumor was once again active, but because of my fall we are going to give it a chance to heal.

My oncologist wants to wait to see what the August PET Scan has to show before we consider a next move on this monster that lives within me.  BTW - I've named my cancer Boris.  Unfortunately my doctor has a cousin named Boris!  We had a good laugh over that one.  In the mean time, I am going to continue with the Zometa and the Fosladex until August.  At that time we will re-evaluate.

One of the option my doctor mentioned if the tumors do not change is to perform a Radio-Frequency Ablation of Focal Tumors.  This would be an alternative to having a surgery where they go in and remove part of my liver where Boris has taken root.  I've found an article that describes this procedure and I've cut and pasted it here so you can check it out.  Like I said, this is only a possibility if the Fosladex is working and we just need to get the tumor's removed.  Note that this article refers to liver cancer originating from that organ.  I just discovered that this procedure is also used on patients with metastasis (like me) as an alternative to performing a full surgery to remove the tumor(s).  What is left behind is scar tissue that eventfully goes away.  You can search to learn more if you like.  The big question of the day is, if I need this procedure, will my insurance pay for it.  The doctor will be checking this option out – just in case 

As for me, my spirit is in God's hands.  I have decided to let the light and love of the Christ's internal flame from within me destroy Boris.  Well, this and an organic diet will help too.

Stephanie

Radio-Frequency Ablation of Focal Tumors

From a University of Wisconsin web site.

I. Overview

Radio-frequency ablation is a minimally invasive treatment for focal cancers (cancers limited to one area of the body). Radio-frequency ablation destroys tumors with localized heat from electrical energy. After the patient has been sedated, the physician inserts a special needle through the skin. (Unlike a catheter, the instrument does not travel through a blood vessel.) Using CT or ultrasound imaging technology, he or she maneuvers this instrument into the tumor and activates an electrical circuit that generates intense but localized heat. Because the heat is generated within the tumor, surrounding healthy tissue is mostly spared.

This procedure can be performed under local anesthesia but is usually performed under general anesthesia, to eliminate the possibility of pain during treatment. Patients generally stay in the hospital overnight, but many go home the same day. They can usually return to work in one or two days. Side effects include soreness at the site of the puncture. Rarely, the puncture site can bleed. If heat is released near the diaphragm (which divides the stomach from the chest cavity), the treatment can occasionally cause hiccuping that lasts several weeks.

II. Medications

General anesthesia is administered during the procedure. Pain medications may be given afterward.

III. Considerations

Patients with focal tumors who are not eligible for surgical resection (removal of the tumors) should consider this treatment. Very large tumors (those greater than 4 centimeters in diameter) can be difficult to treat fully with this technique. Determining which treatment is right for an individual patient is a complex process requiring consultation with many different specialists.

IV. Effectiveness

The efficacy of radio-frequency ablation varies with tumor type, size, and location. The technique has outcomes similar to those of surgical resection for appropriately selected tumors. In one study of radio-frequency ablation for liver tumors, 94 percent of primary tumors (those originating from within the cancerous organ) had not grown back 10 months after being destroyed by the treatment. Radio-frequency ablation can be used in combination with chemoembolization for liver tumors, which may further improve the outcome. (Radio-frequency ablation can penetrate to the center of tumors, while chemoembolization is most effective on the outside of tumors.) One study showed only a 2 percent recurrence of primary liver tumors one year after such a combination therapy. For background on liver cancer and the range of treatments available, see the E-Health article on chemoembolization, as well as this article about the multidisciplinary Liver Tumor Clinic at UW Medical Center. (Radio-frequency ablation is also used to treat cancers in organs other than the liver.)

V. Risks of Treatment

In addition to the rare side effects mentioned above (bleeding and hiccuping), there is a small risk in undergoing general anesthesia.

VI. Risks of No Treatment

Focal tumors that receive no treatment are likely to grow and spread. Depending upon tumor type and location, such progression can lead to significant complications or death. With treatment, the risk of progression may be reduced.

VII. Urgency

Cancer should be treated as soon as possible.