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Liver resection following bowel cancer relapse

28 May 2015 15:08

Hello,
My boyfriend was diagnosed with rectal cancer last summer- he was 41 at the time. He underwent chemo radiation and then a seemingly successful op. He was given the all clear and told the cancer was moderately differentiated at T3 N0 M0. We were delighted and could begin planning our lives again.

However, his first scan has just shown 3 tiny spots on his liver. The doctors carried out an MRI scan and they have confirmed that he now has metastasis. We are devastated. He is due to start 2 months of chemo on Monday and will have a liver resection in August, followed by more chemo.

We have Googled and it seems that there is a chance of cure with surgery, but I wondered how common this is. I have been trying to find someone who has gone though something similar and it's troubling me that I can't.

I am 28. We were planning to get married next summer; we are now wondering how we can go about planning our lives with so much uncertainty.

Any advice or info would be really appreciated.

Thanks.

Re: Liver resection following bowel cancer relapse

28 May 2015 16:50 in response to Miss.mase

Hi, I'm sorry to hear this :(. I take it ur partner had all mri, ct scans etc when they descovered the rectal cancer? Was nothing spotted then? I'm only asking as 6 wks ago I was diagnosed with rectal cancer , I due to start chemo/radio at any time now & due for the op in bout 12 wks, they said the tumour was confined to the rectum, .I'm sure use are devasted, I'm getting scared myself to know that this can happen:0 . Xx 

Re: Liver resection following bowel cancer relapse

28 May 2015 17:08 in response to kat32xo

 

I'm sorry to have made you anxious, I think my partner has just been really unlucky- from what I can gather the chances of this happening when it hasn't even reached the lymph nodes are quite slim.

His scans have always been clear, aside from the rectal tumour, up until this point so it was a complete shock. 

Everyone is different and I think we've just been really unlucky. Sad

Try not to worry- things are in your favour. I spent a whole year worrying about this happening and after he was given the all clear last November, I decided to stop worrying and just enjoy life. What I've come to realise is that all my worrying and despair has changed nothing, except my ability to enjoy my life. 

Good luck with everything Happy x

 

Re: Liver resection following bowel cancer relapse

28 May 2015 18:40 in response to Miss.mase

Awful for use to have more bad news like that, although ther is a real good chance of a cure for liver aswell , just more stress & bother to go along with it :(. I no it does happen ,just hearing it from some1 it really hit home , ur partners so young also. & ur rite worrying ur self can't solve it, it's hard not to sometimes , . :(. Hoping everything goes smooth for use & u get ur big day soon xx

Re: Liver resection following bowel cancer relapse

28 May 2015 21:49 in response to kat32xo

 

Hi Miss Mase.   Welcome to the forum but I am so sorry to see what has brought you here.  I hope I can help a little although I have a different type of cancer which has spread - breast cancer (which behaves differently to bowel cancer where mets is concerned).  I was diagnosed with mets to the liver in 2012 and was one of the first  BCpatients to have a liver resection - in my case to prolong life rather than cure the disease (although there was always that chance too).  There is also a lady on the forum who has bowel cancer and underwent a liver resection when it spread there  -  her name is Jo (Meerkat) - I have her email address and will ask her to post on this thread.  In my case (as I say - BC behaves differently) I have had further tumours in my remaining liver - but I have had them ablated by Nanoknife - I now have two more and they are due to be ablated in June.  There are several different methods of ablation and it may be worth asking if this is an option instead of a resection if the the tumours are only small - it is a very easy thing to go through in comparison to an operation and obviously leaves you with more choices in the future should more tumours appear.  I will have a look online for you to see if I can see any links re rectal cancer and please also remember that the nurses here on the site are brilliant at getting information for you.  You can ring them on the number shown at the bottom of the page (freephone) Monday-friday office hours.  I am happy to share any info on resection, just shout, and if you prefer to talk privately let me know and we can email.  Love to you both x

Re: Liver resection following bowel cancer relapse

29 May 2015 17:12 in response to Miss.mase

Hi Miss Mase, 

As promised, Max emailed me and suggested I pop a comment on your thread. 

I'm a little older than your partner, but just like him, was found to have mets in my liver. Just to say, the surgery I had (liver resection) removed 40% of my liver, but after a few weeks, I felt pretty much back to my normal self - had to remember to watch what I got up to! As Max has suggested, ablation may be worth investigating as an alternative option. In my case, the surgeon felt surgery would suit me best. If you want to ask any questions about the surgery, please ask away. 

I love your attitude to 'stop worrying and enjoy life' It takes a while to master the art, but I think I'm there now, too! 

Take care, Jo xx

Re: Liver resection following bowel cancer relapse

31 May 2015 09:56 in response to Meerkat@65

Thank you all for your messages. I really appreciate your kind words and hearing about your experiences. No one mentioned ablation to us. From what I can gather, surgery is the most successful option(?) I could be wrong though.

Jo, thanks you for the reassurance about the surgery. I'm glad the recovery didn't take too long. My partner had his bowel resection in October and then stoma reversal in Jan and to be honest, it's only in the last month or so that he's started to feel himself again. He was just getting everything back to 'normal' and then we got the news about the liver mets. We really thought we were through the end of the tunnel before that happened. We always knew there was a chance it could come back, but i think we, and the doctors, were under the impression it was unlikely.

Jo, if you don't mind me asking, did you have chemo before and after your liver surgery? Did they say there was a chance of cure before they operated? Sorry to ask, and please don't worry if you'd rather not go into details.

Thanks again everyone!

Claire x

 

 

 

 

Re: Liver resection following bowel cancer relapse

31 May 2015 12:48 in response to Miss.mase

Hi Claire,

I don't mind you asking at all. I didn't have chemo before or after my liver surgery as I'd shown an intolerance to it after my bowel resection op. I'd coped with it prior to the op (had chemo/radiotherapy for five weeks prior to surgery) then, after the bowel resection, tests showed 1 out of 3 lymph nodes affected, so it was a 'belt and braces' approach to have more chemo. I only managed 2 infusions (Oxaliplatin and Capecitabine) before we realised chemo was not for me! 

Further scans showed I also had lung mets, so I was told that the liver surgery would not 'cure' me, but certainly prolong my life expectancy. Remember, everyone is different so I hope my post doesn't worry you. I would have had chemo before the liver op if it had been an option. Most recent scans have shown that my liver is still Cancer free, so I consider the operation was successful and worthwhile . 

I can appreciate that your husband took a little while to recover after his stoma reversal op - I understand from a friend who's just had one, that she's found it a steep learning curve to readjust to her 'new' plumbing. 

Let us know how things are going for you and your hubby and if it helps, keep asking! 

Jo xx

Re: Liver resection following bowel cancer relapse

1 Jun 2015 17:39 in response to Meerkat@65

 

Thanks so much for your reply Jo.

I'm glad to hear the liver op was worthwhile but so sorry to hear about the lung mets. How are you now? Did they know about the lung mets before the liver surgery?

My husband had his first chemo today. He seems to be ok so far. He has another 3 x2 weeks cycles to go. They've said he can have a 3 week break (we'd already booked a holiday before this all happened) and then surgery. In our last consultation she seemed quite confident that the resection would remove all 3 spots, but I thought she seemed a bit noncommittal today when I asked her about the plans for the op. Maybe I'm being paranoid but she said that they don't make any decisions on surgery until after chemo. She said he is definitely down for surgery but they might do other things too. As far as I understand it, surgery is the only possible way they can 'cure' liver mets(?) ablation isn't as effective I think?

I know I need to prepare myself for all eventualities, but right now all I can do is hope and pray they can get rid of it because otherwise I find it impossible to cope.

Thanks again for your message Happy xx

Re: Liver resection following bowel cancer relapse

1 Jun 2015 18:50 in response to Miss.mase

Hi Claire, 

You and your partner will probably find yourselves mentally 'ticking off' the chemo sessions (I know we did with the chemo/ radiotherapy sessions!) it's great that you've already got a holiday to look forward to. We arranged little treats along the way during treatments and also had a mini break prior to my bowel surgery. 

Yes, my lung mets were found before my liver surgery, but they were few and very tiny. I've since had an op to remove some of the nodules. 

With regard to ablation versus surgery, I'm sure your partner's team will have considered the best option for his particular case. Although I did have surgery, my surgeon explained that if he felt it necessary or beneficial he would use ablation during my operation. I think I'm right in thinking that ablation can be used when tumours are close to main veins /arteries . (I didn't need to have ablation after all) 

I wish your partner all the best for his next chemo sessions and my advice to you both would be, take baby steps and deal/cope with things a few days at a time. 

Take care, big hug, Jo xx

 

Re: Liver resection following bowel cancer relapse

2 Jun 2015 17:06 in response to Miss.mase

 

Hello Miss.mase,

Thanks for posting. First of all, sorry for the delay in posting, we’ve been quite busy lately.   Meanwhile, you’ve had some really helpful and supportive messages.

There are different treatment options for secondary liver cancer and different types of ablation. If your partner has been recommended surgery in his situation as opposed to another type of treatment, I’m sure there are good reasons for this. It might reassure you to ask the surgeon to explain the treatment of choice a bit more.

Many factors are taken into account when deciding on treatment.  The local treatment of cancer spread to the liver (liver secondaries) is a very specialist area and I don’t have the experience or training to suggest why an individual would have one treatment in preference to another.  From my reading in this area, surgical resection of liver secondaries has significantly improved people’s survival and it is often the surgeon’s treatment of choice for people who only have secondaries in the liver and who are fit for surgery.  Chemotherapy before surgery is routinely recommended for some people in this situation.

Different types of ablation (such as microwave ablation or radiofrequency ablation) can be a useful as an alternative to surgery or as an additional treatment alongside surgery.  For example, combined ablation and surgery may mean that people whose cancer has traditionally been inoperable are now able to have their cancer completely removed.

Ablation or other local treatments for liver secondaries can be helpful in people who are not well enough to have surgery.  It may also have its advantages over surgery in cancer with a particular location.  For example, ablation may be more useful in treating deep seated cancers in the liver (because surgery to remove such cancers could require quite a large area of the liver being resected).

I’m glad you’ve had some posts from max56 and meerkat (Jo) because they can give you their experience.

I hope this helps to reassure you.

Take care,

Helen

Re: Liver resection following bowel cancer relapse

4 Jun 2015 13:23 in response to CRUK Nurse Helen

Thank you both for your replies Helen and Jo.

We actually live in France so fully understanding everything can be a bit challenging a lot of the time as most of what we have to deal with is in French.

I think we are both frightened to ask what they're aiming to achieve. All we were told is that the surgeon can remove all three spots, but they will start with chemo as apparently their studies have shown that chemo before liver surgery is the most effective. Since then i've read that chemo is usually only done to shrink the tumours; from my understanding my husband's tumours are so small that their concern is that they will disappear entirely before the surgery. The problem with that is that the surgeon then has nothing to visibily remove. They were trying to tattoo his liver but the lesions didn't show up on the scan so it didn't work. Anyway, our oncologist has assured us that the surgeon's don't think it will be a problem as the MRI will give them enough info to work with... it all sounded fairly 'ok' but then when we saw her next she said that no decision are made until after the chemo has been done. I don't really understand why they're unsure when everything seemed to have been decided based on the MRI.

I realise I'm not a doctor and should just leave things to the experts but I really like to know and understand it all and it's not always easy to ask people in the hospital here. I have tried to ban Googling for info- I think I was getting a bit obsessed with it. I need to find a way of 'switching off' because my entire life is just about cancer.

Anyway, sorry for the long internal monologue of my woes. Just feels better to write these things down and talk to someone who understands a bit.

Thanks again!

Claire

Re: Liver resection following bowel cancer relapse

29 Jan 2018 11:40 in response to Meerkat@65

Hi i know your post is few years ago and you may no longer need visit this forum .woyld you mind just answering couple questions please .i am waiting to hear of date for liver resection and operation for bowel cancer how long did you stay in hospital for was in open or keyhole surgery thanks 

Re: Liver resection following bowel cancer relapse

29 Jan 2018 11:52 in response to tigercub

Hi Tigercup, Meerkat sadly passed away in June 2016. Before my time on this site, but she was clearly a lovely person and very popular member.
Fabulous to hear that you are suitable for liver resection. I was hoping for that! And while you are waiting I hope someone else can answer your questions.

xx Harry

Re: Liver resection following bowel cancer relapse

29 Jan 2018 11:57 in response to Harry2

Oh dear that.is shame .docs are very pleased with response from 4 cycles chemo to reduce tumour on liver and they cand see tumour in bowel at all .so am waiting to hear from specialist hospital for surgery its not done at my local one .and they will discuss whether both surgeries together is possible ..thanks for reply