Metastatic liver lesion treatments

[D.ap]

Found a VERY simple easy to read article on liver metastatic treatments

http://www.cpmc.org/advanced/liver/pati ... ofile.html

[D.ap]

Josh and family are exploring 2 different procedures
One being Cyberknife radiation, and two being ablation by radio frequency ablation(RFA)
On reading the different articles it appears that radiation is a very strong candidate as it is precise and the possible side effects and complications of ablation can be by passed going the route of cyber knife .

The articles on RFA

Ablation of Malignant Liver Tumors
http://theoncologist.alphamedpress.org/ ... /1/14.full

Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959111/

This is a case study of a simalir RFA that Josh would have , as his liver tumor is located in his left lobe anteriorly. 4.3cm x 2.5cm.

Radiofrequency Ablation of a Solitary Liver Metastasis Complicated by Colonic Perforation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193340/
As Olga says , find someone with the most procedures and as important ,the most experienced to do the procedures

[D.ap]

-How Does the CyberKnife System Treat Liver Cancer?

http://cyberknife.com/cyberknife-treatm ... ancer.aspx


-Cyberknife Stereotactic Body Radiation Therapy for Nonresectable Tumors of the Liver: Preliminary Results

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905697/

[Bonni Hess]

Dear Debbie, Thank you for all of the important shared liver met treatment information which should be of special interest to everyone on this Board given the unfortunate nature of ASPS to frequently metastasize to the liver. I applaud your dedicated proactive efforts in researching and exploring the best currently available treatment for Josh's growing liver met, and Hope that a treatment decision can be made and the procedure done as soon as possible before Josh's liver met grows any larger. As you know, Brittany had an ASPS liver met successfully ablated with RFA ten and a half years ago. VERY thankfully the RFA seems to have destroyed the liver met and there has been no reoccurence. A critical factor/consideration with liver RFA is the location of the met since RFA cannot be safely done if the met is located too close to a blood vessel due to the inability to precisely control the area of burn from the RFA procedure which could damage a blood vessel if it is too close to the area being treated. As you have noted, it is vitally important that the RFA doctor be very experienced and knowledgeable to try to ensure a safe and successful outcome to the procedure. My very best wishes are with Josh and your family in making the best treatment decision and moving forward with scheduling it as soon as you are able. With special caring thoughts, healing wishes, much love, and continued Hope, Bonni

[Olga]

It can also be cryoablated (they use several cryo probes to create larger ablation zone of the complex shape and it can often be done close to the blood vessels, consult Dr.Littrup or Dr.Aoun). We talked about how the ablation modalities evolving during our last visit to Dr.Littrup for the lung cryo and he said that RFA is getting phased out by the improved cryo, microwave and radiosurgery. Cryo has better visualization of the tumor during the process of ablation and can often be done in the locations where heat technologies can not be used - blood vessels can be frozen/defrozen without the loss of their elasticity. The location is the key in determining the best modality.

[D.ap]

Our liver tumor was treated with microwave cooled tip by Dr Auon at
Karmanos Cancer Institute - Barbara Ann Karmanos Cancer Institute
I found this exert from a link Olga had posted to explain the pros of MWA

There had been three probes used to ablate the 4cm on the surface of Joshuas liver as well as water to help buffer the skin from severe burns

Radiographics
Radiological Society of North America
Microwave Ablation.—Cell death in microwave ablation is nearly identical to that observed in RF ablation (21). However, the mechanism of microwave heating may have advantages in certain clinical applications. Polar molecules (primarily water) continuously realign with the oscillating microwave field, effectively increasing kinetic energy and tissue temperature. In contrast to electric currents, microwaves radiate through all biological tissues, including those with high impedance to electric current, such as bone, lung, and charred or desiccated tissues (22). This allows microwaves to continuously generate heat in a much larger volume of tissue surrounding the applicator (23). As a result, microwave energy can produce faster, hotter, and larger ablation zones in multiple tissue

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319523/