Attack on the Liver War Front: Round One!
Well the day is finally just about here! After a longer than wished for wait over the course of May, tomorrow I go in for my first liver-focused therapy – my first attack on the liver front of the war!
At 10:00 AM tomorrow morning I’ll be checking in at the UCSD Hillcrest hospital to treat the right lobe of my liver with “Selective Internal Radiation Therapy (Y90-SIRT)” a fascinating medical technology I briefly talked about in previous posts both in terms of patient viewpoint (that I gleaned from the logistically identical (but non-radioactive) “mapping procedure” done two weeks ago) and in terms of technology description. Of course there is a range of patient responses to this procedure for both efficacy and side effects but I have overall heard mostly good experiences in both regards so I am very excited to do it!
The procedure will take all day but barring complications I expect to be home by dinner time. I have heard from patients who had very quick responses (which they could track by changes in disease symptoms even before a scan was performed to confirm) and this possibility makes sense based upon the technology. As the general term for the procedure (“Radioembolization”) implies, even before the up close and personal radiation effects fully hit the tumors, they are “embolized” i.e. blood-flow to the tumors is physically blocked by the 20-60 micron sized spheres. Then on top of that, the tumors are immediately hit with high dose local radiation (Yttrium-90 is a beta-emitter with a 2.6 day radiation half-life) that subsequently further kills them off via radiotherapy. In some patients the efficacy can be quite dramatic – I know a number of fellow patients who, like me, had “too many liver tumors to count” have all their tumors dramatically shrink completely (or at least below CT-scan detection limits)! I of course am hoping to be in that group of responders!
In terms of side effects, I have heard a wide range. There is of course a small chance of serious complications but taking that aside, most patients I have talked to have mostly mentioned significant fatigue that last for a few days to a week but I also know patients that were 100% up and about within a day or two. Some patient friends had other side effects like nausea but they seemed to be in the minority, so I am hoping for the best right now!
The plan after this procedure is to continue on chemotherapy as much as possible this summer (ideally I will have an infusion next Monday) with the goal of keeping the left lobe of my liver under control until it can be treated with the same procedure in August! They need to space out the procedures to allow the right lobe of my liver to regain enough function to take over when the left lobe is attacked.
We’re not messing around here…
So those are the plans… once I have some confirmed safety “breathing room” in my liver, I’ll get back to talking about more experimental ideas to be pursued when I am medically able…
I have been thinking about this SIRT procedure non-stop over the past month – looking at the possibility of catastrophic liver failure focuses a guy ha – and tomorrow morning the first attack on the liver front of the war begins!
Thank you for your positive vibes and prayers – To Life!
PS An update on the other war front: The SBRT-focused radiation to the 6 cm lymph node mass that had been causing me intense pain appears to have been wildly successful! My pain has been dramatically lowered and I am in the process of steadily removing pain medications to as low a dose as possible – ideally completely. The end to continuous pain & the ability to regain mobility and leave the house daily has had an incredibly positive impact on my quality of Life!