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!

SIRT Cartoon

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!

29 Comments on “Attack on the Liver War Front: Round One!

  1. I will pray that tomorrow goes very, very well. Thank you for sharing your strong spirit and helpful information. SPB


  2. Wonderful news Tom and all the v v v best for tomorrow, positive vibes and prayers aplenty 🙂


  3. I am simply elated to hear this news! It has seemed like an eternity since finding out in May you would have the SIRT procedure. All the best to you, Tom! Thank you for your continued posts and your advocacy for us all!


  4. You will be foremost in my thoughts tomorrow! And I am so glad to hear your pain is greatly diminished from the radiation procedure. If anybody can foil this cancer foe, it is you Tom!


  5. wish you all success Tom ! you are an amazing person, and you have to know that you inspire to many persons around the globe.. I am one of these, and I live in Egypt ! My sister has exactly the same disease as yours, and I breath hope through your posts !!
    Please keep the positive energy up !!!


  6. Tom, I have been as focused on your Y90 and SBRT treatments almost as much as you. My whole reference to time since you announced the June 1st procedure date has been … next week, in a few days, and now finally the day is upon (us) you. I truly believe that you will be okay and from your new treatments will be again both a warrior and a scientist for the many thousands of people with cancers of all types. It’s truly amazing and hopeful… #TOLIFE!


  7. Good luck, Tom! I had the procedure in February and it has given me a break from treatment with limited side effects.


  8. This is absolutely wonderful and will be following you throughout. Prayers for success!


  9. So happy to hear about the success of the SBRT, and best of luck with the SIRT! Will be thinking of you tomorrow Tom.


  10. So glad that your pain and quality of life are improving! That is huge! I wish you all the best tomorrow and pray that your results of SIRT are the best possible. To Life.


  11. Tom you are an inspiration to so many. I am right behind you with this procedure … waiting for mapping appt. thank you for sharing all of your experiences and knowledge. My thoughts and prayers are with you tomorrow as you go through this procedure.


  12. You are being continuously lifted in prayer, Tom. So glad you’ll be at a UCSD hospital–lots of confidence in them. To life! To health! To walks in the woods and on the beaches!


  13. You’re in my prayers and on my mind today. The first day of June and another beginning as well!


  14. To Life!!! You will be in my thoughts and prayers….hoping for an easy go of it 😆


  15. Praying that the Y-90 will be as successful as the SBRT – I am cheered to learn that you have pain relief and back to some quality of life. TO LIFE!


  16. Tom,
    I’m so happy that your day has finally arrived! I will be thinking of you today and send positive and healing energy! Go get ’em!!! To Life!


  17. Pingback: ATTACK ON THE LIVER WAR FRONT – BATTLEFIELD REPORT | AdventuresInLivingTerminallyOptimistic

  18. Pingback: ATTACK ON THE LIVER WAR FRONT – BATTLEFIELD REPORT | AdventuresInLivingTerminallyOptimistic

  19. Hi Tom, hope you are doing great and getting ready for your second SIRT in August 🙂 wishing you the best of luck. Update us please 🙂


    • Hi Farah – Overall I am doing well! Based on CT-scan, my June SIRT was quite successful and took care of the most worrisome tumors in that lobe. My SIRT #2 schedule has been sped up (for scheduling reasons) to this Thursday (August 3) – the interventional radiologist believes that since the tumors in the first lobe were so sensitive to Y90 that the tumors in the second lobe will be too – so he is optimistic for Thursday’s treatment. I had a very easy recovery the first round so I hope that happens again this week! Thanks for checking in! -Tom


  20. Pingback: Going Off-Roading – Experimental Treatment Strategy Style | AdventuresInLivingTerminallyOptimistic

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