Thursday, August 18, 2016

Bland Liver Embolization was a Success!

On July 15th, I had a bland liver embolization on the right/middle of my liver.  This is a minimally invasive surgical procedure where “beads” are put into the arteries in the liver to block the blood flow to the tumors.  The beads are inserted via a small tube in an artery the groin area.  By blocking the blood flow to the tumor, it should experience necrosis or tumor death.   For more information on the different types of liver embolizations and an explanation of the procedure, please take a look at the blog Walking with Jane as follows:

My doctors explained that the bland embolization was safer for me than either chemoembolization or radioembolization because my tumors were extremely vascular, meaning there was a lot of blood flow to the tumors.  Both chemoembolization and radioembolization use beads treated with chemotherapy or radiation, respectively, to treat the tumors.  The risk of treated beads is that they can miss the target of the liver tumors and apply chemotherapy or radiation to the wrong areas of the body. Bland embolization, which uses untreated beads, can also miss the target and wind up in another area of the body but these beads may be less harmful without the chemotherapy or radiation. When having this procedure, it is important to have an interventional radiologist that has a lot of experience with liver embolization.

Many times, a patient will need two treatments, one for each side (lobe) of the liver.  These treatments are usually about a month or more apart.  I just had a one month CT scan and a post-op appointment with the interventional radiologist who said that the embolization went very well and that the tumors that were embolized were dead.  He showed me the images on the CT scan and they were all black.  The largest mass in my right lobe was 8.8 x 4.8 cm and the next largest was 4.4 x 3.1 cm.  At this point the tumors in the left side of my liver are very small and my doctors do not believe that they should be embolized unless they grow.  They will monitor with another CT in November and do the left side embolization if they grow. 

After the embolization I experienced postembolization syndrome (fever, nausea, vomiting, abdominal pain, and elevated liver enzymes).  It was quite painful for 2-3 days after the procedure.  After about a week, I felt a little better but I could still feel my liver area every time I inhaled, which was annoying.  This lasted several days and then I really had no symptoms after about 3 weeks post-embolization.  My alkaline phosphatase, one of the liver enzymes measured in a comprehensive metabolic panel is still elevated and my doctor said it could stay that way for a few months.  The rest of my liver enzymes are normal now. Also, I used to have occasional flushing, even when taking Sandostatin LAR.  Since the embolization, I have not had one episode of flushing.

On another interesting note, the tumors outside my liver, mostly in and around my lymph nodes, have been stable since I had the first round of PRRT in the clinical trial.  I wonder if the PRRT might have worked on these tumors, just not for the liver lesions. Now it’s time to give my body a break from treatments for a few months.