nickysfight's Cancer Blog

April 21, 2008

SIRT (Selective Internal Radiation Therapy) or SIR-Spheres Views: 220

I havenâ€™t posted recently so I have a lot to cover. Since Mom pulled her catheter out she has received a Port Catheter. We donâ€™t like it as much as the Groshong catheter because it is quite painful when they insert the needle. But it has less risk of infection because it consists of a disc that was surgically inserted under the skin.

Momâ€™s CEA levels went up to 119 which is indicating that the cancer could be becoming resistant to the chemotherapy. She is presently still receiving the Avastin with the 5-FU but after next week she will not be getting Avastin anymore for awhile. Due to the hemophelia side-effects she has to stop taking it before she can have any surgical-type procedures. She is hopefully going to be receiving SIRT therapy which I address below. But I want to talk first about the drug she will be receiving in place of the Avastin first, Erbitux. It does not have the hemophelia-type side effects of the Avastin and therefore is safe for use during surgical procedures. However, it has some nasty side-effects of itâ€™s own including a acne-like rash covering the face and chest. Although, in clinical trials it only occured in 14% of patients. Regardless, Mom is not exactly looking forward to starting this new therapy!

I was lucky enough to spend last week in Colorado and accompanied Mom to several of her doctorâ€™s appointments. We met with 2 new doctors that are being added to Momâ€™s Cancer Team; Dr. Schefter and Dr. Durham whom are both at the University of Colorado Cancer Center. Mom is presently being considered for Selective Internal Radiation Therapy (SIRT). She will undergo 2 tests to see if she is a viable candidate and then we anxiously await insurance approval. The SIRT procedure involves radioactive beads, Yttrium-90 microspheres, being introduced into the affected organ. In her case, they will be injected into the liver through the femeral artery. If introduced correctly, the side effects are minimal. There is little pain and itâ€™s less symptomatic than the chemo. The beads will be given in 3 seperate instances over several months. Initially, they will inject them into the right lobe of the liver, the second time they are injected into the left lobe and if all goes well then they will be inserted into the entire liver during the 3rd procedure. They say Mom is a perfect candidate for the procedure because she isnâ€™t eligible for many other treatments, such as resection, because her tumors are too widespread and plentiful. She has around 12 lesions on her liver. This procedure can only be performed once because of the tolerance of the liver to the radiation. However, the doctors also spoke to us about putting the chemotherapy directly into the liver after this procedure to hit the cancer hard. Dr. Schefter is the radiologist in charge of the dosing and radiation type that Mom will receive. The type used in this procedure is flown in directly from Australia. -Dr. Durham is in charge of placing the radiation in the correct artery and re-plumbing Momâ€™s arteries if needed to assure the radiation does not travel to any undesired locations (severe side-effects). Dr. Durham will also perform the initial tests to determine if she is a candidate for this procedure.

We are very appreciative that we have this team of great doctors that are choosing agressive treatments. And we have our fingers crossed that the tests will show Mom to be a viable candidate for this procedure! We are also hoping for good results from the procedure itself! It takes several months to see the results of this procedure which already has me stressing. This is due to the fact that the liver is initially inflamed and irritated by the radiation which translates to metabolic activity on the PETScan which usually indicates Progression of the cancer. So we are not going to know if the PETScan is showing true progression and Momâ€™s cancer is growing or if it is simply due to the inflamation from the procedure. And only time will tell. Mom will have the prerequisite tests in a few weeks and I will definately post as soon as we find out anything. We wonâ€™t know about the insurance approval until after that. I hate that we even have to worry about that!

And last but not least, we also met with Ann, the colostomy nurse to discuss Momâ€™s bleeding problems. Mom has had a lot of problems with bleeding from her stoma (colostomy) all year. We were very concerned about it but assumed it was due to the chemotherapy and Avastin. However, we talked to the nurse and learned that it is a common problem with ostomy patients, especially those with liver disease. She showed us several options of appliances and bags that can help minimize irritation to the area and lessen the bleeding. We ordered a few samples from the company she recommended, Cymed. We are hoping they will help!

Posted on April 21, 2008 at 3:59:08 PM by Julie Scheffer for Nicky Hopper ( Link to this post.