After having completed 10 rounds of chemotherapy dating back to May 2017 and having been on Mitotane (oral chemo) since August 2017, Alexis had her latest MRI and a PET scan and we met with Dr. Fojo on March 13th for the results. Fingers (and toes) were crossed. It was an emotional appointment.
The scans showed that 3 of the lesions on her liver were stable while 1 had grown in size. It also showed 3 new tiny spots in her lungs (all less than 1cm). Dr. Fojo did not seem too concerned with the lungs and said that they might even be incidental or an infection of sorts, not necessarily cancerous, so we will monitor them over time. The 3 stable lesions on the liver have shrunk so much that it is hard to tell if they are "alive" anymore or if it is just dead tumor tissue. Again, he was not too concerned with them. For the 1 liver lesion that did grow in size, he recommended TACE, which Alexis will undergo on April 3rd. He said that TACE is highly effective and feels very confident that it will kill this tumor. He also wants Alexis to do another two rounds of EDP chemo (rounds 11 and 12!) after TACE is done.
So on the spectrum of things, this was not the best news but it was also not the worst. Dr. Fojo remains very optimistic. Considering the dire situation that she was in when we first met Dr. Fojo last July (9+ liver lesions), she has done better than anyone could ever have expected and, in some regards, has surprised Dr. Fojo himself. Her response to the EDP chemo has been remarkable and now we have a plan to get her to NED status ---> TACE + 2 additional rounds of chemo.
A little background info on transarterial chemoembolization (TACE):
TACE is an image-guided, non-surgical procedure that is used to treat malignant lesions in the liver. Performed by specially trained radiologists using real-time image guidance, TACE often require smaller incisions, have fewer risks of complication, and take less recovery time than traditional surgery. The procedure uses an X-ray guided catheter to deliver both chemotherapy medication and embolization materials into the blood vessels in the liver that lead to the tumor.
With this technique, the chemotherapy targets the tumor while sparing the patient many side effects of traditional chemotherapy that is given to the whole body. The embolization cuts off the blood supply to the tumor. The special embolization beads delivered to the tumor are impregnated with the chemotherapy agent and the chemotherapy is slowly released from the beads, destroying the tumor over a period of time.
- Treats malignant lesions in the liver.
- Through very small catheters, a specially trained physician will deliver chemotherapy medicine directly to the tumor using image guidance.
- Also involves the injection of materials (metal coils or special gels) that physically block the blood vessels feeding the tumor.
- Optimizes the ability to shrink or eradicate tumors by targeting them precisely and blocking their blood flow.
- Requires only a small incision in the groin area.
- Most often, the procedure takes approximately two hours, but requires an overnight stay for observation.
- As a minimally invasive procedure, involves a smaller incision, fewer risks of complication, and less recovery time than traditional surgery.