UW Liver Tumor Clinic Visit

It was a long morning at UW in the new Surgical Pavilion spent mostly waiting.  The purpose of today's visit was to meet with a multi-disciplinary team of doctors who were "conferencing" on my case to discuss my case and make recommendations for treatment.  The conference was called the Liver Tumor Clinic as they specialize in tumors that metastasize to the liver from other origination areas.  The person who walked us to the exam room mentioned how "this is a big deal", and that patients fly in from Europe and Asia just to have this consultation and recommendations on treatment at UW.  How fortunate this is in our own backyard.

The doctors conferencing included a general surgeon, an oncologist, pathologist, and a radiologist. We met with first just the surgeon (was 1 hour late) who asked some basic questions who then met with the team of doctors separately to discuss the case, review the CT scans, and come to a joint recommendation.  We then met with the surgeon and the oncologist (who was 1.5 hours late btw).  Below are some bullets from the discussion, again provided for education and general piece of mind:

• The plan for now is to wait to see the biology of the tumors by observing how they react to the chemotherapy, as the chemo will attack it at all sites (colon, liver, lungs) and in the bloodstream.
• Ideally, the chemo will shrink down the tumors and nodules to a very small size or get rid of them all together, in which case we would discuss potentially cleaning up (resection or removing parts of the liver, lungs, or colon; ablation, or radiation).
• What will remain after the chemotherapy may be chemotherapy-resistant cells, which we would need to monitor.
• Cancer that presents itself in younger patients is typically more aggressive.
• Based on the surgeon's estimates, the tumor probably began forming 5-10 years ago, but there is no way of knowing.
• The surgeon called this a "chronic disease" in that we will need to continually monitor.  In other words, the goal right now is not curing or eliminating the cancer, but keeping ahead of it through aggressive and proactive treatments.
• It would take 80% of the liver to be covered before we see liver functionality decrease.  Luckily, I'm no where near this.
• If we do go for surgery, we will likely act on all 3 sites, as it makes sense to handle the cancers in all organs at the same time, rather than one followed by recovery, followed by another, and so forth.
• The regime I'm on is one of the most aggressive treatments for colon cancer, and should hopefully shrink the tumor down to almost nothing, again leaving the cells that are resistant, which we will need to watch.  This regime is also good at shrinking down the cancer cells in the other organs.