Sara met with her oncologist today and the verdict was “go for surgery!”. More details to come in the near future, but for the moment the plan is that she will have surgery on the right lobe of the liver in 2 weeks (!). It may sound strange to be “happy” about surgery, but in this case it is definitely a good sign. Way back when Sara was first diagnosed (ok not so far back, but it already feels like a long time) it didn’t even look like surgery on the liver mets would even be a possibility. Sara was very glad to prove the stats wrong 🙂 .

According to existing literature, a large share of the liver mets reduction can be attributed to a relatively new chemo drug she is taking, Erbitux. This drug has been found to be extremely effective in shrinking colon cancer mets to the liver, when administered in conjunction with other more standard CRC treatments (such as 5FU and Oxaliplatin). Unfortunately Erbitux is also responsible for giving her a painful rash on her face and body – kind of like having teenage acne all over again – but in view of the great response rates I think that she feels it is worth it.

So back to the surgery – there are different types of liver surgery, called a “resection” in the case of operating on liver mets. A surprisingly large amount of the liver can be hacked off, as long as there is a decent amount of healthy liver left behind. I came across some examples of good recovery rates after removal of even 80% of the liver! As you may remember from high school biology class, the liver does actually regenerate itself, and remarkably fast – 6 to 8 weeks, depending on the amount which was removed. For surgery purposes, the liver is divided into 8 “segments”, and the right lobe contains segments 5 – 8. We don’t know yet if just a few segments will be removed, or if all of the right lobe will be removed (in this case it is considered to be a “lobectomy”).

Despite the somewhat giddy tone of this update, liver surgery is a serious procedure. There are many blood vessels, veins, etc flowing through and around the liver. Recovery from a liver resection is often a bit of a long but generally smooth road, though complications can happen and everyone’s case is different. Sara will also need to have a PET (positron emission tomography) scan prior to the surgery, to make sure no little bits of undiscovered cancer are lurking. While we wait for more information, please keep Sara and her family in your thoughts!  

P.s. Just as a reassurance, I am using respected sources when I cite the information above, such as the efficacy of Erbitux and the odds of eligibility for liver resection, for example. But I am not going to turn this blog into a research paper with corresponding citations. If anyone is particularly interested in the sources, feel free to contact me directly and I’d be happy to provide the information.

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