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Sue
@sue_in_delaware

Posts: 46
Joined: Mar 14, 2015

Have you had TACE or SirSpheres radiation treatment? Please share

Posted by @sue_in_delaware, Oct 4, 2015

Does anyone have experience with receiving TACE or SirSpheres, which are 2 types of radiation to the cancer tumor. I have colon cancer with mets to the liver. I’ve had 8 chemo treatments since starting chemo on April 22, 2015 and the 7.2 tumor in my liver has only shrunk to 6.2. They want it smaller before trying resection surgery. I’m wondering about the side effects of the TACE or Sir Sphreres treatments, pros and cons, risks and benefits etc. Thanks!

REPLY

Hi @sue_in_delaware.
I can understand why you posted this question here. It is not easy to find information comparing TACE and SIR-spheres for metastatic colon cancer. I found this from ASCO 2012 about NETS with liver mets http://meetinglibrary.asco.org/content/88512-115 but it doesn’t give you the experiential information you’re looking for.

Are both options offered where you are being treated?

Liked by Sue

@colleenyoung

Hi @sue_in_delaware.
I can understand why you posted this question here. It is not easy to find information comparing TACE and SIR-spheres for metastatic colon cancer. I found this from ASCO 2012 about NETS with liver mets http://meetinglibrary.asco.org/content/88512-115 but it doesn’t give you the experiential information you’re looking for.

Are both options offered where you are being treated?

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Hi Colleen, thanks for the link, I’ll check it out. Yes both options are offered and I have an appointment for a consultation with the Interventional Radiologist who will tell me all about them, this coming Wednesday. I’m on several different “forums” on the internet where I’ve posted questions, hoping to hear from people who’ve actually had one or the other procedures.

Please check back in after your appointment on Wednesday. I’d like to hear what the radiologist has to say and what feeds in to your decision making. Not simple. In the meantime, I’m going to search for someone who has had the procedure and may be willing to share here. No promises, but one can try.

Liked by Sue

@colleenyoung

Please check back in after your appointment on Wednesday. I’d like to hear what the radiologist has to say and what feeds in to your decision making. Not simple. In the meantime, I’m going to search for someone who has had the procedure and may be willing to share here. No promises, but one can try.

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Thanks Colleen for your input!
After looking at all my information, scans, my chemo routine up to this point, etc., the Interventional Radiologist that I spoke to yesterday at Penn Hospital in Philadelphia, came to the conclusion that SIR-Spheres is the best route for me. It’s a 2-step procedure. I’ll go back on Nov 5th and have what’s called “mapping” where they put a catheter up through the groin to the liver tumor. They inject a dye of sorts and see if it mostly stays there. If too much of it goes to the lungs or elsewhere, then it’s a No-Go and they’ll do something else (like the TACE). If the “mapping” goes as planned, I’ll go back within the next week to have the actual procedure where they place the radioactive “spheres” in the tumor. The spheres will shrink the tumor and it can take up to 6 months, although they do MRI scans at intervals during the 6-month period to observe shrinkage. My tumor is at the Vena Cava and the liver surgeon wants the tumor shrunk as much as possible before he can do a safe resection. I found a decent link in case anyone else wants to read about this at http://www.sirtex.com/us/patients/about-sir-spheres-microspheres/frequently-asked-questions/

Hi Sue,
It sounds like you had a thorough consult with the radiologist. Rather than having to make a choice, you get to try plan A, with a backup plan B in the wings. Is this the way you read it too? Seems like SIR-Spheres works well if the location can be more targeted and TACE when the solution needs to be more systemic.

Did you feel like you were listened to and got clear answers to your questions? That is so important.

Liked by Sue

@colleenyoung

Hi Sue,
It sounds like you had a thorough consult with the radiologist. Rather than having to make a choice, you get to try plan A, with a backup plan B in the wings. Is this the way you read it too? Seems like SIR-Spheres works well if the location can be more targeted and TACE when the solution needs to be more systemic.

Did you feel like you were listened to and got clear answers to your questions? That is so important.

Jump to this post

Hi Colleen,
Yes, that’s the way I read it too. The Interventional Radiologist seemed like a brilliant man and I liked the way he addressed all the issues. I can’t wait to get this going. (The only downside so far is that it’s a 3-hour trip to Philadelphia each way and it looks like it’ll be several trips in the near future, ugh.)

Hi @sue_in_delaware,
I thought I would check in to see how you are doing. How did the mapping go? Was it tough? I’m not sure how soon you get results or a treatment plan, but would love to get an update.

Also, a new member joined Connect, @Jackiewizardof. While I know your diagnoses are completely different, I was wondering if you could pop over this thread and welcome her. https://connect.mayoclinic.org/discussion/hello-well-i-am-52-and-found-out-yesterday-that-i-have-something/?pg=1#post-214820 I’m sure she’s like to know that someone is listening.

Talk to you when you get a chance.

Liked by Sue

@colleenyoung

Hi @sue_in_delaware,
I thought I would check in to see how you are doing. How did the mapping go? Was it tough? I’m not sure how soon you get results or a treatment plan, but would love to get an update.

Also, a new member joined Connect, @Jackiewizardof. While I know your diagnoses are completely different, I was wondering if you could pop over this thread and welcome her. https://connect.mayoclinic.org/discussion/hello-well-i-am-52-and-found-out-yesterday-that-i-have-something/?pg=1#post-214820 I’m sure she’s like to know that someone is listening.

Talk to you when you get a chance.

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Hi Colleen, thanks for checking up on me. The arteriogram “mapping” procedure went well. They’ve scheduled the SIR-Spheres procedure for Tues, 24th. I have a pamphlet from SIRTEX (who make the Yttrium 90 microspheres.) It’s been used in Australia since 1980s and got approved in the US in 2002. Between the pamphlet and their website I feel like I know all about it and feel less anxiety now. I’m ready to get this tumor shrunk down to nothing! I’ll keep you posted. Take care!

Knowledge is power. At least that’s what works for me. Some people prefer not to know, but you sound like you like to be prepared for what to expect. I’m glad you found information to conquer some of the anxiety.

Thanks for sharing your experience. Imagine how helpful this will be for the next person looking for this type of information. They’ll have the pamphlets and website, as well as your experience. Hopefully we’ll add more people to the conversation. I just met someone on Twitter who is getting TACE treatment today for GIST. I’m hoping when she feels up to it, she’ll tell us about it.

Thanks for replying to Jackie too.

What do you have to do to prepare for the SIR-Spheres procedure? Anything in particular?

Liked by Sue

@colleenyoung

Knowledge is power. At least that’s what works for me. Some people prefer not to know, but you sound like you like to be prepared for what to expect. I’m glad you found information to conquer some of the anxiety.

Thanks for sharing your experience. Imagine how helpful this will be for the next person looking for this type of information. They’ll have the pamphlets and website, as well as your experience. Hopefully we’ll add more people to the conversation. I just met someone on Twitter who is getting TACE treatment today for GIST. I’m hoping when she feels up to it, she’ll tell us about it.

Thanks for replying to Jackie too.

What do you have to do to prepare for the SIR-Spheres procedure? Anything in particular?

Jump to this post

Exactly! Knowledge is power! I’ve always used that motto, lol. I had started taking Xeloda on Oct 20th at 3000 mg (half taken twice a day after breakfast and evening meal.) It will be a 2 weeks on and 1 week off maintenance chemo that I’ll be on for quite some time (possibly.) My Oncologist, however, told me to stop it 2 weeks prior to the procedure, so, since it’s 2 weeks away, I’m currently not taking Xeloda. I’ll probably get back on about a week after the Sir-Spheres procedure though. I’ve seen (or read) about tons of people who have had good luck being on Xeloda. It shrinks cancer. The info I have about the Sir-Spheres does suggest that we be on other chemo all the way to keep any possible “other” cancer tumors from popping up and to help shrink the ones we have now.

Dear sue_in_delaware,

I had the TACE procedure last Thursday (Nov. 12). Please feel free to ask me anything you want about the procedure and I will be happy to answer you/walk you through it. I am the gist patient mentioned above ^^.

Take care,
Laydeewinx

Hi @Laydeewinx. Thanks for joining us here on Connect. I love it when networks of connections intersect.

I’d like to ask you about the TACE (transarterial chemoembolization) procedure. Can you walk us through it? For example, were you sedated, general or local? How long did you stay in the hospital? What did it feel like? How are you feeling now?

That’s a lot of questions. You don’t have to answer them all 🙂

Liked by Sue

@Laydeewinx

Dear sue_in_delaware,

I had the TACE procedure last Thursday (Nov. 12). Please feel free to ask me anything you want about the procedure and I will be happy to answer you/walk you through it. I am the gist patient mentioned above ^^.

Take care,
Laydeewinx

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Thanks so much for replying. Colleen saw your reply before I got here, but my questions are much like hers for now so I won’t repeat them as you probably see here questions above (or below?) Any info you can tell us will be helpful. I can’t remember at the moment why my Interventional Radiologist told me to try Sir-Spheres first, and if that doesn’t work, we’ll do TACE later. Is yours a liver tumor or elsewhere? Thanks again.

Hi ladies,

I will try to answer as best I can, please keep in mind that I am an art historian so my “medicalese” is not really up to snuff 😉

A little bit of history: My primary tumour is in my duodenum and I have multiple mets in both sides of my liver. I also have a bleeding issue where my liver randomly decides to split open and bleed. There is no rhyme or reason to it, and no way to prevent it from happening. It has happened to me 4 times in 2.5 years so it makes treatment options where internal bleeding is a potential side effect a giant no-no for me, thus we have to find alternate solutions. I was supposed to have a liver resection in summer 2014, but when the surgeon got there he decided that my liver “felt funny” and that it would not be safe enough to resect, so they did an open RFA instead.

Fast forward to this fall: There was not really any advanced preparation to do in the weeks before TACE, other than to make sure that my liver was strong enough to withstand the procedure. The procedure was set for November 12 and I went through the usual pre-op “speed dating” session where you get your blood tested (there was an extra, special TACE related blood test that they had to do… ), meet a nurse, meet a doctor, etc… Then I was told they would call me the day before to confirm. They called me Wednesday afternoon to tell me they had a bed for me and that I should admit myself later that afternoon (which was a bit of a problem since no one told me about having to be there before… but my husband and I worked out the kinks and we got there around 8pm.)

The fist thing they make you do is take an antimicrobial shower and put on the gown and any pj pants/slippers etc… you amy have brought with you. Then they install (insert?) two IVs one on each arm, take blood pressure, temperature etc… and then they pretty much left me alone until 4:30am when they made me take another antimicrobial shower and then started the IV fluids. They said that they found that TACE works a lot better if your kidneys are functioning really well, so they keep you SUPER hydrated. They also inserted a foley catheter. I was also not allowed to eat/drink anything until MUCH later that day.

Around 8:45 they came to bring me to angio where there was a LOT of waiting around, bring a blanket and socks – it gets chilly. I forgot to wear socks and I regretted it, also bring easy to slip on footwear like crocs, or similar – just because after they remove the catheter you will be going to the washroom a LOT!!

Once I was finally in the actual procedure room, I climbed upon a really narrow table and they covered me until the prep person came. They had a lot of IV bags full of antibiotics, the chemo, anti-inflammatories, and morphene that they were prepping for later use. I asked about them all and they were super nice when they explained them all to me. So the prep person came and prepped the table of tools that they would be using and then prepped me. Be prepared to be shaved down *there* if you are not already. Then they put on disinfectant and a very large blue paper cloth that covered me from my neck to my ankles (I am also 5’8″ so I imagine it would cover a less tall person completely.) The person who was doing the actual procedure came in and explained that they were going to give me a local anesthetic and that they were going to put a hole in my leg to my femoral artery where they were going to place a catheter that would go up to my liver, then they “park” the catheter and inject the chemo and the other IVs mentioned previously, directly into my liver. They said the longest part of the procedure was the actual infusion. There were moments when he was going up the artery that he asked me to hold my breath. I was not sedated per se, but I was experiencing some back pain so they gave me a little morphene to take the edge off which made me very compliant.

When the infusions were over they removed the catheter and bandaged me up (I have a 1/4″ incision, not even enough for a stitch.) Afterwards, you are not allowed to move your leg for about 6.5 hours just in case you should open up the wound and start bleeding from the femoral artery – no bueno. They kept up with the anti-inflammtories, anti-nausea, and pain killers the whole time I was there so I felt pretty good, albeit sleep deprived. I was there from Wednesday 8pm until Friday around noon. The procedure itself didn’t feel like anything. But there is a big concern about pain and nausea afterwards, so they take care of you very well to make sure none of those things happen.

Now, I still have some pain, but honestly I have not been sitting around resting either, I have been going out and doing stuff. As a Masters student, it is necessary to keep moving. I am not sure how I would feel if I took a few days to rest, maybe the same, maybe better. I am not sure.

Follow up includes, 4 blood tests at specific intervals and then a CT scan on January 7, 2016 to see how things are shrinking and then we will discuss doing the other side. They chose the left side this time because that is where my largest tumour is/was.

Laydeewinx

@Laydeewinx

Hi ladies,

I will try to answer as best I can, please keep in mind that I am an art historian so my “medicalese” is not really up to snuff 😉

A little bit of history: My primary tumour is in my duodenum and I have multiple mets in both sides of my liver. I also have a bleeding issue where my liver randomly decides to split open and bleed. There is no rhyme or reason to it, and no way to prevent it from happening. It has happened to me 4 times in 2.5 years so it makes treatment options where internal bleeding is a potential side effect a giant no-no for me, thus we have to find alternate solutions. I was supposed to have a liver resection in summer 2014, but when the surgeon got there he decided that my liver “felt funny” and that it would not be safe enough to resect, so they did an open RFA instead.

Fast forward to this fall: There was not really any advanced preparation to do in the weeks before TACE, other than to make sure that my liver was strong enough to withstand the procedure. The procedure was set for November 12 and I went through the usual pre-op “speed dating” session where you get your blood tested (there was an extra, special TACE related blood test that they had to do… ), meet a nurse, meet a doctor, etc… Then I was told they would call me the day before to confirm. They called me Wednesday afternoon to tell me they had a bed for me and that I should admit myself later that afternoon (which was a bit of a problem since no one told me about having to be there before… but my husband and I worked out the kinks and we got there around 8pm.)

The fist thing they make you do is take an antimicrobial shower and put on the gown and any pj pants/slippers etc… you amy have brought with you. Then they install (insert?) two IVs one on each arm, take blood pressure, temperature etc… and then they pretty much left me alone until 4:30am when they made me take another antimicrobial shower and then started the IV fluids. They said that they found that TACE works a lot better if your kidneys are functioning really well, so they keep you SUPER hydrated. They also inserted a foley catheter. I was also not allowed to eat/drink anything until MUCH later that day.

Around 8:45 they came to bring me to angio where there was a LOT of waiting around, bring a blanket and socks – it gets chilly. I forgot to wear socks and I regretted it, also bring easy to slip on footwear like crocs, or similar – just because after they remove the catheter you will be going to the washroom a LOT!!

Once I was finally in the actual procedure room, I climbed upon a really narrow table and they covered me until the prep person came. They had a lot of IV bags full of antibiotics, the chemo, anti-inflammatories, and morphene that they were prepping for later use. I asked about them all and they were super nice when they explained them all to me. So the prep person came and prepped the table of tools that they would be using and then prepped me. Be prepared to be shaved down *there* if you are not already. Then they put on disinfectant and a very large blue paper cloth that covered me from my neck to my ankles (I am also 5’8″ so I imagine it would cover a less tall person completely.) The person who was doing the actual procedure came in and explained that they were going to give me a local anesthetic and that they were going to put a hole in my leg to my femoral artery where they were going to place a catheter that would go up to my liver, then they “park” the catheter and inject the chemo and the other IVs mentioned previously, directly into my liver. They said the longest part of the procedure was the actual infusion. There were moments when he was going up the artery that he asked me to hold my breath. I was not sedated per se, but I was experiencing some back pain so they gave me a little morphene to take the edge off which made me very compliant.

When the infusions were over they removed the catheter and bandaged me up (I have a 1/4″ incision, not even enough for a stitch.) Afterwards, you are not allowed to move your leg for about 6.5 hours just in case you should open up the wound and start bleeding from the femoral artery – no bueno. They kept up with the anti-inflammtories, anti-nausea, and pain killers the whole time I was there so I felt pretty good, albeit sleep deprived. I was there from Wednesday 8pm until Friday around noon. The procedure itself didn’t feel like anything. But there is a big concern about pain and nausea afterwards, so they take care of you very well to make sure none of those things happen.

Now, I still have some pain, but honestly I have not been sitting around resting either, I have been going out and doing stuff. As a Masters student, it is necessary to keep moving. I am not sure how I would feel if I took a few days to rest, maybe the same, maybe better. I am not sure.

Follow up includes, 4 blood tests at specific intervals and then a CT scan on January 7, 2016 to see how things are shrinking and then we will discuss doing the other side. They chose the left side this time because that is where my largest tumour is/was.

Laydeewinx

Jump to this post

Dear Laydeewinx,

Thanks so much for your detailed description of the TACE procedure. (So sorry about your duodenum and bleeding liver!) Your “medicalese” is just fine and as I was reading your story I felt like I was right there with you.

I’ll come back after my Sir-Spheres microspheres procedure and hope I can give as good a description as you did with your treatment because I believe that these (on this and other forums) help so many people in many ways.

Please keep us posted as you progress.

Thanks again,
Sue

Liked by martid

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