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Joined: 2/16/2009
Posts: 6
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Dear Sirs, My mum is 61 and was diagnosed with bowel cancer in May 2008 and had surgery which removed a large tumor in June 08. She was due to have a short course of chemo following this but her scans showed that although the bowel was clear she had several lesions on her liver. She has now had two courses of chemo, including the BOXER (bevacizumab) trial. One tumor has shrunk, one has grown and the rest remain the same size. She has been told she won't be eligible for any further cycles on the BOXER trial as she is not responding and also that she is not able to have surgery. Her consultant has offered her the option to participate in two other trials, PICCOLO or Aflibercept. Is CK a possibility for her? We are in the UK, but from reading other posts it would seem that her chances of treatment may be better in the US. Would a starting point be to contact the London centre? If CK isn't an option, I'd be really grateful for your thoughts on any other options. Thank you for your help. Kind regards Sue.
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Joined: 10/10/2008
Posts: 2354
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How many is several?
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 2/16/2009
Posts: 6
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There are nine in a cluster.
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Joined: 10/10/2008
Posts: 2354
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If that means that they could potentially be treated as a single tumor, then yes that is treatable. But usually that many would not be treatable with CK. I would suggest just getting the scans reviewed by the CK center of your choice. If they say not, you might want to try one or two more, since some centers are more conservative than others.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 10/11/2008
Posts: 928
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Any way you look at it, nine is a large number of lesions to treat.
Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828 Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717
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Joined: 2/16/2009
Posts: 6
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Thank you both for replying so quickly. I'll contact the London centre, but I believe if there are more than 5 lesions it's generally a no. Are you able to suggest any centres that have particular experience with this & may therefore be more willing to take it on? Many thanks for your help Sue
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Joined: 10/11/2008
Posts: 928
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You might try Georgetown in Washington, D.C. or Sinai Hospital in Baltimore but I doubt if it would be worth the trouble and expense.
Jerome J. Spunberg, M.D., FACR, FACRO
CyberKnife Center of Palm Beach
jspunberg@radiationoncologyinstitute.com
(561) 799-2828 Radiation Oncology Institute
10335 N. Military Trail, Suite C
Palm Beach Gardens, FL 33410
(561) 624-1717
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Joined: 10/10/2008
Posts: 2354
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Why don't you send me the images, or better yet post them somewhere where I can look at them. I can then give you a better idea as to whether it is worth pursuing this.
Milan seems to be the European center that is most willing to be more flexible.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 2/16/2009
Posts: 6
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Many thanks to you both. I've asked my mum to get the scans & will email them as soon as I have them. I really appreciate your offer to look at them, at least we'd know one way or another if it's a possibility. Given that CK seems to be a long shot, do you think SIR-spheres might be another option to look into? Thanks again, Sue
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Joined: 10/10/2008
Posts: 2354
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The files are too large to e-mail. We needthe actual DICOM images, not some small jpeg's. They either need to come on disk or else get posted online somewhere for download. You might look into a service such as yousendit.com
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 2/16/2009
Posts: 6
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I've sent the scans via yousendit, please let me know if you have any problems viewing them. Thanks again for your kind offer to have a look at them and for your continuing help. Sue
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Joined: 10/10/2008
Posts: 2354
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I counted at least 9-10 tumors. This really would not be good for CK. You might want to investigate whether you would be a good candidate for radiolabelled spheres.
Clinton A. Medbery, III, M.D.
St. Anthony Hospital Cyberknife Center
(405) 272-7311
buddy@swrads.org
Mail to:
Clinton A. Medbery, III, M.D.
Southwest Radiation Oncology
1011 N. Dewey Ave. #101
Oklahoma City, OK 73102
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Joined: 2/16/2009
Posts: 6
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Thanks for looking at that so quickly. It was always going to be a long shot, but I really do appreciate you taking the time to have a look. I've found a centre in London that does radiolabelled spheres, so I'm trying to arrange for a referral for my mum there. Many thanks again for all of your help and the wonderful work you do on this forum. Kind regards Sue
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