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Y-90 radioembolization for mCRPC with liver mets

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Posted 7/26/2016 11:31 AM (GMT -5)
MO mentioned this at last visit. MO not recommending at this time, waiting to see if I respond to Zytiga. Hard to find much info out there relative to its use in mCRPC. My liver is currently only known site for metastatic disease.
Anyone have experience with (knowledge about) this procedure?
Randy

It's a great day to be alive. Enjoy the gift.
Posted 7/26/2016 11:43 AM (GMT -5)
This procedure has a decent track record in treating liver metastasis from primary colon or rectal cancer, but I have not seen it performed for PC. I would think it could work as well.(it is effective at slowing disease progression but does not cure)
But, due diligence is advised..

be well...
Posted 7/26/2016 12:47 PM (GMT -5)
I don't know much about it, but I had a question: Is there a reason they can't surgically remove the 2 liver mets or zap them with SBRT or HIFU? Also, are they certain they are metastases?

- Allen
Posted 7/26/2016 1:42 PM (GMT -5)
I am watching this thread carefully. When I had my scans, my liver was noted as having "spots" too small to Dx. also noted in my bloodwork was a less than stellar liver performance. So.....I am watching this thread "just in case".
Posted 7/26/2016 2:03 PM (GMT -5)

Tall Allen said...
I don't know much about it, but I had a question: Is there a reason they can't surgically remove the 2 liver mets or zap them with SBRT or HIFU? Also, are they certain they are metastases?

- Allen

Allen, this procedure is a catheter based procedure. The hepatic arteries that feed the area of interest are selected and Radiation is administered via Yitrium 90 (Sirsphere or Theraspheres) directly to those areas.

As for removal, the tumors are likely to return and the surgery is difficult, so the risk is higher than reward.

But again, I have not read any of these performed for PC mets. That is new.

Be well..
Posted 7/26/2016 2:11 PM (GMT -5)
Yet surgery is still the preferred way for removing liver mets. What makes them more likely to return with surgery vs Y90?
Posted 7/26/2016 2:17 PM (GMT -5)
I was not aware that removal was the preferred treatment for liver mets. My understanding is that treatment of liver mets is more prophalactic than curative.
Primary liver tumors are often removed if diagnosed early.

Ok an edit after reading your reply again. The tumors may be as likely to return after Y90, but the treatment is much easier and less risky than open surgery.



Be well
Posted 7/26/2016 4:14 PM (GMT -5)
[url]http://prostatesnatchers.blogspot.com/2015/12/sir-spheres-for-liver-metastases-from.html

Link is to a blog written by an MO in California about use of Y-90 radioembolization in mCRPC for liver mets. Apparently the results of a small (6 patient) study was presented at the 2016 Genitourinary Cancer Symposium in January of this year. Worth the read.
Posted 7/26/2016 4:36 PM (GMT -5)
above link doesn't work. Google: prostatesnatchers sir-spheres
Posted 7/26/2016 7:03 PM (GMT -5)
jer-

Interesting stuff. I couldn't find an abstract at the GU conference. Perhaps yours are in a place that is difficult to get to. Is there a danger of the beads circulating systemically? I wonder if results are better than surgery, SBRT or HIFU. As always with new technologies, there are more questions than answers. Let us know if you wind up doing this.

- Allen
Posted 7/27/2016 1:13 PM (GMT -5)
Fixed the link by Dan0:

Sir Spheres for Liver Metastases from Prostate Cancer
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