Liver met without lymph node involvement?

[SoConfused]

Hi everyone - just polling to see how many of you had liver involvement at diagnosis WITHOUT any lymph node involement?

[BrownBagger]

I had a lung met without any node involvement, but that was after 5 weeks of Xeloda and pelvic radiation for RC.

[Guinevere]

Until recently, I did. However, the last scans showed some kind of node involvement but, without contrast, it was hard to really tell. The next CT will be with contrast and LOTS of steroids and Benedryl to stave off Anaphylaxis to see what's really going on.

[Bev G]

I sort of had a liver met without node involvement, in that of 22 nodes, 2 were positive, but all the cancers cells in those two were dead as doornails, prior to any treatment (ie they had burned themselves out). At diagnosis I had a tangerine size tumor in the posterior caudate lobe of my liver. That tumor was almost certainly there by hematogenous spread (thank God) as there were no positive nodes anywhere around it (thank God again) which is probably why I have yet to have any recurrent cancer in that area.

HTH,

Bev

[juliej]

I had liver mets at diagnosis but no lymph node involvement.

[SoConfused]

thanks for your posts ... Bev, how can you/doc determine whether a liver met is a result of hematogenous spread?

[Bev G]

thanks for your posts ... Bev, how can you/doc determine whether a liver met is a result of hematogenous spread?

The two dead nodes were the ones closest to colon tumor, the were no positive nodes distal to the those, there were no positive nodes anywhere close to the liver, therefore, the really aren't other ways for the malignant cells to have gotten to liver other than via bloodstream.

HTH,

Bev

[SoConfused]

Bev - your presentation sounds similar to mine. I had 2 out of 15 nodes closest to my tumor in the sigmoid colon test positive for cancer ... there was active cancer in those nodes, and I also had an almost 2cm met in the right lower lobe of my liver at diagnosis.

I am just trying to figure out whether the nodes and/or hematogenous spread is to blame for this particular misfortune?

I have seen so many folks on here who have had N2 nodal involvement at diagnosis but no distant organ involvement ... human anatomy is so confusing.

[NedPlease]

No positive nodes, two liver mets, one lung met six months post chemo.

[Bev G]

Hi So-scared,

Cancer is a real bugger, and does whatever it feels like, as we all (or almost all ) know too well. I always laugh when we talk about "microscopic cells" because they are all, of course, microscopic. The little bastards can start in the lymphatics and migrate from there into the vascular (blood) system, then go anywhere. However, there are some places that they usually "like" to go: areas that closely mimic their host environment (ie colon) ---highly vascular areas (liver and lung), but, because cancer sucks, it can go other places, too, of course. (That is, of course, why Avastin works. It prevents the growth of new vessels at the tumor site to nourish the tumor; that's why it's only given to stage IVs---tumors die, just as everything else does, without a blood supply). I had 3 doses of Avastin, and my large tumor in my liver was 100% dead when it was removed.

To make things even more complicated, it's possible that there may be an interstitial fluid spread of cancer. Virtually every cell in the body is bathed in interstitial fluid, which ultimately drains into the lymphatic system. it is possible that during surgery, or a biopsy even, a stray cell can get into the interstitial fluid, and begin it's travel to a metastatic site. There is not total agreement on this mechanism. There IS sufficient concern however that in the operating room, there is a table set up, remote from our bodies, that is there specifically for the tumor, any other specimens for pathology, and any instruments that were used in touching our tumors in any way. Our docs are extremely careful in wanting to keep that crap as far away from us, and open incisions, as possible while operating on us. I don't suppose anyone can ever say with 100% certainty, but for my liver tumor, hematogenous spread is the only thing that makes sense to me and my surgeon. I would MUCH prefer it be that way.

I am so glad for you that you only had this very minimal lymphatic involvement. I can't remember, is your liver tumor in the lab yet? (The ONLY place for them to be )

Best wishes to you!

Bev

[jobasar]

Hey, I had my colon ruptured and when they found out 3 months later that I had colon cancer, I had one met to the liver. I did 3 rounds of folfox, after my colon resection which was an emergency surgery. I then recovered and did 9 rounds more of chemo but 3 months after all this they saw another met on liver so then I did 2 rounds of folfiri in 2010 Jan-Feb but then had 20 percent of right lobe removed and no treatment for 2 yrs. Now I am back in the battle with rib met but tiny along with deep tissue next to rib and tissue next to right kidney. They did radiation to rib and tissue and pain is gone. Feel better. Just completed 3rd round of folfiri and getting ready for 4th round but I am scanning tomorrow to make sure chemo is kicking some butt here. So I never had lymphnodes involved. Although they bill and code things and had a scare that there were a lymph node involve but I questioned it and the onc said you must have had it during surgery but my surgeon said it was all negative. Not sure when this all appeared but I think they have to code and bill a certain way. I am almost 4 yrs since colon ruptured and found out in Dec 24th of 08 that I was stage 4. Good luck to you and treatments.

Allie

[Ivona]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1459485/

some interesting reading there...

[Bev G]

Hi Ivona,

This explained things so well! Thanks a lot for posting it!

Bev

[Jimswife]

Ive just read that , They say cells can't stay in circulation for very long at all and less then 0.01 percent of cancer cells will be sucseful in forming mets ? Makes you wonder how and why so many people have got extensive spread if the above it true ? Of course I know it only takes that one bad cell but still it seems a cancer cells forming a secondary cancer is not an east task at all ??

[Jimswife]

Easy