1cm Spot On Liver, Stage 4???

[meatie]

So, my mom got a second ct scan (triphasic) on 9/1/14. And the original 10cm mass on the liver is more like 1cm. Since colon surgery is this friday (9/5), no additional scans will be taken and instead a biopsy of the liver spot will be taken during the colon resection surgery. Does it mean that my mom's colon cancer is stage 4 already?

[canadiandaughter]

from what I have read, stage iv is when it has spread to more then one organ other then the colon. My dads is stage iv as it is in his liver and his lungs, but I am no expert, just going by what I have learned. Hopefully some of the others will chime in here soon for you and correct me if I am wrong.

[Bev G]

If your mother has metastatic colon cancer in the liver she has stage IV disease, whether it's one lesion or many. You won't know until the biopsy is back. There is/was something ASTONISHINGLY WRONG with the first scan (or the recent)! the difference between 1 cm and 10 cm is enormous and not explainable by the use of different machine or examiner. I would expect a very clear explanation about this.

Bets wishes,

Bev

[GrouseMan]

The fact that they wish to biopsy the suspect spot and take a look is good. It always better to take a look under the hood if you will. They will get a clear picture of what it is. The surgeon took a look at my wife's liver mets when he did her colon resection, but he didn't attempt to remove them at that point. He pointedly wasn't all that concerned about them, and left them for the oncologist to deal with. Of course people with mets to more than one organ are usually not candidates for resection of those mets. My wife's biggest liver met was 7.7 cm back on July 30th of 2013. Her latest CT scan from July 7th 2014 shown this had shrunk to 2 cm in size with partial calcification, and the Spleen looked within "Normal Limits" according to the radiologist. Oncologist couldn't see anything now on her spleen. Her CEA went from 110 last year now to about 1.9 to 2.2.... Her CEA is now checked every three weeks prior to her "Maintenance" treatment of 5-FU/Avastin.

So I think they have a good plan for your mom. She may be lucky and they resect it when they do the colon resection, and might be on her way towards long term NED or even a cure. Not all Stage IV patients get that chance.

Regards,

GrouseMan

[pog451]

If there was a 1cm spot on the liver at Dx that has grown to 10cm (!!!) in 7 months, then your mother has been StIV from the start (it isnt confirmed as a met, but at that rate of growth a9 what else could it be and b) even if its benign ist going to destroy your mums liver soonest). I would want something growing that fast out, whatever it is.

TBH I would be pushing very very hard for then to plan a combined colon/liver resection when they open her up. A met that grows that fast will probably continue to grow that fast (or even faster, due to the organism being weakened) in the two or three months before she can get chemo.

They can do a needle biopsy beforehand and personally i would rather get that done, get the results in and if necessary delay the op a couple of days but then get everything done at once.

Alternatively, cancel the op., get on Chemo ASAP and see how things look in 3months or so.

BTW - If you havent already get a liver expert on your surgical Team stat (I assume the guy doing the colon is a board-certified bowel guy). rather put the OP back a couple of days and have some People going in who know what they are doing.

Going in just for a colon resection, then finding out its a met in the liver but having to wait weeks or months to heal before you can continue treatment sounds like the first step into a Vale of tears to me.

[janderson]

If the biopsy is positive for colon cancer she will be considered stage IV. The good news is they will most likely be able to take care of the liver with a second surgery or RFA.

[sailbd]

Hey Meatie:

I don't know all the facts about your mother's condition and I am certainly not a physician - neither are most of the people posting on this board. With that said, resection of the liver is generally recognized as the only viable way to a cure for colon cancer. It may be possible that your mom's liver met can be resected at this time due to its relatively small size. The surgery can be combined with the removal of the primary tumor in the colon. IMO - If you are not already at a major (NCI) hospital, go to one and see a surgical oncologist before any surgery. A week or two delay in removing the primary is not going to make much, if any, difference. However, a 3-6 month delay in addressing the liver could make a significant difference in the outcome of your mom's condition. Don't be afraid to postpone the colon surgery to get a second opinion! Good luck.

[elise]

Perhaps it was 10mm vs 1 cm (the same thing)??

[dianetavegia]

Wish I'd seen this earlier and I would have told you to demand a hepatic resection (removal of part of the liver with the 1 cm (10mm) tumor NOW and not at a later date.

Needle biopsies are not being done in many of the better cancer treatment centers now because of tumor seeding. I refused a needle biopsy 2 1/2 years ago when my met was found. I had a PET scan and went right to HR.

If that is all the cancer found in your mom, she would be Stage IVa. That's a new 'grading' and has much better stats than a typical Stage IV where multiple mets are found in more than one place.

Hope to hear soon how mom is doing.