Colon cancer mets ??? Options

[Ceebo]

My 64 year old husband was dx with colon cancer last April. He went In for a routine colonoscopy and large adenocarcinoma was found in cecum. Right hemicolectomy was done; 5 pos. nodes; 3 liver tumors. Started FOLFOX treatments to shrink liver tumors and then do a resection. Last Sept. while he was opened up for the liver surgery they found the peritoneal mets and aborted the liver surgery. The surgeon said "he has hundreds of tiny tumors on his bowels and in his pelvis. He needs systemic chemo at this point. There's no point in doing the liver surgery now." He has been getting FOLFIRI and Avastin since October and his CEA levels have decreased from 456 to 54 and his CT scan in January showed some of the larger liver tumors had shrunk 50%. He also has several 1-2mm tumors in his lungs but many of those have disappeared.

I guess I just wonder what to expect in the future. Our oncologist says he'll be on chemo the rest of his life. No one has mentioned anything about any surgical procedures to remove the liver tumors in the future.Is that totally out of the question? Does peritoneal mets ever go away or is it able to be controlled? Evidently it is not usually detectable on a CT scan or PET scan.

I've been reading about the clinical studies that are being done using low dose chemo over a longer period of time instead of the traditional type of dosing schedule. Anyone heard of that?

We are very thankful he's tolerating the chemo well and his QOL is good. He is not having any physical symptoms from the tumors and his major side effects from the chemo are a few days of fatigue and some biwel issues. We are just taking each day as it comes and appreciating out time together.

Thanks for any input you may have.

[Lee]

First WELCOME, sorry for the reason you are here. Butt you will find a lot of information and support here.

My best advice is get a 2nd opinion at a major cancer treatment center. Two good hospital are Sloan Kittering in New York City and MD Anderson in Houston, TX. Cancer Treatment Center of America is another possible Since he has responded well to chemo, sometimes surgical procedures can be done. Butt again, you need the opinion from a major cancer treatment center. They tend to be on the leading edge of the latest and greatest procedures.

Others will be along who have been in your shoes right now.

Don't give up hope or the fight.

Lee

[Ceebo]

We were told at the University of Michigan Cancer Center, where the peritoneal mets was found, that systemic chemo was what the next course of action should be. We returned to our local cancer center to begin a different chemo regimen than he had been on previous to the surgery. Avastin was also added. Maybe if he keeps responding well to the chemo we should ask for a PET scan to evaluate his progress and then decide if we should get another opinion on surgery for the liver mets.

Thanks for your comments!

[plastikos]

Sorry to hear about your husband. First of all do not lose hope. There are always options whether traditional or alternative, evidence-based or otherwise. I would suggest you look into HIPEC. I have no personal experience or testimonial but based on my limited knowledge of oncologic sugery its may be an option for your husband. As far as I know the authority on HIPEC is Dr. Sugarbaker in Washington. Look it up.

[Voxx66]

Systemic chemo is definitely the standard and likely best option for the foreseeable future. However, eventually HIPEC may be an option though they might want to combine it with a liver resection. There is also the possibility that new treatments will become available which could better the situation. If your husband is tolerating chemo well and is still responding, then you may be well advised to continue with it. When that changes however, you should have a plan in place as to what you want to do next.

[dianetavegia]

"he has hundreds of tiny tumors on his bowels and in his pelvis."

I don't think a low dose chemo would be a good choice with the scenario you've presented. I'm so sorry for your husband's dx but looks like he's had a pretty good year with shrinkage, etc!

[Ceebo]

Thanks for all the input. Yes, I definitely think we want to continue this chemo regimen since he is responding positively. I just keep searching through clinical information about colon cancer to be sure I'm not missing something else that might be available for him. I definitely trust our onc, so I also know he will make suggestions for future treatment when needed. In fact, he mentioned on our last visit with him that there's a drug similar to Avastin that is currently being used for Gastric cancer that may be approved for colon CA in the near future. He said it is a "stand alone" drug. Besides Styvarga, which I'm not enthused about, that's his only other potential drug in the weaponry for him at this time.