Newly Diagnosed wife - Stage 4 w Liver Mets

[sotorey]

I also had a colon-primary with too large liver-mets. Had immediate colon repair, followed by chemo (6 mos of Capox/Avastine) to make the mets shrink. It all worked out beautifully: successful colon resection (no bag) and chemo killed all cancer; no cancer cells found during liver resection.

The same 'by-the-book'/'standard' approach as recommended for your wife. See my signature below.
My best wishes, Leon

Thank you Leon. If I may ask, how long did you have between your colon resection and starting chemo? The colon surgeon says "no bag" is not an option since she will be starting chemo quickly. It may have to do with the location of her tumor in the rectosigmoid junction.

[Redtexa5]

I think you have a good handle on things certainly find a "Surgical Oncologist" or two one for the liver on for the colon, but if your wife is blocking they should be able to put in a colostomy which will likely make her feel much better then you she go through treatment. They did this for me then reversed it when they operated to remove the tumor. I don't know why this hasn't been done, but a liquid diet makes it hard to maintain proper nutrition and this can make getting through chemo etc. very hard.

Just a thought, talk to your doctors if you wish.

[LeonW]

how long did you have between your colon resection and starting chemo? The colon surgeon says "no bag" is not an option since she will be starting chemo quickly. It may have to do with the location of her tumor in the rectosigmoid junction.

May colon repair was on Jan 16 (2013). Left hospital 10 days later. Chemo started Feb 21 (2013).
My tumor was in the transverse colon close to the spleen. Just before where colon bends down.

Best wishes, L

[Nik Colon]

Wow! Thank you all for the great advice and the hope your stories provide. I was also recently diagnosed with stave iv prostate cancer and our 6yo son has thankfully been NED for 3 years after Neuroblastoma treatment. Unfortunately I'm getting used to advocating for treatments :/

They agreed to discharge my wife on a liquid diet and pain meds. She is still symptomatic (difficulty passing stool, pain and cramping), so we need to hurry to get our second opinions. I spent the last two days on the phone with insurance and doctors and we will see a liver surgeon (Dr Alan Hemming) and colorectal surgeon (Dr Sonia Ramamoorthy) at Moores Cancer Center at UCSD for second opinions this Thursday. Unfortunately, we have a very restrictive HMO (which I hope to change Jan 1) so not sure if the treatments will be covered at UCSD.

I have two follow up questions if anyone has any advice:

1. Does anyone have a recommendation for an oncologist in Southern California? (Preferably with experience treating colon cancer with liver mets)

2. Does anyone have a recommendation for a second opinion on the pathology? (The pathology report took a week and a half and there was some talk that it may be primary ovarian cancer that has spread. They discussed her case in a departmental conference and came to the consensus of Colon Cancer. But the question of ovarian cancer worries me especially since she has had ovarian cysts in the past).


I hope its okay I post questions on this board as they come along. This seems like the best source of information I've found. I really appreciate all of you willing to help out strangers in need, and wish you all the best

Cysts are common, in have had them come and go over many yrs, but I recently decided on a histo. Too long with this crap and pain, etc. But if just Cysts, I would not worry, but talk to a gyno surgeon if you want more info.

[sotorey]

Just to update the thread:

We saw a liver surgeon at UCSD (Dr. Hemming) who told us (as many of you said) that the size of the liver lesions only matter incidentally, what really matters is if he could preserve enough liver that it will not fail. This could be with a large lesion if it isn't in the wrong spots. In my wife's case, she has the larger lesion and two smaller lesions, which unfortunately each sit on a different vein. He would need to be able to preserve one of these veins for a successful surgery.

So she will undergo three months of chemotherapy and then be re-evaluated for liver surgery. In the mean time they have placed a colonic stent to relieve her bowel obstruction so she can begin chemotherapy asap. The doctors think she has a good chance at responding to chemo and becoming resectable, so that is the plan

Thank you again for all your help and best wishes to all.