Are you sure of your mnl's staging? Have you seen a post surgical pathology report? To be dx St IV w/o distant organ involvement that they cannot confirm, it must be distant lymph nodes affected. Any nearby lymph nodes might have been removed during, I'm assuming, a colon resection since you state she had surgery. You stated that they are not clear if spots on liver or lung are cancer. An MRI can be done instead of PET...or sounds like the onc wants to watch CT scans for growth in liver/lung & if lesions grow, then most likely cancer. Something is just not adding up in my mind
My understanding is, assuming she is USA resident is that Medicare will cover 3 Pet scans in a lifetime, don't know limits on MRI's. I know my mother had MRI's medicare covered.
A link to NCCN Guidelines to Standard of Care:
https://www.nccn.org/patients/guideline ... ndex.html# FOLFOX = FOL– Folinic acid (leucovorin)
F – Fluorouracil (5-FU)
OX – Oxaliplatin (Eloxatin)
FOLFIRI =
FOL – folinic acid (leucovorin), a vitamin B derivative increases the cytotoxicity of 5-fluorouracil;
F – fluorouracil (5-FU), a pyrimidine analog and antimetabolite which incorporates into the DNA molecule and stops synthesis; and
IRI – irinotecan (Camptosar), a topoisomerase inhibitor, which prevents DNA from uncoiling and duplicating.
W/o leucovorin your mil is not getting FOLFOX OR FOLFIRI technically speaking. Onc w/b administering 5-FU & Oxi (for short).
We have a sticky thread for Terminology & Abbreviations you may find useful:
viewtopic.php?f=1&t=5366I hope they implanted a port a cath in her left chest (most common)for IV delivery of chemo meds & don't intend on delivery through veins.
To answer your question regarding other elderly folks: Yes, if you read the links on my 1st post, you will see that we have had other members w/elderly parents.
I understand your position as dnl. Your mil is entitled to chemo if that is what she wants. I think the input you have received so far should help your family to ask good questions of her onc, good enough to get everyone to come to an understanding along w/your mil of preferences in treatment & testing options...thanks to you.
You said you are an avid researcher. Boy, have you landed @ the right place! You have found a site w/a wealth of information @ your fingertips.
Best Wishes
BS