Need help to understand "dormant" cancer

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GeoChicago
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Joined: Fri Mar 03, 2017 1:46 pm

Need help to understand "dormant" cancer

Postby GeoChicago » Fri Jul 28, 2017 10:31 am

Hi Everyone,
Around 4-5 months or so ago I posted that my 86 year old father had been diagnosed with colon cancer. He is stage 3 with a "well differentiated" tumor of about 4 centimeters, plus some lymph node involvement. Since that time he has undergone chemo-radiation treatments with the goal of shrinking the tumor for a potential subsequent surgery. Well, the treatments have ended around 6 weeks ago and the doctor told him the tumor had shrunk to some degree (to what extent I don't know). His radiologist has recently told him a post-treatment CT scan showed no spread of cancer to anywhere else, and his lungs seemed okay as well. He further told my father that the cancer is "dormant" at this point. I've done a bit of Googling of that term and I'm still not entirely sure what this means from a practical standpoint. Is "dormancy" about the best outcome that could expected from chemo-radiation alone? "Dormancy" sounds like it's a good thing, but then again I don't know. Does the cancer come back more powerfully after a dormant stage? Can it perhaps lay dormant for a long period? Any info is appreciated to help me get my head around what this means. Thanks very much.


G

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CRguy
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Joined: Sun Feb 10, 2008 6:00 pm

Re: Need help to understand "dormant" cancer

Postby CRguy » Fri Jul 28, 2017 7:48 pm

GeoChicago wrote: Is "dormancy" about the best outcome that could expected from chemo-radiation alone?
No, there can be complete responses : either clinical or pathological
"Dormancy" sounds like it's a good thing, but then again I don't know.
Dormant is Ok... BUTT cured is better
Does the cancer come back more powerfully after a dormant stage?
Depends on type of cancer, prior treatments, individual metabolism/biology/genetics of the patient
Can it perhaps lay dormant for a long period?
Yes, some tumors are very slow growing i.e. don't appear to be there BUTT actually still exist at the molecular level

I would ask the doctors SPECIFICALLY what they mean by "dormant" in the scope of their practices,
with particular reference to your father's case.
Push them to get some specific answers and ask what they feel is their best recommendation for best standard of care,
and an appropriate follow up plan for your father.

Typically, surgery would be done at some point after the chemo-radiation.

Get more info.
Be persistent.
Advocate .... knowledge is power

Cheers and best wishes ...and keep us in the loop if you need more feedback
CRguy
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

behconsult
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Joined: Fri Jul 04, 2014 4:53 pm

Re: Need help to understand "dormant" cancer

Postby behconsult » Fri Jul 28, 2017 9:02 pm

I also wonder if quality of life issues are the driving factor in the statement of 'dormancy" in an 86 year old in addition to what CRguy mentioned. Chemo and radiation at that age would radically change current functioning quickly. Oncs see enough suffering- the cost benefit curve is skewed unfortunately. Additionally, cell division in an 86 year old is so slow; everything seems to be dormant. This is the case with wound healing in the elderly as well as other functions being diminished. Despite such statements this is still someone you care about very much about and want the best for. Best treatment option IMO is well spent time and a focus on meaningful life. Peace to you and yours. Bob
Stage 4 Age 56 BrafV660E 5/14
spot on perit/ Right side tumor
Resctn 6/9/2014
Folfox strt 7/2014. 6 of 12 tx
Chemo induced DM2
Pet 4 mets to lung (1 cm, 6 mm) Xeloda/Avastin 9/16 to present.
Cryo-ablation to four spots- Collapsed lung/chest tube 2x
Possible local recurrence in a spot or two on PET. Stable CT

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CRguy
Posts: 10473
Joined: Sun Feb 10, 2008 6:00 pm

Re: Need help to understand "dormant" cancer

Postby CRguy » Fri Jul 28, 2017 11:42 pm

I think behconsult raises a valid point which is a sub-context to my comments ... BUTT if I may offer this, from a more critical perspective :

sometimes medicos " assume" that the elderly may not benefit from this or that treatment,
OR ... treatments will not make a meaningful difference to the Quality Of Life or longevity
and in using those metrics ... triage elderly patients differently than younger patients.

ergo ... my comment :
Get more info.
Be persistent.
Advocate .... knowledge is power

Perhaps I was being too polite, so I will clarify :

Do NOT let the Docs dismiss or "write off" your loved one simply because they are older.
Kick ASS and take names.
I myself, am now in my third term as caregiver for geriatric loved ones ( 92, 86, 89 )

CRguy ... on a continuing Journey
Caregiver x 4
Stage IV A rectal cancer/lung met
17 Year survivor
my life is an ongoing totally randomized UNcontrolled experiment with N=1 !
Review of my Journey so far

GeoChicago
Posts: 10
Joined: Fri Mar 03, 2017 1:46 pm

Re: Need help to understand "dormant" cancer

Postby GeoChicago » Mon Aug 21, 2017 6:01 am

Thank you for the replies. My father was recommended surgery but has declined at this time and has instead decided to "ride out" his condition. I do not live in the same country as he does so cannot effectively persuade him in any particular direction. He was given an estimate of 1 to 5 years, a rather broad range for an 86 year old. He would have to have a colostomy bag, probably permanently, were he to have the surgery and he doesn't seem to want that. On top of this is his attitude that doctors just want to "make a buck" off him. I have some anxiety over the whole thing of course, and part of me wishes for him to have the surgery. But I can't convince him to go that way. He says he's in no pain and his bathroom habits have returned to, more or less, normal (I guess because the tumor shrank). I have to be grateful for the 86+ years he's had. Hopefully he has a few more.

G

NHMike
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Joined: Fri Jul 21, 2017 3:43 am

Re: Need help to understand "dormant" cancer

Postby NHMike » Mon Aug 21, 2017 6:41 am

My mother (93 back then) had a heart attack two years ago and we were told to say our goodbyes in the hospital. She had the heart attack because she went off her medication to try an alternative/natural remedies. She survived the heart attack and is still alive today though she has to take several medications to live. I'm in my late 50s and am looking at a permanent colostomy (I will consider myself fortunate if this is not the case though it would be a lot of work and time to adjust) and I imagine that there are many younger folks in their 30s and 40s looking at the same thing.

I don't know what decision I'd make at 86 though.

I am impressed that he made it through the chemo and radiation at that age. I'm halfway through and it's rough and it's going to get a lot rougher.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8, 2/12 1.2
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal
2/19: Clean CT

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susie0915
Posts: 945
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Need help to understand "dormant" cancer

Postby susie0915 » Mon Aug 21, 2017 7:41 am

My surgeon told me that all that was left after chemoradiation was scar tissue, and may not need chemo after
surgery. However, the pathology report from surgery showed clear margins, no lymph node involvement but there were
dead cancer cells, so he recommended chemotherapy. Was a disappointment to me but I made it through. I was never
really clear why he wanted me to have chemo if cancer cells were dead. I could only think he couldn't be sure that no cells
got into my bloodstream, not sure. Not sure about dormant cells though.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 PET scan NED
9/15 LAR
0/24 nodes
10/15 blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 C 4mm lung nod
10/17 pel/abd CT NED
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, CT pel/abd/lung NED
11/18 CEA .6
5/19 CT NED, CEA <.5
10/19 Clear colonscopy
11/19 CEA <.5


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