Colon Cancer with mets to liver

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SMacDonald
Posts: 3
Joined: Fri Jul 20, 2018 2:18 pm

Colon Cancer with mets to liver

Postby SMacDonald » Fri Jul 20, 2018 2:34 pm

My dad was diagnosed with Stage 4 colon cancer on April 27th - Cancer in the Sigmoid with mets to the liver. He was relieved of the blockage through an ostomy and now just finished 4 cycles of chemo - (IV Oxaliplatin, Avastin and then 7 days of Xeloda pills). After the 4th cycle, the oncologist ordered a new scan and we just received the result. Doctor said the tumors have not grown and have not shrunk either - so it is stable. He asked my Dad about the side effects (which luckily have been very mild - fatigue, weakness and balance issues) and if he was in any pain. Dad said no pain besides the leg weakness. Then he asked if my Dad wanted to continue treatment, Dad said yes and we are signed up for 4 more cycles then a scan. The doctor pressed on Dads stomach and asked if it hurt - the answer was no. The doc almost seemed surprised that Dad is not in pain. The Doctor made us think that there is no hope. My Dad is 80, and he opened up our family store every day (even on April 27th) so he is not one to be sick or take time off. He is not one who gives up either. All of his other organs, bloodwork, heart, brain etc are all in great shape.

For those of you who have gone through this or are going through it, is it a bad sign of no shrinkage of the tumors after 4 cycles? The obvious question is - is there hope? I know that is not something that can be answered here but we could use a little insight from someone who is going thru this or has gone thru this.

Gravelyguy
Posts: 77
Joined: Thu Jul 05, 2018 6:03 pm

Re: Colon Cancer with mets to liver

Postby Gravelyguy » Fri Jul 20, 2018 7:08 pm

Hi There,

Sorry your Dad has to go through this. I am not a Dr. but would think that no growth is a good sign. Certainly shrinkage is better. But from my reading, I think your dad is doing ok.

My local oncologist was pretty down on my chances early on but I ended up having surgery at Mayo in Rochester and they were very optimistic. Don’t give up hope. Not sure where you Dad lives but finding a larger cancer center wouldn’t be a bad idea.
6/17 dx mCRC t3n1m1 very low rectal tumor 2 very small liver Mets

6/17 begin 4 rounds Folfox w/Vectibix
9/17 short course radiation
10/17 rectal and liver resection cancer is out of here!
11/17-3/18 8 rounds Folfox
6/18 still NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear
12/12 clear scans, CEA .9 still NED!

plastikos
Posts: 309
Joined: Wed Jan 14, 2015 6:09 am

Re: Colon Cancer with mets to liver

Postby plastikos » Sat Jul 21, 2018 1:10 am

No growth is better than progression (growth) but not as good as shrinkage. I think continuing chemo is the right step but only if the goal is to get to a point where surgery is an option. Ask your doctors if they plan to do surgery. Of course the decision on how aggressive you want to be will depend on your father’s age and general medical condition. There is ALWAYS hope. Good luck!
St. IV Colon CA @ 37, male, Kras wild, MSI-high (2014)
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
10/2015 - Recurrence liver
Liver resection 10/2015
FOLFIRI 11/2015 - 5/2016
Recurrence liver, nodes 11/2016
Pembrolizumab started 12/2016 -> pseudoprogression(?) -> biliary obstruction -> biliary stenting
Chemo 4x: most mets inactive and smaller on PET-CT
March 2017 - Back on Pembrolizumab again
Sept 2017 - SIRT - > NED

mpbser
Posts: 504
Joined: Wed Apr 19, 2017 11:52 am

Re: Colon Cancer with mets to liver

Postby mpbser » Sat Jul 21, 2018 6:28 am

I wonder why some people respond well to chemo while others do not. Could there be a reason why his tumors have not shrank? I second the suggestion of going to a major cancer center or large hospital with a good reputation for oncology.
Wife 4/17 Dx age 45
5/17 - Lap left hemi
Adenocarcinoma
5 x 4 x 1 cm
low grade
T3 N2b M1a
Stage IV A
lymph nodes: 9 of 54
8/17 Sub-total colectomy
2nd tumor 5.5 cm T1 N0
CEA: 1.4, 2.1, 1.5, 1.9, 1.9, 2.1, 2.1, 2.4, 1.7, 2.0
MSS/MSI-L
Lynch no; KRAS wild
Immunohistochemsistry: Normal MLH1, MSH2, MSH6, and PMS2
Tumor DNA variants: MTOR, APC, TP53
Liver left hepatectomy seg 4 1/31/18
5/18 NED

stu
Posts: 901
Joined: Sat Aug 17, 2013 5:46 pm

Re: Colon Cancer with mets to liver

Postby stu » Sat Jul 21, 2018 7:21 am

Stability is also good . He is managing chemo well and living his life . Sounds as though he is striking a balance and has quality of life and a focus . Lots of positives there . I would not underestimate him . He sounds as though he has a bit of strength in him .
Take care,
Stu
supporter to my mum who lives a great life despite a difficult diagnosis
stage4 2009 significant spread to liver
2010 colon /liver resection
chemo following recurrence
73% of liver removed
enjoying life treatment free
2016 lung resection
Oct 2017 nice clear scan . Two lung nodules disappeared
Oct 2018. Another clear scan .

mhf1986
Posts: 158
Joined: Sat Mar 11, 2017 8:30 pm
Location: near DC

Re: Colon Cancer with mets to liver

Postby mhf1986 » Sat Jul 21, 2018 7:52 am

People surprise doctors all the time. That's why it's called 'practicing medicine.' :lol: According to the first oncology group my DH saw, he wasn't supposed to be here right now! Highly second the "Get to a major cancer center." They have all the bells and whistles. There are other treatment options. But...stable is good.
Caregiver to DH, dx @ 50, mets to liver/lungs, MSS, wild
9/16 CEA 114, blockage, left hemi, perm. colostomy
11/16 port in, FOLFOX + Avastin
6/17 CEA 15, 5FU + A only due to neuropathy
11/17 CEA 38, CAPOX + A
1/18 CAPOX = hi bilirubin/bad hfs, back to FOLFOX + A
5/18 growth; Vectibex + 75% Irinotecan
7/18 CEA 23, shrinkage
10/18 CEA 28, growth of 2 liver tumors/shrinkage of few and lung nodes
11/18 Lonsurf, looking at spheres, proton, trials
11/19/18 Peace

boxhill
Posts: 125
Joined: Fri Apr 06, 2018 11:40 am

Re: Colon Cancer with mets to liver

Postby boxhill » Sat Jul 21, 2018 2:18 pm

This may be a silly question, but are they certain that the nodes in his liver are actually cancer mets? Are they not resectable?

Do you think the doctor is considering limited options because of his age, and not considering his good health? As they say, there are people who are young old and people who are old old.

Definitely, at least get a second opinion, preferably from a major cancer center.
F, 64 at DX CRC Stage IV (or "3 1/2" per Dana Farber consult, LOL)
3/17/18 blockage, emergency surgery, r hemicolectomy
11 of 25 nodes
5 of 5 mesentery nodes, matted
0.5 cm sub-capsular liver met removed
pT3 pN2b pM1
Neg CEA, neg BRAF, KRAS G12D, germline mut ATM
dMMR, MSI-H, Neg for Lynch
5/4/18 FOLFOX
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule
11/20/18 CT scans NED. Lung nodule likely calcified granuloma. Enlarged spleen.

SMacDonald
Posts: 3
Joined: Fri Jul 20, 2018 2:18 pm

Re: Colon Cancer with mets to liver

Postby SMacDonald » Tue Jul 24, 2018 6:10 pm

We are located in Southern Maine and go to New England Cancer Specialists that work out of Maine Medical Center in Portland. The doctor said surgery is not an option for the liver. When we first were informed of the issue, the doctor said if Dad had no treatment, he would die in 3 to 4 months. With chemo he could live 2 to 3 years, and obviously this hit us like a ton of bricks. So we had the surgery to bypass the tumor in the colon and let that heal for a couple of weeks then started the chemo to try and shrink everything. We have been told that the liver mets are not operable because there are so many, however, I have been reading on this site that others had that same info from doctor and after treatment to shrink, they had them removed. So that is what we are striving for - the doctor only looks at Dads age, he does not realize just how strong he is - he worked 7 days a week, opening everyday up to the day he went to the hospital.

My Dad is definitley a young old person. He is not on any medication for anything prior to this diagnosis. He simply took his vitamins everyday and that seemed shocking to the doctor too. No high blood pressure, no prescribed meds at all for his entire life. Even now, he does not take any of the nausea medicine, and none of the pain meds they prescribed (just in case he had pain). He takes the same vitamins, and we have added Milk Thistle and Acetyl - LCarnate to his daily regimen of vitamins.

Obviously, we are novices to this disease - and are trying to maneuver down this road that honestly, has aged all of us these past 2.5 months or so. Seeing no "Progress" makes us worry further. Thank you for the responses and we are looking into Dana Farber in Boston for a second opinion.

weisssoccermom
Posts: 5883
Joined: Thu May 10, 2007 2:32 pm
Location: Pacific NW

Re: Colon Cancer with mets to liver

Postby weisssoccermom » Tue Jul 24, 2018 6:35 pm

One thing you may want to have your dad stop taking is the multivitamin. When a patient is on 5FU or Xeloda (FOL or XE in the FOLFOX or XELOX combos), the folic acid in the multivitamin is NOT a good thing to be taking. This is because the folic acid allows the 5FU or Xeloda to build up in the patient's system and can make the patient ill...particularly nauseous. Did your dad tell his oncologist that he was taking a multivitamin? In the 12 years since my diagnosis, I have only found ONE multivitamin that doesn't contain folic acid. Just please, be aware of that and tell your dad, at least while he is on chemo to stop taking his multivitamin. It would only be for a short time.not permanently.
Dx 6/22/2006 IIA rectal cancer
6 wks rad/Xeloda -finished 9/06
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 months Xeloda only Dec '06 - April '07
10+ blood clots, 1 DVT 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
Perform random acts of kindness

SMacDonald
Posts: 3
Joined: Fri Jul 20, 2018 2:18 pm

Re: Colon Cancer with mets to liver

Postby SMacDonald » Wed Jul 25, 2018 11:52 am

Thank you for this info. We did tell the oncologist of all of the vitamins he is taking. I will definitely look into this.

martd
Posts: 61
Joined: Tue Nov 21, 2017 3:48 pm

Re: Colon Cancer with mets to liver

Postby martd » Wed Jul 25, 2018 1:02 pm

I was told the same by my onc that there were too many tumors for surgery, I had 17 liver Mets. But I was told different from my surgeon, 7 months later I had a 2 stage lver resection. But not everyone can do some of the more advanced surgeries like this. Maybe call all the nearest major cancer centers for a second opinion. Also look into MSK in New York.
49 y/o male dx 11/2017 crc
Stage 4 with 17 liver Mets, cea 490
RAS, BRAF WT
12 rounds folfox , avastin / oxi
5/18 cea 2.8 liver resection and pve
7/18 part 2 liver resection, remove right side of liver
Surgical site mrsa infection, wound vac
8/18 cea .9 cCR, rectal tumor is gone
Rectal surgery postponed, watch and wait
10/18 clear scan CEA .7


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