The Colon Club

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.

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.

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!

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.

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

People surprise doctors all the time. That's why it's called 'practicing medicine.' 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.

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.

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.

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.

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

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.