Stage 4 Colon Cancer

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Jimt
Posts: 12
Joined: Sun Aug 05, 2018 5:05 am

Stage 4 Colon Cancer

Postby Jimt » Sun Aug 05, 2018 7:20 am

Dear all,

My english is not good. Plz let me know if my words create confusing or you dont understand what I describe

I just experienced the surgegy for colon cancer. The turmour is removed from my colon a week ago. The turmour already spread to my liver (1 small turmour) and the surgeon removed it during the surgery. I guess they can do that because it is resectable. Chemo therapy is expected to start in next 3-4 weeks.

I have some questions that need your support:

1> Is there any risks for my liver after removing the mets ?

2> From my point of view, the biggest risk for patients like me is that the mets are unable to remove or be surgical. Is it right ?

3> The recurrence will happen at some points due to the chemo or surgery fail to eliminate all turmour inside the body, maybe it is too small to detect or it is resistant to chemo ? Is it right ?

4> Can Stage IV be cured ? What conditions should be viewed as cured ?

Cheers

Gravelyguy
Posts: 39
Joined: Thu Jul 05, 2018 6:03 pm

Re: Stage 4 Colon Cancer

Postby Gravelyguy » Sun Aug 05, 2018 8:49 pm

Hi Jimt,
Glad you found us. Your English is just fine. I think I can answe your questions.

1. I think you are asking can anything bad happen to the liver after resection. If that is the question, there is always a chance of infection or internal bleeding but since you are a week out of surgery, I think you will be fine.

2. You are correct. The current best option is to resect liver mets. There are some other options that if you read the forums you can find out more on.

3. Yes, the surgery is to get rid of all visible tumors and the chemo is to to either shrink tumors or kill any cancer cells that could be traveling in your bloodstream. I don’t know why it comes back in some people years later.

4. Yes, people can be cured of stage lV colon cancer. All the current statistics are at least 5 years old and there are new protocols being developed all the time. I hope to be one of those cured and pray that you will be one too. We both had small liver mets so that gives us a better chance than those that have more invasive tumors.

Hope this helps,

Dave
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
11/17-3/18 8 rounds Folfox
6/18 NED!! Takedown
8/28/18 still NED! CEA .8 new low for me
10/18/18 colonoscopy clear

Jimt
Posts: 12
Joined: Sun Aug 05, 2018 5:05 am

Re: Stage 4 Colon Cancer

Postby Jimt » Sun Aug 05, 2018 9:03 pm

Thanks Dave.

I met 2 doctors with 2 different views. One said Stage 4 can be Cured, the other said It can be controlled. I think cured or controlled disease mostly depend on individual’s heath status and various factors. Do you know which factors detemine the stage can be cured or controlled ? I guess this depend on the mets can be resected or unresected ?

stu
Posts: 849
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 4 Colon Cancer

Postby stu » Mon Aug 06, 2018 2:58 am

Your questions have all been covered very well . Just to encourage you my mum had 73% of her liver removed in 2010 and she keeps very well .
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

Jimt
Posts: 12
Joined: Sun Aug 05, 2018 5:05 am

Re: Stage 4 Colon Cancer

Postby Jimt » Mon Aug 06, 2018 6:42 am

Thanks stu

My stage is: T1NOM1

A silly question is that if the liver met is resected by the surgeon. What is the difference between Stage 4 with other stages ?

With NO, the risk of recurrence is less ? Is is right ?

stu
Posts: 849
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 4 Colon Cancer

Postby stu » Mon Aug 06, 2018 3:45 pm

Hi ,
I would imagine so . The way the consultant described it to us was some cells travelled to other areas of the body as microdisease prior to the primary tumour being diagnosed. Surgery and chemo may successfully clear all the microdisease and there should be no further issues . If however some cells travel and lodge in another area they may present further down the line . So my mum had a recurrence in her lung seven years after the original spread . The good news, good scanning helps get on top of the spread quickly and if possibly treatment started . That would fall within the “ controllable” group . So some people will be cured and never get a recurrence and some will have to manage the disease .
I have to say other friends of my mum’s have had other health issues to manage . On the whole she has been fortunate and lives well . She accepted that this is part of her life and actually feels safer when she gets scanned and gets more concerned when they talk about reducing her scans .
My mum also had a significant spread at diagnosis so I think that would have been a factor in her having a recurrence .
Hope that helps ,
Getting to surgery is the biggest hurdle .
Take care,
Stu
Ps I should add that is how I remember the description it may not be accurate .
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

heiders33
Posts: 288
Joined: Sat Nov 04, 2017 11:08 am

Re: Stage 4 Colon Cancer

Postby heiders33 » Mon Aug 06, 2018 5:24 pm

This is good to read because I am facing a possible liver resection. I have a 1 cm liver spot that came back abnormal on my PET scan. Looking for encouraging stories anywhere I can!
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS G12A
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump
October 2018: Clear CT and colonoscopy

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Stage 4 Colon Cancer

Postby boxhill » Mon Aug 06, 2018 8:37 pm

Hi, JimT.

I am sort of like you in that I was diagnosed as Stage 4 because I had one tiny liver met--not even visible on scan--that was removed during surgery. Unlike you, I had a number of cancerous lymph nodes. But apparently all of them were removed also. My most current scan shows no masses or suspicious nodes anywhere.

What does this mean? Well, I quickly realized, when I started reading the (outdated) Stage 4 survival stats, that "Stage 4" included everything from you, with your uninvasive tumor and one tiny met to a person with multiple mets to the liver, lungs, brain, peritoneum, and spine at diagnosis. My initial impression that the stats were of minimal value was confirmed by the doctors, who pointed out that in addition there were effective drugs now that didn't exist when those patients were being treated.

My various doctors have talked of everything from possible stage 4 "cures," to controlling it as more or less a chronic disease. A chronic disease that might eventually be "cured" by one of the new treatments coming down the pipeline. I think that most doctors try to strike a balance between being optimistic and encouraging and being fairly realistic about the potential negatives.
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 started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

Jimt
Posts: 12
Joined: Sun Aug 05, 2018 5:05 am

Re: Stage 4 Colon Cancer

Postby Jimt » Tue Aug 07, 2018 5:59 am

Thanks for sharing your stories

I am just 26 years old. I was shocked when receiving the results from the doctor: Stage IV with liver mets.

Can all let me know what is the advantage/disadvantage for me when I have the disease at my age.

My doctor said at my age, the tumour is growing at much faster rate compared to that of the older. I am wondering is it high chance for recurrence or mets with my age ?

stu
Posts: 849
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 4 Colon Cancer

Postby stu » Tue Aug 07, 2018 1:02 pm

Hi Heiders ,
Sorry to hear about your need for more treatment . I think if you look you will find the stats are much better for one solitary liver met . My mum has seen over ten mets removed from her liver and it’s been clear for seven years .
As Boxhill stated and it’s true you can’t make direct comparison in a stage 4 setting . My mum’s disease was always described as a “ significant spread”
When she started chemo back in 2009 oxaliplatin had just been introduced five years earlier . I never heard of immunotherapy and hardly anyone was offered surgery . Within the last decade it’s is changing fast .
I can encourage you further . My mum’s liver surgeon removed a liver met from a patient over 22 years ago and he continues to do well .
Hope it goes well for you ,
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

stu
Posts: 849
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 4 Colon Cancer

Postby stu » Tue Aug 07, 2018 1:12 pm

Hi ,
I have never heard that before Jim . The problem for patients like my mum at 69 , when she had her bigger liver resection , she was at the upper age limit for the procedure . She would also have more risks for surgery and recovery compared to a younger patient . She also had a more significant spread than you so that would increase her risk of recurrence.
The stats for one solitary liver met I think are much better than those like my mum who have a significant spread . I was saying in the post above the treatment has advanced so much since my mum started having treatment . Surgeons are speaking a lot more positively and going in a lot more aggressively with surgery . Oncologists have a lot more treatment options with credible ones in the pipeline .
There has also been a lot of research done on the benefits of exercise and reducing the risk of recurrence .
You are very young and I can totally understand what a shock it has been for you . Your tumour burden appears very small so hopefully you can put this behind you and focus on your recovery . You have faced a horrible time but come through it .
The stats are very much a rear view mirror and especially now with so much changing .
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

boxhill
Posts: 118
Joined: Fri Apr 06, 2018 11:40 am

Re: Stage 4 Colon Cancer

Postby boxhill » Tue Aug 07, 2018 2:23 pm

Stu, I was 64 when diagnosed, and all the doctors said my prospects for doing well with chemo, etc, were good because I was "young and healthy"! What a different from being considered barely treatable a mere 5 years later. Things are indeed changing fast.

JimT, I think one thing you are going to need to be very firm about is making sure that the genetics of your tumor are tested. You need to find out if you have any of the genetic mutations that can affect your likelihood of developing cancers. It will likely be a good idea for them to test your blood, as well as the tumor, to distinguish between a somatic mutation in the tumor, and a germline mutation in you.
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 started
Added Neulasta 6/28/18
7/9/18 CT scans show no masses or enlarged nodes, 2mm indeterminate lung nodule

heiders33
Posts: 288
Joined: Sat Nov 04, 2017 11:08 am

Re: Stage 4 Colon Cancer

Postby heiders33 » Tue Aug 07, 2018 2:37 pm

Thank you, Stu! I’ll let you know how it goes.
36 year-old female
May 2017: Dx rectal cancer at T3N2M0
MSS, KRAS G12A
June-July 2017: 28 days of chemo/radiation
September 2017: laparoscopic LAR with loop ileostomy
October 2017 - February 2018: XELOX six rounds
March 2018: reversal
April 2018: CEA 2.1, all blood counts normal
May 2018: CT scan showed liver spot
August 2018: Abnormal PET, CEA 2.4
September 2018: liver resection with HAI pump
October 2018: Clear CT and colonoscopy

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: Stage 4 Colon Cancer

Postby NHMike » Tue Aug 07, 2018 2:41 pm

Jimt wrote:Thanks for sharing your stories

I am just 26 years old. I was shocked when receiving the results from the doctor: Stage IV with liver mets.

Can all let me know what is the advantage/disadvantage for me when I have the disease at my age.

My doctor said at my age, the tumour is growing at much faster rate compared to that of the older. I am wondering is it high chance for recurrence or mets with my age ?


It's unusual for someone so young to have Colon cancer though there are a few genetic reasons why someone could get it so young such as Lynch's. So genetic testing might be useful. A family history could be indicative of something too.
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; 9/8: 1.8; 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
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

stu
Posts: 849
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 4 Colon Cancer

Postby stu » Tue Aug 07, 2018 2:45 pm

Hi boxhill ,
It has been incredible watching the changes unfold . I am now reading about fit patients in their eighties getting liver resections . This was not the case ten years ago . I have spent the last decade urging people to get a surgical opinion. I find I have to do it less and less as it’s more common to be referred automatically now . That has to start impacting stats .
I can also see the stats starting to move in a better direction .
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


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