Stage 3/4 Colon Cancer

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rahlac
Posts: 2
Joined: Thu Jan 24, 2019 9:08 pm

Stage 3/4 Colon Cancer

Postby rahlac » Fri Feb 08, 2019 2:56 am

Hi all,

I would like to share the story of my mother's diagnosis of Stage 3/4 colon cancer and request information from people on this board. It is unlike anything I am reading here on this forum, especially to be considered Stage 3/4, so I would appreciate any opinions or information from experience. She was diagnosed in December 2018 due to unable to pass stool and pain. After multiple CT scans, PET scans, MRI and Mammogram, here is the information:
- Adenocarcinoma (~4x4cm) in Sigmoid Colon
- .5cm and 1cm (2 lesions) metastasis to Liver.
- Surgery was done today (liver resection and colon tumor resection) & 12 lymph nodes removed from Biopsy.

My Mom is doing great and despite this diagnosis, she appears to be very healthy. She is age 56. We are not waiting for biopsy results for the lymph nodes before we are prescribed a Chemo treatment. I have the following questions:

- If there were only 3 cancerous tumors that showed up on numerous scans, and those tumors were removed, why would Chemo be necessary?
- If cancer cells are not visible on scans and this is the reason Chemo is prescribed, how many rounds is normal? There were some discussions (by the GI surgeon) saying 8 rounds over 4-6 months is most likely the case. How can they say things like this when they haven't even biopsied the lymph nodes and all other tumors were resected?
- Is Stage 4 the correct term for this even if all 3 lesions were able to be removed?
- If none or minimal Chemo is done, what are the metabolic pathways for the cancer to return?

These are just a few questions I have right now but as I see discussion, I will most likely have more. I appreciate everyone's help in this. If I need to provide any additional information for feedback to be more useful, please let me know.

Thank you and I look forward to joining the family on this board.

hiker
Posts: 130
Joined: Thu Aug 09, 2018 10:15 am

Re: Stage 3/4 Colon Cancer

Postby hiker » Fri Feb 08, 2019 11:29 am

Hey rahlac,

Hopefully, I can answer your questions without adding confusion:

Chemo is standard for anything beyond stage 2. Once the cancer has spread and there are visible tumors, there's most certainly cancer cells floating around that have not yet developed into tumors.

I was scheduled to do 12 rds of chemo post liver resection surgery (I did 11), but I also did 3 rds between surgeries and 5 rds of HAI pump chemo. The standard is usually 12 rds although I have read where some oncologists are now recommending 8 rds. particularly when the cocktail is FOLFOX since the oxi is really hard on a person.

If your mom had cancer originate in the colon and spread to the liver, she is indeed stage 4.

Chemo is like an insurance policy. It's effectiveness varies; however, with it a person has a better chance of not having a recurrence. How much of a better chance? I have no idea. But if it gives me 10% better odds, I'll take it.

Where is your mother being treated? Is she at a facility that offers the HAI pump? If not, you may want to consider getting a second opinion before starting chemo. I was given a 2 year expiration date when diagnosed - I'll hit that mark later this month and am currently cancer free.

hiker
Colonoscopy 2/17, 5cm tumor descending
Diagnosed stage iv, liver mets 3/17
Colon resection 3/17
Told surgery not an option, get my affairs in order
Meet w/MSK team 5/01/17
Folfox(3rds) 5/17-6/17
Liver resection/implant HAI pump 7/17
HAI pump chemo(5rds) 8/17-2/18
Folfiri+Vectibix(11rds) 8/17-2/18
Spot on chest CT 10/17
Lung biopsy (that was fun) 11/17
Nocardia bacterial infection w/spread to brain (this is serious) 11/17
IV antibiotics 12/17-2/18
Oral antibiotics 3/18-12/18
Clear of cancer since surgery

User avatar
LPL
Posts: 519
Joined: Fri Apr 22, 2016 12:49 am
Location: Europe

Re: Stage 3/4 Colon Cancer

Postby LPL » Fri Feb 08, 2019 1:30 pm

rahlac wrote:
We are not waiting for biopsy results for the lymph nodes before we are prescribed a Chemo treatment.

I agree with member hiker. But I am wondering.. Why are you Not waiting for the pathology report regarding lymph nodes etc.? I hope they also will do gene tests so that you will find out for example MSS/MSI and KRAS. These things influence what kind of chemo will likely be most effective. Your mother needs to heal from the surgery before starting chemo.
All the best to you.
DH @ 65 DX 4/11/16 CC recto-sigmoid junction
Adenocarcenoma pt 35x15x9mm G3(biopsi) G1(surgical)
Mets 3 Liver resectable
T4aN1bM1a Stage IVa 2/9 LN
MSS, KRAS-mut G13D
CEA & CA19-9: 5/18 2.5 78 8/17 1.4 48 2/14/17 1.8 29
4 Folfox 6/15-7/30 (b4 liver surgery) 8 after
CT: 8/8 no change 3/27/17 NED for now :D
:!: Steroid induced hyperglycemia dx after 3chemo .. hospitalized, insulin -> Metformin
Surgeries (open):
3/18 Emergency colostomy 5/23 Primary+gallbl+colostomy reversal (+port) 9/01 Liver mets

stu
Posts: 994
Joined: Sat Aug 17, 2013 5:46 pm

Re: Stage 3/4 Colon Cancer

Postby stu » Fri Feb 08, 2019 1:47 pm

Hi ,
Your mum is young . Great to hear she was operable and all the very best to her going forward .
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 .

hopie
Posts: 33
Joined: Fri Jan 18, 2019 12:15 pm

Re: Stage 3/4 Colon Cancer

Postby hopie » Fri Feb 08, 2019 2:22 pm

Hi rahlac,
Others pretty much have answered your questions, but here's a recap (I might be wrong but this is what I understood so far):
Stage 1 & 2: These are differentiated based on the invasion of the tumor, that is, how far it has grown into tissue.
Stage 3: If lymph nodes are involved, it's stage 3.
Stage 4: If other organs are involved, it's stage 4 (it doesn't matter if lymph nodes are involved or not).

Cancer cells usually wander around the body and sometimes they form new tumors. Even if liver mets and the tumor in the colon are removed, chemo makes sure to clear those remaining wandering cancerous cells. It also takes care of smaller things that don't show up in CT/PET/MR.

They will likely wait for your mom to recover from surgery before they give her chemo. My mom's liver mets were initially going to be removed during her colon surgery too, but her surgeon discovered new mets during surgery so now she'll start chemo to see how they react. And I would also like to say that your mom is lucky to have her mets and colon tumor removed at the same time! This is a terrible path, but it's a great start!
Caregiver to my super-mom (62), diagnosed Dec 2018
Sigmoid colon, Stage IV
G3, Poorly differentiated adenocarcinoma (5,5 x 4 x 1 cm)
T4N2bM1
13 positive out of 23 lymph nodes, largest one 1,8 cm
4(?) mets in liver, located at Segment 3 & 7, largest one 2 cm
LVI & PNI present
Clear surgical margins
MSS, KRAS G13D mutant
Laparoscopic anterior resection, Jan 2019

First chemo 11 Feb 2019 (Folfox).

Punky44
Posts: 203
Joined: Mon Oct 01, 2018 4:29 pm

Re: Stage 3/4 Colon Cancer

Postby Punky44 » Fri Feb 08, 2019 10:43 pm

Everyone has given great info—just wanted to say I’ll be praying for your mom!
Caregiver to my amazing mom (68)
10/1/18 DX with rectal cancer; CEA 17 at diagnosis
MRI/CT/PET puts staging at T3N2M0
Trying total neoadjuvant therapy—chemo first, then short course radiation, then surgery
Completed 8 rounds of neoadjuvant Folfox 11/5/18 - 2/11/19
Current CEA 7.0

Me: 34, first colonoscopy 11/16/18—normal! Come back in 5 years.

rahlac
Posts: 2
Joined: Thu Jan 24, 2019 9:08 pm

Re: Stage 3/4 Colon Cancer

Postby rahlac » Fri Feb 15, 2019 11:33 pm

Thank you all for the responses! Correction to my post above, I meant "now" rather than "not" when mentioning waiting on biopsy results. Anyhow, new update is surgery went very well. Mom had full colon tumor resection done, and 22 lymph nodes, only 1 of 22 is cancerous it appears. She is now recovering from surgery and we will discuss chemo options within next month.

Does anyone have any alternate options to Chemo or where it would be best to get a second opinion on Chemo? She is currently being treated at Stanford Hospital, CA.

Pyro
Posts: 57
Joined: Mon Oct 12, 2015 7:40 pm
Location: Tucson, AZ

Re: Stage 3/4 Colon Cancer

Postby Pyro » Sat Feb 16, 2019 6:29 am

rahlac wrote:Thank you all for the responses! Correction to my post above, I meant "now" rather than "not" when mentioning waiting on biopsy results. Anyhow, new update is surgery went very well. Mom had full colon tumor resection done, and 22 lymph nodes, only 1 of 22 is cancerous it appears. She is now recovering from surgery and we will discuss chemo options within next month.

Does anyone have any alternate options to Chemo or where it would be best to get a second opinion on Chemo? She is currently being treated at Stanford Hospital, CA.


The University? If so, I’d think you’re in some of the best hands, do what they say. Alternative treatments look pretty good right now due to what you’ve hear/seen about chemo, but I put it up there with the anti-vaxers.
Aug 2015- Diag Stage 4 CC with mets to liver (38/m)
Sep 2015- Avastin/Folfox/Iron
Dec 2015-Not a surgery candidate for liver
Jan 2016- Erbitux/Folfiri, 2nd opinion at MDA in TX
Feb 2016 -MD Anderson liver surgery, Dr. Vauthey
Mar 2016 -30% of left lobe removed, PVE
May 2016 - 70% of liver removed
Jun 2016-Radiation
Jan 2017-permanent colost @ MDA
Jul 2017-Erb/FOLFURI
Nov 2017 -Lung & Liver ablations@MDA
Jan 2018 -Xeloda & Avastin mx
Jul 2018-Avast/FOLFURI
Sep 2018-Radiation
Chemo for life


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