The Colon Club

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.

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

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.

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

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!

Everyone has given great info—just wanted to say I’ll be praying for your mom!

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.

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.