Possible Liver Met

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Wints Dad
Posts: 2
Joined: Sun Jun 28, 2020 11:11 am

Possible Liver Met

Postby Wints Dad » Tue Jun 30, 2020 9:04 pm

My son was diagnosed in 2016 with T4aN0M0 (stage IIb) colon cancer at age 21. Following resection and chemo he has been NED for about 3.5 years. His most recent CT scan showed a small spot on his liver. His doctor advised him not to be too alarmed as it could easily be something other than cancer and scheduled him for another CT scan in 3 months. If it is a liver met then I worry that 3 months seems a long time to wait and wonder if he should push for an earlier follow up of some type (MRI, PET scan, biopsy?). It is of course his decision but he does call me to discuss these things. Anyway, I know that there is a lot of experience and wisdom on this board. I used to visit here quite often during his chemo and received a great deal of helpful info and insight. I would welcome any opinions about what any of you would recommend in his circumstance.

Wints Dad
DS dx CC Stage IIB (T4N0M0) 3Aug16, 21 yr old
poorly differentiated, lymphovascular and perineural invasion
CEA 29
Colon resection 4Aug16
CEA 2.5
Genetics testing negative
6 mo FOLFOX Sep16 - Mar17
CT Scan Mar17 clear
Colonoscopy Apr17 clear
CEA 1.8
NED
Emergency appendectomy Jun17
Adhesion surgery to clear small bowel obstruction Dec 17

Rock_Robster
Posts: 1027
Joined: Thu Oct 25, 2018 5:27 am
Location: Brisbane, Australia

Re: Possible Liver Met

Postby Rock_Robster » Wed Jul 01, 2020 8:19 am

Hey mate,

I agree it could definitely be something else (I had several benign cysts), but also agree 3 months is too long to wait to find out. If it is a met, one small one with prompt treatment can still have a good prognosis.

I’d be pushing for a PET now - it’s an absolutely appropriate modality for proper disease staging, particularly if he hasn’t had one before/recently. If they’re worried it’s too small to image properly then you could consider a biopsy, but just ask about and be informed of the potential risks from this first (re tumour seeding).

“Watch and wait” is of course an option, but 3 months on a liver for a young guy is not a strong case in my view.

Have they been tracking other markers as well - eg CEA and CA19-9?

Best of luck,
Rob
41M Australia
2018 Dx RC
G2 EMVI LVI, 4 liver mets
pT3N1aM1a Stage IVa MSS NRAS G13R
CEA 14>2>32>16>19>30>140>70
11/18 FOLFOX
3/19 Liver resection
5/19 Pelvic IMRT
7/19 ULAR
8/19 Liver met
8/19 FOLFOX, FOLFOXIRI, FOLFIRI
12/19 Liver resection
NED 2 years
11/21 Liver met, PALN, lung nodules
3/22 PVE, lymphadenectomy, liver SBRT
10/22 PALN SBRT
11/22 Liver mets, peri nodule. Xeloda+Bev
4/23 XELIRI+Bev
9/23 ATRIUM trial
12/23 Modified FOLFIRI+Bev
3/24 VAXINIA (CF33 + hNIS) trial

Wints Dad
Posts: 2
Joined: Sun Jun 28, 2020 11:11 am

Re: Possible Liver Met

Postby Wints Dad » Wed Jul 01, 2020 10:52 pm

Rob,
Thank you for the input. They have been tracking CEA and it remains good (around 2). Since his CEA was well over 20 pre-surgery and has been low ever since, I am hopeful that it is a good marker for him and might indicate that the spot seen on his liver is not cancer. I will ask him if a PET scan or biopsy was discussed and if not, urge him to inquire about those options. When this all started we would go to his oncology appointments with him (at his request) but in the past couple of years he has moved away and we are less involved. He is a 25 year old man but he is also my kid (and on my insurance for another 10 months).
Thanks,
Joe
DS dx CC Stage IIB (T4N0M0) 3Aug16, 21 yr old
poorly differentiated, lymphovascular and perineural invasion
CEA 29
Colon resection 4Aug16
CEA 2.5
Genetics testing negative
6 mo FOLFOX Sep16 - Mar17
CT Scan Mar17 clear
Colonoscopy Apr17 clear
CEA 1.8
NED
Emergency appendectomy Jun17
Adhesion surgery to clear small bowel obstruction Dec 17

michelle c
Posts: 1929
Joined: Wed Dec 02, 2009 3:58 am

Re: Possible Liver Met

Postby michelle c » Thu Jul 02, 2020 12:01 am

Three months is a long time to wait, wonder and worry in my opinion. I had a small spot on my liver that was discovered on a CT scan. The same doctor sent me for an MRI and it turned out to be a cyst. Hope your son’s liver spot turns out to be nothing sinister. Sending positive vibes and best wishes
May 25 2009 Dx with CC (sigmoid colon) 2 days after my 44th b'day
CEA prior to surgery 4.7
Jun 3 2009 LAR - Stage III 3/10 lymph nodes
Jul 6 - Dec 10 2009 - 12 cycles FOLFIRI
Genetic testing - inconclusive for Lynch
Jul 2012 port removed & hernia repair


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