If there are numerous small tumors in both lungs and both sides of the liver, there are definitely not a lot of options for a cure at this point. However, there is always hope - there is still hope for a cure, and after that is gone there is always hope for a good quality of life, regardless of how long or short that might be.
Surgical removal is still the best chance for long-term survival, so if that is what he is still working towards, his concentration should be on trying to get those spots to the point where they could be surgically removed.
I am guessing that is what he is already being told, and it is probably correct from the limited info I have. I would guess that his best - or only - choice is to have systemic chemo, which I think you said that he is having. From that point, the hope is for the miracle that some of the spots will shrink and/or disappear in at least one of the locations (lungs or liver) to the point where they can be surgically removed. With systemic chemo, there is a chance (although to be honest it is pretty small) that this could happen. If it happens in either the lungs or the liver and the tumors at the other site don't grow, he could be in a position to reduce his situation from two metastatic sites to one. IF all of this happens, that means that he then only has to deal with the lung or liver, which is good.
Obviously this is a lot of "ifs" and "hopes" and "maybes" - and believe me, I know first-hand how hard all of that is to hear about someone you love. I do not take it lightly for one single second. I believe so deeply in always having hope, but what "hope" means can definitely change as cancer progresses. I like to be realistic and educational, and to continue to hope while not giving false hope (the kind that wants to believe something that is next to impossible).
Again, I know how crappy this all is - I hate having so few options, and such bad options, for people we love. I also hate the "wait and hope" aspect of this disease - just do the chemo and wait around and hope that the tumors might shrink or maybe even, hope beyond hope, disappear completely!
All of that said - YES, this does happen for some patients, and it is happening more and more often with the number of drugs that we have available to fight metastatic colorectal cancer. It sounds like your friend is doing all of the right things, making sure he has the education he needs, and getting second opinions. As long as he has a doctor who is up on the latest things and is not afraid to use combinations of chemo, surgery, radiological intervention, RFA, etc, he is probably in good hands.
Please keep us updated and let us know if there is anything else we can do.
Hannah K. Vogler
Co-Founder, The Colon Club
cousin of Amanda Sherwood Roberts
dx 1/99 Stage III at age 24
died January 1, 2002 at age 27