The Colon Club

is radiation an option ? SBRT for sure would kill it. FOLFIRI worked on the other met and managed to stop this one, is he still on it ?
I imagine no biopsy possible there, if you go in, might as well get it. Do they even know if it is active ? Could be dead.

We messaged about the skipped chemo cycles, it takes a bit but works again.
How is his energy and appetite ? I finished my 8 cycles and seriously need to come off prednisone and control my glucose, the weight i put back on has my at my correct BMI, so i'll try to ride the CRT train a little longer with corticosteroids.

He's still on Folfiri+bev and it does seem to have worked on the lymph node mets. It may well be working (slowly) on the bone met as well. I will need to discuss SBRT with his oncologist. The standard of care is they don't do it unless the met is painful (symptomatic) which his is not. There are risks to it, especially fracture, but I assume the fracture happens when a chunk of bone is hollowed out by the minimal support it's getting from the cancer collapsing. This one is so small I doubt that's a big risk for that. It is almost certainly still active since his CEA is 6.8 and the other mets appear to have been knocked down.

His energy and appetite have flagged with an increasing number of cycles but he's hanging in there. We are going to try Ritalin. I may consider ginseng, which seems to have some scientific support (not just folklore) for this type of fatigue, but it takes a while to work. He will probably go to maintenance after another cycle or two (after the current one).