Postby claudine » Mon Jan 24, 2022 2:53 pm
For those of you who've been following our journey...
My husband's stage 4 CRC was diagnosed almost 4 years ago, via the biopsy of a lytic vertebrae met. The primary tumor was never found. - only some irritated bowel tissue from Crohn's disease flares he had as a teenager.
But.
BUTT!
Last Friday DH had a colonoscopy, the first one since the diagnosis and attempt to locate the primary; this was prompted by SUV uptake in his rectum during his December PET scan. And there, mid rectum, in all its glory, is a flat tumor, 4cm in diameter...
My take on this is that this is the primary that's been eluding us all these years. From what I can read, CRC doesn't metastasize back into the rectum (or very rarely and close to the anus, but that's not the case here). It was probably a very small, flat tumor that went undetected (but sent cancer cells that developed into mets), and since DH had about 2 years of chemo right off the bat, it stayed hidden. When he stopped chemo (January 2020) it started growing, but being flat, it was asymptomatic (no rectal bleeding) and went undetected on 3-month control CT scans, until this most recent PET.
He hasn't met with his oncologist yet (meeting scheduled for February 3, by which time biopsy results should be in). My understanding is that because it's mid-rectum, it will be possible to remove it surgically and avoid a permanent ileostomy (although a temporary one may be required while things heal). In a way, it's almost a relief - this would explain his high CEA values, and now we know where it all started. Unless I'm completely mistaken?
Thoughts???
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A, no primary
Tumors: L4 04/18; left adrenal gland & small lung nodules 03/19
rectum 02/22 (pT3 pN0 stage 2A); L3 09/22
Surgeries: intestinal resect. 05/18 (no cancer - Crohn's); adrenalectomy 02/20
L3-L4-L5 fusion and corpectomy 05/20; LAR 04/22; ileo reversal 09/22
L2-L3 fusion and corpectomy 09/22
Treatments: EBRT 04/18; SBRT 02/19; Failed adjuvant Xelox ; Folfiri/Avastin 03/19 - 01/20
adjuvant chemorad (Xeloda) 06/22; SBRT 11/22; Xeloda/Avastin since 01/24