I am seeking some very specific information about possible treatments for metastasis to the sacrum.
I was diagnosed with stage 3 colon cancer, low in the sigmoid area, in late September 2007. I had a sigmoid colectomy on Oct. 4, 2007 followed by chemo, "xelox," from November 2007 to May 2008. I did well until early this year when I began to have excruciating pain in my right buttock. The cause was found to be a tumor in the soft tissue adjacent to the S2 and S3 areas of the sacrum, beginning to grow into the bone. I had 6 weeks of daily radiation treatments, ending in late April. The pain receded until mid-July when it began to increase. It quickly became extreme, and an MRI shows a new tumor at the sacrum, this one entirely within the bone, extending from S2 to S4. The pain is presumably caused by pressure of the tumor on nerve roots. The presacral tumor shows no growth and was probably killed by the radiation.
I'm hoping some of you have specific information about possible treatments and the effectiveness of treatments for this very specific, somewhat unusual tumor. My oncologist is seeking specialized opinions from experts, and I'm hoping for your own expertise in the form of your own experiences and any resources you may know of.
I know of three treatment possibilities right now:
1. Surgery to remove part or all of the sacrum.
2. Chemo with Xeloda, Irenotecan, and Avastin ("xelira").
3. Treating the pain only.
Further radiation may be very limited in dose and duration or impossible because of the radiation treatments a few months ago.
Have any of you had a full or partial sacrectomy? Know of any sources where I could learn more about this procedure, its potential risks and benefits, its likely success in relieving the pain, how likely the surgery may be to delay or reduce the likelyhood of another recurrence elsewhere?
Do any of you know how effective xelira -- the drug combination above -- may be in reducing the pain and in delaying further spread of the disease? My oncologist tells me that it has a 50% chance or less of reducing the pain.
I'm currently taking ms contin and roxanol for the pain, and that is effective but also limits my activities somewhat. Do any of you have information about other treatments for extreme cancer-related pain, including nerve blocking, drugs other than narcotics, alternative methods including hypnosis, acupuncture, biofeedback, etc.?
Thanks very much!
Stage III colon T4N2M0
Sigmoid colon resection Oct. 2007
metastasis to sacrum and anastomosis 2/09
radiation 3/16/09 to 4/24/09