Colon cancer turning into liver cancer

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This topic contains 7 replies, has 3 voices, and was last updated by  Dr West 1 year, 6 months ago.

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January 14, 2013 at 10:03 am  #1252575    

ktinoco

I have a friend that has gone through four rounds of Folfox chemo treatments. He was diagnosed with stage 4 colon cancer in Oct. 2012.

During his surgery, the doctor removed the tumor from his colon and removed the lymph nodes that also had cancer. At that time the doctor found 2 spots on his liver and biopsied them.

After surgery, doctor confirmed the two spots on the liver had cancer.

Here we are 3 months later, my friend had a pet scan last Friday and doctor told us this morning that all that the cancer cells on his colon appear to be gone, the two original spots on his liver appear to be gone, but now two NEW spots have appeared on his liver. doctor ordered an MRI for this wednesday.

Here’s my question…is this normal? Can cancer still continue to spread even though you are taking chemo? I thought chemo would kill all the cancer cells. Can and is his colon cancer turning into liver cancer? Can he have a liver transplant and stop it? Can they just operate on him and cut the cancer (old and new spots) out?

He’s 61 and his only other ailment is high blood pressure. Any thoughts, words of advice are greatly appreciated. Thank you,

January 14, 2013 at 11:40 am  #1252582    

catdander forum moderator

Hi, I’m really sorry to hear about your friend’s difficult time. The first thing that comes to mind after reading your post is to remind you that cancer has it’s horrible reputation for a reason. (FYI, I was in your place several years ago when my husband was dx with lung cancer. I knew nothing.) Cancer will do what it wants to do. Sometimes you can guess or assume what it might do but you must also accept that it isn’t unusual to have something unusual happen…oxymoronic yes but again we’re talking about cancer.

Unfortunately we don’t have colon cancer experts to give expert content on specific questions about your friend’s disease.

Just a quick overview of how cancer works and moves through the body; When cancer breaks off from it’s original tumor it does so through the lymph system or the blood system. That means it can have microscopic cells in the body without doctors being able to see them. Since your friend’s cancer has shown to spread from his colon to his liver it is unfortunately very possible for it to show up again in the liver. If it is cancer it probably isn’t liver cancer it is probably colon cancer (cancerous colon cells that have traveled to the liver).

Chemo given after surgery offers the person a larger percentage chance of a cure though again there aren’t any guarantees.

I hope your friend does well even if he can’t be cured he may do well for a long while.
Janine
forum moderator


My husband, 53 @ dx of stage 3 squam nsclc R. pancoast tumor 8/09 caused destruction of 3 ribs, touching brachial plexus. 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable). Chemorads, 9/09. MRI by pancoast specialty surgeon 11/09 spine met found, stage IV, Rad to spine, Chemo changed from cis/etop to navelbine/carbo. 6 cycles total. Tarceva 2/10-11/10. 3cm tumor L lung, biopsy undx w/collapsed lung. Gemzar, 12/10 through 7/12. NED 3/12, stop tx 7/12. Remains NED as of 2/14.

January 14, 2013 at 11:49 am  #1252584    

ktinoco

Thank you for the information. Also, the doctor said he removed the affected lymph nodes during surgery and they didn’t see cancer in any of his other lymph nodes. I think that’s good news. He also said Richard’s bone marrow was “lit up” in the pet scan and that was because they are giving him meds to increase his white blood cells. Does that sound accurate?

January 14, 2013 at 12:24 pm  #1252587    

catdander forum moderator

Yes pet scans measure cell proliferation so that makes since.


My husband, 53 @ dx of stage 3 squam nsclc R. pancoast tumor 8/09 caused destruction of 3 ribs, touching brachial plexus. 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable). Chemorads, 9/09. MRI by pancoast specialty surgeon 11/09 spine met found, stage IV, Rad to spine, Chemo changed from cis/etop to navelbine/carbo. 6 cycles total. Tarceva 2/10-11/10. 3cm tumor L lung, biopsy undx w/collapsed lung. Gemzar, 12/10 through 7/12. NED 3/12, stop tx 7/12. Remains NED as of 2/14.

January 14, 2013 at 10:23 pm  #1252601    

Dr West

The colon cancer hasn’t turned to liver cancer, but rather it’s colon cancer that has metastasized to (spread to) the liver, which is a very common pattern of spread for a metastatic colon cancer. Although we hope to see a cancer respond well by shrinking on chemotherapy or at least not growing on it, unfortunately we definitely can see cancers that are resistant enough that they grow right through good chemotherapy. I’m sorry to say that it sounds like this is the unfortunate situation your friend is facing now.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

January 15, 2013 at 6:09 am  #1252610    

ktinoco

The doctor is keeping him on his chemo schedule. Do you think this is beneficial knowing that the cancer is still spreading and “growing”?

I’m sure you have seen cases like this before…what, if any time line can you give? Before the surgery the doctors had said Richard would have up to 5 years with chemo and 12 months if he didn’t do any chemo. So, he opted to go with chemo.

I will not share this information with him, but I would like to know some type of time range. I’m familiar with cancer in that my mom had cancer and only lived 5 months after her chemo and she had non-Hodgkins lymphoma that “turned into” leukemia. Officially, she died of complications of leukemia.

If I’m interpreting the doctor’s serious and somber delivery of the news yesterday, I’m thinking these new cancer cells popping up is not good news.

Thanks again for any insight you can provide.

January 15, 2013 at 11:11 am  #1252621    

catdander forum moderator

When there is a question as to whether the treatment is appropriate it is very appropriate to get a 2nd opinion. For many reasons. Here is a link to a blog/post on the subject. http://cancergrace.org/cancer-101/2011/11/13/an-insider’s-guide-to-the-second-opinion/

As for a prognosis, doctors here freely admit that they are not good at giving that answer. You should also not try to compare your mom’s lymphoma/leukemia to colon cancer. There’s even very little reason to put a lot of credence into an average of how long thousands of people with stage 4 colon cancer will live when talking about one loved one. An average or even median is one number, an answer to a math problem. Your friend fits somewhere but doctors are notoriously wrong when asked to guess about one person’s life span.

You will read about trials in the post i’ve linked you to above. Since our doctors aren’t colon cancer specialists they won’t know of promising trials, but there may be some out there. If it is thought that chemo isn’t helping then a trial might be a very good option. clinicaltrials.gov is a place to search for trials in your area that may fit your friend’s needs.

All best,
Janine


My husband, 53 @ dx of stage 3 squam nsclc R. pancoast tumor 8/09 caused destruction of 3 ribs, touching brachial plexus. 2 core and 1 VATS undx biopsies. Open thoracotomy for 1 positive biopsy (unresectable). Chemorads, 9/09. MRI by pancoast specialty surgeon 11/09 spine met found, stage IV, Rad to spine, Chemo changed from cis/etop to navelbine/carbo. 6 cycles total. Tarceva 2/10-11/10. 3cm tumor L lung, biopsy undx w/collapsed lung. Gemzar, 12/10 through 7/12. NED 3/12, stop tx 7/12. Remains NED as of 2/14.

January 15, 2013 at 8:55 pm  #1252661    

Dr West

I agree that it’s not good news when you see new lesions appear when someone is on chemotherapy. However, I don’t treat colon cancer, and I’ve never met your friend, so I’m not the person to offer a time line.

I also agree that it’s hard to understand the rationale for continuing a treatment on which someone has clear evidence of progression, unless there are no alternatives, the progression is minimal or ambiguous, and/or the treatment is very well tolerated. A second opinion may be a strong consideration, as Janine suggested.

-Dr. West


Howard (Jack) West, MD
Medical Oncologist

Views expressed here represent my opinion, not those of GRACE or Swedish Cancer Institute. This information does not constitute medical advice and is intended to supplement and not replace medical information provided by your doctor.

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