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Liver Cancer

Runforlife
Posts: 10
Joined: May 2010

Does anybody know how long the positive effects of chemo will continue when treating Met. liver cancer. My father has just received his third chemo treatment and is tolerating these treatments very well. He doesn't even get sick or have any of the other side effects we were warned of. We are very greatful that the chemo has really made him feel much better. His cancer is metacised (sp) from colon cancer and has also gone to his liver and lungs. The Dr. said it's the worst he has seen in many years and beat around the bush avoiding telling us of any life expectations, but alluded to something like 6 Mo. We tried to find out how this will go and what to expect, but were simply told he can continue with this chemo until he dies. Is there a point in time when the chemo is no longer helpful?? what happens with that, and how long do we have while things are going so well?. This is very hard for our family and my father, any information you can offer will be appriciated.

Tina Blondek's picture
Tina Blondek
Posts: 1560
Joined: Nov 2009

Hi Runforlife,
My dad had mets to his liver from esophageal cancer. He passed away on March 9,2010. Some people can beat it, some can not. You have to keep trying. From what I have learned, the chemo will stay and keep working in the body for up to 90 days from last treatment. There does come a time when enough is enough. Your dad will know it, and you, even though you do not want to believe it will know it too. Look at his quality of life. My dad no longer had one. If your dad's quality of life is still good, keep going for it. You will know when to stop. When that time comes you have to respect your dad's wishes. I had to do that and I know my dad went peacefully. Good luck to all of you. Stick together, work as a team. Come back and let us know how he is doing.
Tina

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

Most chemotherapy is eliminated from the body fairly quickly, and the fatigue that patients experience after treatment is a prolonged effect that continues long after the chemotherapy is gone. A person should not assume that feeling fatigued means that the chemotherapy is still in the body

While the effects of chemotherapy can take place over a longer period of time (maybe weeks), the actual chemicals that are chemotherapy are generally out of the person's system within 24 hours. This assumes that the person's kidneys and liver are able to process the chemotherapy within a normal period of time

Andrew Putnam, M.D. is the director of the Palliative Care Program at Lombardi Comprehensive Cancer Center and Georgetown University.

Runforlife
Posts: 10
Joined: May 2010

why does the chemo stop working, we were told that this is only to make him feel better, but won,t cure him, that at best it would add 6-8 weeks to his life. The Dr. said when he got his last treatment that he is doing much better than he should be doing given the extent of his cancer. Why won't it continue to work as it is now. Hope you can answer my questions, no one else seems interested in letting me know the truth,,, thank you!!!

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

By your explanation above regarding your fathers cancer, sounds like his primary cancer is colon that has met to the liver and lungs and that the cancer tumors found in the both liver and lung are classified as "Colon" & not liver. A pathology report would reflect type of cancer cells based on a biopsy done previously. You mentioned he has had 3 chemo treatments so far. Often after 2 or 3 cycles of chemo, a catscan, blood test measuring tumor marker levels for that cancer, or possibly a pet scan will be done to indicate how affective the chemo has been so far as the scans and tumor markers are compared to the previous scans and blood tumor marker.

Chemo is designed to to target fast dividing cells, both heathly and cancer and depending on the type of chemo agent, either attack the cells during phases of division, inhibit division of cancer cells, by damaging the RNA or DNA that tells the cell how to copy itself in division. If the cancer cells are unable to divide, they die. The faster that cancer cells divide, the more likely it is that chemotherapy will kill the cells, causing the tumor to shrink. They also induce cell suicide (self-death or apoptosis).

The "normal" cells most commonly affected by chemotherapy are the white, red and platelet blood cells produced by bone marrow, the cells in the mouth, stomach and bowel, and the hair follicles; resulting in low blood counts, mouth sores, nausea, diarrhea, and/or hair loss. Different drugs may affect different parts of the body. Sometimes the side affects of chemo and rad can be worse than the cancer itself.

How is response defined?
Response to cancer treatment is defined several ways:

•Complete response - all of the cancer or tumor disappears; there is no evidence of disease. A tumor marker (if applicable) may fall within the normal range.

•Partial response - the cancer has shrunk by a percentage but disease remains. A tumor marker (if applicable) may have fallen but evidence of disease remains.

•Stable disease - the cancer has neither grown nor shrunk; the amount of disease has not changed. A tumor marker (if applicable) has not changed significantly.

•Disease progression - the cancer has grown; there is more disease now than before treatment. A tumor marker test (if applicable) shows that a tumor marker has risen.

When is response measured?
For a newly diagnosed person who has been prescribed chemotherapy for cancer, the number of treatments is set. For example, an oncologist will prescribe a specific number of chemotherapy cycles based on the treatment protocol. Responses may be measured during the chemotherapy, but the number of cycles does not generally change unless the cancer grows. If the cancer grows, the chemotherapy will likely be stopped or changed to different drugs.

For a person who has had a recurrence or has advanced disease, a specific number of cycles may not be prescribed. Rather, 2-3 cycles are given and then response is evaluated. If the disease is stable or shrinking, additional chemotherapy may be given as long as responses are maintained, provided the toxicity of the chemotherapy is tolerable. In general, a minimum of 2-3 cycles of chemotherapy is required in order to measure response. One cycle of chemotherapy may not be adequate to evaluate its effectiveness.

What Is Chemotherapy Resistance?

Chemotherapy resistance occurs when cancers that have been responding to a therapy suddenly begin to grow. In other words, the cancer cells are resisting the effects of the chemotherapy. You may hear statements like the "cancer chemotherapy failed." When this occurs, the drugs will need to be changed.

There are several possible reasons for chemotherapy resistance:

•Some of the cells that are not killed by the chemotherapy mutate (change) and become resistant to the drug. Once they multiply, there may be more resistant cells than cells that are sensitive to the chemotherapy.

•Gene amplification. A cancer cell may produce hundreds of copies of a particular gene. This gene triggers an overproduction of protein that renders the anticancer drug ineffective.

•Cancer cells may pump the drug out of the cell as fast as it is going in using a molecule called p-glycoprotein.

•Cancer cells may stop taking in the drugs because the protein that transports the drug across the cell wall stops working.

•The cancer cells may learn how to repair the DNA breaks caused by some anti-cancer drugs.
•Cancer cells may develop a mechanism that inactivates the drug.

Research is underway to investigate ways of reducing or preventing chemotherapy resistance.

The development of drug resistance is one reason that drugs are often given in combination. It is thought that this may reduce the incidence of developing resistance to any one drug. Often, if a cancer becomes resistant to one drug or group of drugs, it is more likely that the cancer may be resistant to other drugs. This is why it is very important to select the best possible treatment protocol FIRST. In other words, when treating cancer, one should use the best weapon when there is the smallest possibility of chemotherapy resistance.

Runforlife
Posts: 10
Joined: May 2010

How long does it normally take for a person to develop chemotherapy resistance, and then is the cancer much more aggressive, or painful? I guess I,m asking if chemo is really making the end stage of cancer much worse?

Runforlife
Posts: 10
Joined: May 2010

Thanks Tina, I am so sorry to hear of your father, he must be very proud of you. Thanks for the info, God Bless I will let you know how things go

HeartofSoul's picture
HeartofSoul
Posts: 732
Joined: Dec 2009

i had replied to your questions in a post above (May 14 12:01am) that you had requested to be answered regarding you fathers cancer. hope it helps

gilou2976's picture
gilou2976
Posts: 6
Joined: Jan 2006

Ihave colon.and restum cancer,mistasize in liver.Had surgery for colon and restum in april 2006 and 3 months later surgery of my liver,took out about half of my liver.
The oncologist treating me at the time told me I had about 6 months to go,its bee 4 years now,and I feel great.I first started chemo in dec 2005,to get ready for the surgerries.I have been getting chemo ever since,exceot for a 2 year period after my doc told me I had 6 months to go.
The reason I started back on chemo over a year ago,I had a blockage .my arteries.Went to hospital they put in 2 stents,twice in about a week apart.That was one year ago,feeling good now.The doctors at the hospital told me I was a case for 3 bypass,but they could not do it because of my cancer,they said see your oncologist,thats when I started chemo again.How many treatments did I get up to now,could not tell you.its been too many,I am still getting chemo,will have a treatment this monday.I ask the doctor how long will I keep getting chemo,he told me as long as its goes you some good.The side aeffects dont bother mr at all,except a littl;e rash in the face and neck,thats it.
My advise to you,keep getting chemo as long as it helps.if the side effects dont bother you. God bless. I am 80 years old
Gilou

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