Have a question, again.

jenben59

I read many posts and I'm wondering why or how colon cancer can return and be in the liver or lungs. Some people posted, they went through chemo for colon cancer and returning for check ups the cancer moved to the liver and lungs. I'm stage 3c the tests came back (when first diagnosed in Dec.08) that nothing was in the liver or lungs. Are there any symptoms if it is in your liver or lungs?

NWGirl

Spread to Liver/Lungs
I was also stage 3c. When first diagnosed the oncologist did a PET/CT scan on my abdomen and chest to determine whether the cancer had spread. According to these tests, it had not. BUT - with 27 of 38 lymph nodes infected with cancer, as he explained it to me - it probably had spread, but just hadn't grown enough to be detected by a scan yet - so he has always kept a very close eye on me. Cancer cells, when they've spread from your colon tumor to liver/lungs or elsewhere are microscopic at first. You can have cancer in the liver, lungs and other parts of your body with no symptoms. It doesn't mean you won't have symptoms, but it could be there and you wouldn't feel it - at least initially.

One purpose of chemo for stage 3 cancer patients is to address cancer on a systemic level - meaning the chemo goes throughout your body and (hopefully) kills any microscopic cancer cells that are out there that you can't see on a scan yet.

During chemo I had 2 CT scans to check for spread. The first CT scan was ordered because my "liver count" (I don't know the exact terminology here) on my blood work was rising for several treatments in a row. That was done about 3 treatments in. My second CT during treatment was on treatment #10 because I was having extreme pain under the right side of my collar bone. Fortunately, both times I had a clear CT scan. My liver count subsequently settled down and my oncologist figured it was just a reaction to the chemo. My chest pain turned out to be complications with my port.

Another tests they use to watch for spread is your CEA levels. This is a good indicator for some, but not others. Even at my initial diagnosis when my tumor was growing fat and happy my CEA levels were well within normal ranges - so for me it's not a real reliable test.

During my regular check up with my onocologist for each treatment he would always listen to my chest and ask if I had any coughing.

Chemo works for some people, not for others. And some chemos work better on some than others. It's not perfect, but in my opinion, it's one of the best tools we have to fight cancer at this time. So a patient can go through a chemo treatment - finish up, get a clear CT scan and have cancer show up somewhere else 6 months later, 12 months later or even after that. It's because the cancer cells are so small at first and take time to grow to a size large enough to show up on a scan. That's why when we finish chemo treatment, we are still monitored closely with blood work and CT scans for years after finishing treatment.

dixchi

no symptoms
Jenben, I had no symptoms when a large tumor was found on my liver.....and I
was three years out from right hemicolectomy from Stage 2, no lymph node involvement.
Thought I was doing fine; had routine scan and they found it. The best thing to do
is to stay on top of getting scans and CEA counts always......that way if it does
return, you can catch it early.

Barbara

PhillieG

Cancer Staging
Hi JenBen,
This is from webmd.com

Staging Colon Cancer:

Stage 0
Stage 0 cancer of the colon is very early cancer. The cancer is found only in the innermost lining of the colon.


Stage I
Also called Dukes A colon cancer, the cancer has spread beyond the innermost lining of the colon to the second and third layers and involves the inside wall of the colon. The cancer has not spread to the outer wall of the colon or outside the colon.


Stage II
Also called Dukes B colon cancer, the tumor extends through the muscular wall of the colon, but there is no cancer in the lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).


Stage III
Also called Dukes C colon cancer, the cancer has spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).


Stage IV
Also called Dukes D colon cancer, the cancer has spread outside the colon to other parts of the body, such as the liver or the lungs. The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).

I personally do not know if someone is at stage II then can become a stage III or IV. I was dx at stage IV. As far as it going to the liver and lungs, that's just they way it usually travels. Maybe someone here can answer you better that I did.
Stay well
-phil
One other thing, I felt totally fine, I had no symptoms at all and my cancer was discovered during a routine yearly physical.

kimby

Mets
JenBen,

I was originally diagnosed stage IIIc 8/07. My tumor had ruptured the wall of the colon and I went in for emergency surgery for what we thought was a bowel obstruction. Instead, colon canzer at the age of 43, go figure. At that time there were 3 or 21 local nodes that were positive. Not bad.

I completed folfox in March and went to a genetic onc for HNPCC testing, port removed in April, colostomy take down in May, my father died in June. My original onc assumed the adjunct chemo did its job because it usually does. He did no follow up scans after chemo. It is my greatest regret in my treatment that I did not ask for (and I mean I should have insisted if necessary) a CT or PET scan. I was just so relieved to be done and I wanted to go on with my 'old' life. I changed onc to the genetic one. My original one made me nervous when he didn't want to see me for 6 mos after treatment. Saw my new onc in July and had a cea of 3.5. Slightly high for me, so she ordered a PET and we found the liver mets. Because I didn't have a scan in March, I'll never no if I progressed on folfox or if the mets came because I stopped folfox. I have one onc now that says I progressed and one that wants to try oxy again. They are guessing, too.

So, I don't have the answer to your question. Did my mets come because the tumor had ruptured the wall of the colon and spread through the blood system? Did the folfox not work and allow the lymph node system to spread it further? That seems the likely senario to me since it is now also in distant lymph nodes (celiac). I had no symptoms except a very slight elevation in cea and as it turns out, cea is not a good indicator for me at all. 3.7 is the highest its ever been and that was during chemo.

Although I don't know how or why someone gets mets to the liver or lungs, I do think you shouldn't plan that this will happen to you. Be vigilant. Get all your checkups, scans, tests, etc, but plan on being NED. It happens a LOT. People go from stage IIIc, surgery, adjunct chemo and BAM, back to life as usual (well, new normal). A lifetime of scanxiety, but canzer free. You will never be who you were before but you may be canzer free forever.

Kimby

Unknown

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dixchi

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The Best Nana B
Hoping for the best during your surgery.....am sure the anxiety is
builing but it will soon be done and you will be back on your feet...
the five days I was in hospital are a total blur when I had liver
resection last July.....they kept me on so much pain meds....slept
through most of the time and don't remember much.....think I will
ask them not to medicate me so much that I don't feel like getting
out of bed and walking which is so important and one visitor who
came to see me was a total waste because I could not wake up enough
to actually visit....but biggest hope is I don't have to do it again....
Barbara

CherylHutch

Chicken or the egg?
I think in some situations, it's all a guessing game and we will never really know 100% what the answer is.

I was DX'd in Dec 06 as Stage III with 1 positive lymph node out of 17. We also found a "growth" on my adrenal gland that got everyone all excited until they compared it to a CAT scan I had had 6 years earlier and realized it had not grown even 1mm in the 6 years... so it was considered a benign growth (apparently, not uncommon on one's two adrenal glands). After 8 months of FOLFOX and 6 weeks of radiation (to my abdominal wall), we thought (or hoped) all was going to be well... but a PET scan showed one met on the lung that lit up and this darn "benign growth" on the adrenal gland lit up.

So, the multi-million dollar question... were these there all along, did they become malignant during the chemo treatments, or did they become malignant once we stopped the chemo? No one knows and it's not something we will ever have answers to.

It could be the tiny cancer cells were floating about, landed and took root at any time and the chemo didn't catch them... or perhaps I only had a couple of live cancer cells when I started the chemo and they were totally resistant to that kind of chemo. So I went through the 8 months of chemo only to find those damn tiny cancer cells had been resistant all along... so they set up home, started to grow and we would never have known until they got big enough to light up a PET scan... and a PET scan was actually done.

Right now, I'm thinking that since we are all being watched by our oncs and medical teams, we are in the best position possible... they will catch anything that shows up. To me, the scariest time will be once one hits that 5 year NED anniversary and are declared cured. THEN who is going to watch for any new cancer... be it a late blooming recurrence or a brand new primary cancer?

Hugggggs,

Cheryl

lisa42

no symptoms
Hi,

I was stage IV at diagnosis & had no symptoms in my liver or lungs, even though I had many tumors in both of those locations. I had bowel symptoms from my rectal tumor, but no symptoms from the liver or lungs. I guess that's why it's so important to keep to the schedule of follow up scans. I know they're scary, but it's important not to skip them, since most people (from what I've heard) do not have symptoms when it goes to the liver or lungs.