Very confused caregiver

tko683

Happy Thanksgiving to everyone! Hope you all have a wonderful day with family, friends, and loved ones.
I have a question about my husband's treatment plan. For those who don't remember, my husband was dx stage 4 rectal canncer with mets to liver in June 2011. He had chemo, liver resection, radiation. Then the surgery for the primary tumor had to be cancelled becuase of new liver lesions that popped up during radiation. He just finished 6 months of Folfiri and had scans last week. The surgeon said no areas were lighting up and the CT was clear. He said it was a good time for a chemo break. He wants to see if any more tumors come back like they did last time. That is confusing to me. Why wouldn't he do another liver resection? He said the scan shows no cancer but I always thought surgery was the best choice. I just don't understand this approach at all. I love the idea of a chemo break but last time he had a chemo break for surgery and then radiation 4 new lesions popped up. It is just confusing and they said they would not even do surgery on the rectal tumor now. Has anyone else had this approach? Any comments are much appreciated! Blessings, Teri

Brenda Bricco

Happy Thanksgiving
Happy Thanksgiving Teri!
From what I understand from your post your husband had something show up while waiting for surgery, surgery was cancelled and chemo was given... Are they thinking that the chemo completly killed the cancer and there is nothing to go after? My husband's primary tumor wasn't visable on scans but the surgeon was able to see where is was when he opened him up and removed that area of his rectum.
Do you and your husband like your doc? It seems to me that you are second guessing his or her plan which makes me think another opinion is in order. I am not suggesting what they are doing is not right but it might give you piece of mind to get some other opinions. This is of course just my thought on it but do you two feel like you are in the best hands possible? I don't think you would ever regret getting others involved and any doc worth anything would help you get that opinion fast. I am assuming that you challenged this doc about why he is wanting to take this approach.
I wish you all the best.
Brenda

JayhawkDan

I understand
--all of this is very confusing. I had good scans last month, but have been considered inoperable since the start (dx 9 months ago). But after the tumor board reviewed my case my onc sent me to see a liver surgeon, just to hear what he had to say. He said it was really good news -- that all the lesions in my liver were dead, so there wasn't any point in operating, even if they could. He said my liver was like a shotgun blast -- there were lesions all over the place, but dead at this time. So, in general, it's my guess that they don't operate if the crap is dead and not lighting up. Doesn't mean it won't come back, but I guess my question, and confusion is -- if (or when) it comes back -- does it come back in the same places? Or does it stake out new spots in the liver? They weren't gonna operate on me anyway, I'm just curious for you, and maybe me down the road if that's the case. They gave me a chemo break last week, but I'm back at folfiri/vectibix next Friday...2 more tx's before Christmas, then another 1x break over Christmas. Have a Happy Thanksgiving! Dan

tko683

JayhawkDan said:

I understand
--all of this is very confusing. I had good scans last month, but have been considered inoperable since the start (dx 9 months ago). But after the tumor board reviewed my case my onc sent me to see a liver surgeon, just to hear what he had to say. He said it was really good news -- that all the lesions in my liver were dead, so there wasn't any point in operating, even if they could. He said my liver was like a shotgun blast -- there were lesions all over the place, but dead at this time. So, in general, it's my guess that they don't operate if the crap is dead and not lighting up. Doesn't mean it won't come back, but I guess my question, and confusion is -- if (or when) it comes back -- does it come back in the same places? Or does it stake out new spots in the liver? They weren't gonna operate on me anyway, I'm just curious for you, and maybe me down the road if that's the case. They gave me a chemo break last week, but I'm back at folfiri/vectibix next Friday...2 more tx's before Christmas, then another 1x break over Christmas. Have a Happy Thanksgiving! Dan

Very confusing
Brenda,
Yes, we do feel like we are in good hands My husband's surgeon is the Chief of the Dept. and the only thing he does is liver resections at Duke Hospital. He is top notch but sometimes hard to understand because he is so smart. I just don't understand this approach and wondered if anyone else had similar situation.
Dan,
Yes that is exactly what we were told, no point to do surgery when there is nothing there right now. He plans to rescan after a 2 month chemo break and see what is going on. It it comes back it can be anywhere, sometimes the same area and sometimes in another place. You just never know.
Thanks for your comments,
Best wishes,
Teri

dmj101

It is common to take breaks
It is common to take breaks in treatment. especially when they want to see if drugs/treatments have worked.. Some refer to a taking time to see what blooms.. if anything..
I have heard this many times with my thyroid cancer though not as oftem with colon or metatasis's but I am sure it is probably the same idea..
I am sure the break will feel good.. though somewhat scary..

steved

tko683 said:

Very confusing
Brenda,
Yes, we do feel like we are in good hands My husband's surgeon is the Chief of the Dept. and the only thing he does is liver resections at Duke Hospital. He is top notch but sometimes hard to understand because he is so smart. I just don't understand this approach and wondered if anyone else had similar situation.
Dan,
Yes that is exactly what we were told, no point to do surgery when there is nothing there right now. He plans to rescan after a 2 month chemo break and see what is going on. It it comes back it can be anywhere, sometimes the same area and sometimes in another place. You just never know.
Thanks for your comments,
Best wishes,
Teri

Surgery
You have touched on the reason they won't rush in with surgery in your reply above- they scant be totally sure where any cancer may be at present so can't really know which bit of liver to take out surgically. They sound like they are being sensibly cautious which is a good sign in a surgeon in my opinion.

Steve

tko683

dmj101 said:

It is common to take breaks
It is common to take breaks in treatment. especially when they want to see if drugs/treatments have worked.. Some refer to a taking time to see what blooms.. if anything..
I have heard this many times with my thyroid cancer though not as oftem with colon or metatasis's but I am sure it is probably the same idea..
I am sure the break will feel good.. though somewhat scary..

Thanks
Thank you for your replies. It makes me feel a little better hearing your answers. I just always want to be sure about everything which is hard in the world of cancer. blessing to you all....Teri