Shocked about Stage IV diagnosis

Don't buy into the " can't be resected" crap. Look into ALPPS. My liver looks like swiss cheese with too many mets to count and yet with just a single 7% healthy spot I was able to get a resection using this new procedure.

I am sorry you have to be here. With that said welcome. I was dignosed stage IV 8 years ago. It is not a death sentance but in many cases a chronic disease. I think she will be fine with a general surgeon for her colectomy. That is who I used. BTW I have had 3 liver resections and now looking at possibly a 4th. Get a second third forth opinion. What ever it takes. I have fired 2 oncologist because I didn't like what they said. Take my frien Renews advice above. Also I have read countless stories about inoperable liver mets and chemo was effective enough to make surgery possible.

You're mother CAN be resected.  Probably quite easily.  It's just a matter of finding the right surgeon.  Keep meeting with good surgeons until you get the right person.  Do not take what one doctor says as gospel.  Every surgeon will give a different opinion.  They all have different levels of comfort.  Don't be discouraged by what any one doctor says.  Find someone who you and your mom like.

Chelsea

The surgeons often avoid stage IV operations as "inoperable" because dogma says postsurgical recovery and metastasis will make things worse than just doing chemo.  They appear to be totally unaware of many Life Extension reports on cancer surgery, metastasis, and colorectal cancer.  Obstruction usually can open the operating room's door anyway.  A primary goal of the survivors on these forums is to find that special surgeon (usually colorectal) who can handle their case, get qualified for surgery and get 'er done. 

My wife was pretty much in the same place several years ago, obstructing with bad biomarkers too (much more now known, looking back).   Pre-op, we hopped up part of the LEF Extension formula with some crucial extras, added more after surgery.  In my wife'scase, they only removed the obstruction and nearby stuff in the first surgery.  Some lesions were not immediately recognized, presumably because they were so damaged by a "fortuitous" immune attack, much like some of the cimetidine/immune research showed.  After surgery, she added low dose oral Asian drugs, tegafur uracil + leucovorin, for chemo plus a lot of carefully chosen alternatives recommended by LEF or other supernutritional advocates with MD/PhDs.  After successfully avoiding new mets, she was reoperated on a year later, now over two years ago.  

Renw's ALPPS will likely require recovery time, more travel - it's new and not common.  It has an important feature, major liver surgeries carefully coordinated closer in time to curatively remove liver mets. Some hospitals use multimodal approaches, like surgery, RFAs, chemo, and hepatic arterial chemo in a coordinated sequence.

Are you outside US territory?  If you are a mostly cash customer, Manila or Tapei may be closer/cheaper. You do want specialized surgeons usually located in top hospitals in a big city.   Be warned, none of how we used chemistry is standard and most doctors don't know it, don't want to hear it, so it is done quietly in parallel with their agreement. She's done quite well where the other 99 couldn't argue.   

Bernsantosrn said:

Different segments

The two surgeons we have spoken to have said because the tumors in the liver are in different segments, resection can't be done and wed have to just rely on the chemo.....

Steve had multiple tumors in four segments.  Turned down emphatically by numerous surgeons.  Found a really reputable surgeon that said it would be a fairly simple two stage resection.  Keep looking.

Bernsantosrn said:

Care in Hawaii

Thank you for the welcome and the advice.  Mom has Medicare and private insurance but mom and dad are weary about navigating the system in an area they are not familiar with.  They are not big travelers.  We are currently visiting in Manila seeking consults and just learned that because she has Medicare, she can't do the surgery here. So now we have to decide option A- to self pay here for surgery then go back home to Guam for the chemo, option B- have general surgeon do it in Guam under insurance Option C- go to Hawaii or Cali under insurance.  Mom and dad are comfortable here more than in HI or Cali since they are from here.  They are considering sacrificing paying out of pocket for sake of convenience (means no 10-16 hour plane ride and finding lodging etc).  I think I can't get over the fact that they have insurance and worked for it so shoud use it.  But I also understand they want to be comfortable.  For you who have experience with hemicolectomy, how is the recovery?  What where the course of events?   Again, she is strong right now.  You'd never know she has cancer- walking around, cooking able to shop for hours at a time.....Also, h anyone provided feedback abouscare at Straub in Oahu, Hawaii?

Hello and sorry you have joined this group, but you will find many helpful people here.  My husband had a right hemi-colectomy in December, 2012.  He was not staged until the path came back from the tumor removed so I'm not sure how your mother can be staged yet, maybe they have different tests where you are.

Anyway, his surgery was estimated to take 4-6 hours, but he was done in about 2 hours.  They called it laporascopic where he had about a 4 in incision around his belly button and 4 small holes for the equipment, we called it his "field of dreams" since it looked like a baseball diamond.  They said they removed about 2 feet of his colon and a large tumor, about 4 cm.  He had been admitted to the hospital 4 days prior with a complete obstruction.  He had an NG tube for 4 days before the surgery and less than 2 days after the surgery.  The evening of the surgery (he got done around 6 pm) he was out of it until I left around 11 pm.  He would speak nonsense and would be awake on and off.  He had no temporary or permanent colostomy and was not on the ventilator past surgery.  These were things they told us "might" happen.  The next morning he was calling me at 6 am asking where his newspaper was. I was very surprised at how well he was recovering.  They had him up a few times that day walking with all his tubes.  He also had a catheter until about 40 hours after the surgery.  Both the catheter and NG tube were removed around the same time.  That made him feel like a new man.  I think he was so happy about that, he did overdo it a little on that day.  That evening he was having a slight fever and not feeling so great.  He was still in ICU because the hospital was full of flu patients and had room for him to stay was he was.  I was able to take care of most of his needs so he didn't need much care.  He was moved to a regular room 2 days later and went home 5 days after surgery.  He did not have much pain and only took the pain meds for the first few days after surgery.  He was on a very mild diet for a few days and then was tolerating regular food before he went home.  A little too much info - he did move his bowels within a few days of surgery - they said it was probably was had been "stuck" in his bowels above the tumor and the prep he took for the colonoscopy he had 3 days before the surgery.  They also took 13 lymph nodes and all tested clear, which again we did not know until the path results came back about a week later.

The only advice I can give you is to make sure your mother stays hydrated and keeps moving her bowels.  If she has a tumor in her colon, it can irritate the bowels which may shut down. She should eat a mild diet with plenty of stool softeners, laxatives, etc.  A complete obstruction is no fun and may force an emergency surgery.  I would also think long flights would be exhausting after surgery and during treatment.

Good luck and keep us posted on her decisions and progress.

Linda