Treatment for secondary tumour without doing a biopsy?

run don't walk for a second opinion. 

Much like Abrub.  What happened was my CEA went up a good amount based on all my prior CEA levels.  The Oncologist then sent me to get MRI.  All indications were that the thing in my lung was cancer.  They then sent me for PET scan, the uptake looked like cancer.  (MRI and PET each indicated 75% chance of cancer.)  Was referred to the thoracic surgeon.  Same feeling - either a benign tumor, a met of colon cancer or new cancer in lung.  The surgeon was fairly certain it was cancer of some form.  (My original colon surgery had clean margins, but many lymph nodes were cancerous.  3-4 is usually concerning.  I had 11 out of 20)

I go to MSK (like Abrub) and like Abrub I have a lot of faith in the doctors there.  

As to the communication issues and the rest you are describing, Tru and Pam said it.  Go find a second opinion.  And another oncologist.  You want to be comfortable with all this as much as possible.  

Hello Laura - I originally had an ultrasound for a physical - showed multiple spots in my liver (around 15), next had CT indicated high possibility metastatic cancer, had liver biopsy.  It was adenocarcinoma, which Onco said would be primary in the glands (I believe, not positive of term) like the intestinal tract.  A colonoscopy confirmed colon cancer.  Started folfiri (now chemo #14).  

I had many delays in our Canadian, supposedly "free" health care - but very, very slow for specialist's referrals - we pay quite high taxes in Canada, which I'm sure a lot is allocated to health coverage, so as far as being free - well. It turned out to be very frustrating, exhausting and nervewracking (no liver specialist in our city).  My husband and I had to make numerous phone calls and be such advocates to get biopsy and cancer appt, etc in timely manner, inspite of my own, wonderful GP doing everything right to get me timely care.  My husband finally got an appt with a wonderful Onco, but we have a 2 1/2 hr trip each way - makes for an extremely, busy long day, but worth it because I really respect and think this Onco is so hopeful and knowledgeable - very happy with my care.  

I do think you need to know the type of cancer through a biopsy, if it is possible to biopsy the tumour.  Best of luck.

Did the cancer metastasize to a predictable location ?

Is it behaving in a characteristic pattern ?

Is the treatment palliative or for cure ?

Always weighing risk vs benefit for diagnosis and treatment.

I'm sorry for what you are going through.  Unfortunately, there are bad doctors everywhere.  My husband also was mistreated in a horrendous hospital and cancer center just a few miles from our home in the US.  When he had his recurrence, he went to all the doctors; surgeon, gp, oncologist, GI.  He had a 1 year follow up colonoscopy and stupid GI doctor told him to lose weight.  A few weeks later he was in the ED with a 2nd tumor in his small intestines in bad shape.  Had to wait 6 days for his original surgeon to see him (he was part of a 4-surgeon team who all came to see him to get their co-pays) but no one ordered any tests.  He was being treated for constipation and they did 1 x-ray every day.  I kept asking to see the x-rays but idiot resident team kept laughing at me.  He finally "fired" that resident team and I considered calling 911 to get him out of that hospital.  It was a nightmare, 21 days in patient, c-diff, bad treatment all around.  It happens and it really stinks for the patient and the caretaker.  Our daughter worked at that hospital so we took her advice, looking back, I wish we had never gone there from day 1. 

Can you go to a different hospital where he might get different doctors?  I'm not sure how the system works, but it's worth a try.  Sometimes you have to be the squeaky wheel and throw a fit to get anything accomplished.  I'm embarrassed to say I was "that wife" more than once.

LauraCF said:

The cancer did NOT

The cancer did NOT metastasize to a predictable location.  Apparently it skipped everything; liver, lungs, even the lymph nodes (which were also clean after the initial post-surgical biopsy two years ago).

Behaving like the slow growing colorectal tumour it apparently is.

Treatment is possibly curative; no appreciable data. If he later opts for surgery, there is a small chance of cure, too, but again, very llittle data.

 

My dr said he'd never seen it in the vaginal cuff before, but he was absolutely certain that it was cancerous, and wouldn't trust a pre-op biopsy.  He was right - it was the same cancer they found in my appendix 9 years earlier.