Stage IV Treatment Plan

markatger Member Posts: 314
edited March 2014 in Colorectal Cancer #1
Hi all,

I'm still trying to learn what my treatment plan will be since dx with Stage IV rectal cancer w/ liver mets this month.
-One oncologist told me liver surgery right away.
-One surgeon said 1. chemo /radiation, 2. rectal surgery, 3. more chemo, 4. and then liver surgery if still resectable.
-Next oncologist said 1. FOLFOX and Avastin (with no radiation of course), 2. then 5 - FU and radiation, 3. then rectal surgery, 4. more chemo, 5. then liver surgery.
-Radiation oncologist liked surgeon's plan.

Don't know when they are going to get together to decide what is best.

I'm pretty nervous about my liver. With the surgeon's plan, I wouldn't really be attacking the liver mets with the first round of chemo. It would only be 5 - FU without Oxaplaitin and Avastin because of the radiation. I'm nervous about leaving the liver mets be for 3 or 4 months while I'm doing "weaker" chemo and having rectal surgery.
Also I'm only 33 and still wondering why they won't do both surgeries at once.

Any thoughts?


  • taraHK
    taraHK Member Posts: 1,952 Member
    Hi Maria,
    I'm afraid I don't have any answer to the liver surgery question. But, as someone who had Stage 3 rectal cancer, I have seen good evidence that chemoradiation followed by surgery followed by more chemo produces best results (in general, of course -- the plan for individuals may vary, for various reasons). Good luck with this difficult stage of sorting out the best treatment plan for you.
  • Moesimo
    Moesimo Member Posts: 1,072 Member
    I only had stage 3, but if I were you I would make sure that you are being treated at a major cancer center and also that your surgeon is an oncology surgeon and not just a general surgeon. That makes a huge difference. You are so young and want to make sure that you get the best treatment. Ususally rectal cancer is treated with chemo and radiation, surgery and more chemo. Good luck
  • sallyjoy
    sallyjoy Member Posts: 102
    Maria, I understand your nervousness over this. My hubby had stage 4 with one liver met. He had colon surg. 1st, then after healing had the FOLFOX/Avastin cocktail for a few months which DID SHRINK hte liver met. After healing up after chemo he then had his liver met removed. So far - no eveidence of disease... He had colon surg. March 3 '04 Liver surg. Aug. 24'04. The benefit of doing the chemo and other surgery was that they knew the chemo worked on his type of cancer and it shrunk the liver met. Hang in there, you can get through this too. Keeping you in my prayers...
    Sally Jo

    BTW: Hubby was age 40 when diagnosed...