tumor size

lostit2003
lostit2003 Member Posts: 53
edited March 2014 in Colorectal Cancer #1
hello again

I'm the newbie whose husband got diagnosed 12-14 with stage IV colon caner. After fighting alot of infection we are finally home from the hospital and he is recovering well from the surgery. We met with the onc yesterday and are sch to do his port the 20th and start chemo the 25th. He will be doing a course of oxaliplatin with 5-FU and leucovorin calcium. He will add avastin in a few weeks. You guys have already been very helpful telling me about the side effects we can expect. My questions now is how small do the mets on his liver have to be before they can be removed? He has 5-6 and I don't know what size they are now, but I'll find out next visit. Do I need to get copies of his path report? I'm not sure I'd know how to read it. His CEA level was 178. I thought that was really high then I saw some of the levels you guys had posted and it seemed low. Is it the number that the most important or just that it keeps going down? What else do I need to know?


Thanks
Tina

Comments

  • Sundanceh
    Sundanceh Member Posts: 4,392 Member
    #2
    I'll Try to Answer :)
    Hi Tina

    I don't know if any of us can tell what size a tumor has to shrink to to be removed - I would coordinate that through my oncologist and the surgeon...that's their area of expertise. The liver is a tricky place with all of the veins and arteries and blood vessels involved and such - it's dependent on tumor location (if they are near any of those structures) as to whether they can get close to those for resection.

    Keep in mind that RFA (radio frequency ablation) can be used as an alternative to resection and has very good results, equal to or better than resection. This is a process where a multi-forked prong is inserted into the tumor and is heated to a very high degree and kills the tumor in question.

    CyberKnife is also another treatment option that can be used on the liver. Marker seeds are implanted into the liver in and around the tumor. Surgeon and radiation oncologist determine the tumor location and work out the X and O's and program those coordinates into the software of the CyberKnife so that it knows which path to follow. The patient is outfitted in a special vest hooked up to the machine and this allows the CyberKnife beam to keep on working and it adjusts as the patient breathes in and out.

    CEA's are tricky - alot of folks in this group say their CEA is no indicator at all if they had cancer or not - for others it is is a pretty effective marker on where you are at.
    178 could be considred high although I've heard of much higher. The good thing is if the CEA level drops then that is where you want to be.

    Now technically, here are the CEA values:

    0-3 Normal for non smoker
    3-6 Normal for smoker
    Above 6 is an indicator of cancerous activity.

    This should give you some info to get rolling - hope this helps you and please keep us all posted.

    -Craig :)
  • Nana b
    Nana b Member Posts: 3,030 Member
    #3
    Sundanceh said:

    I'll Try to Answer :)
    Hi Tina

    I don't know if any of us can tell what size a tumor has to shrink to to be removed - I would coordinate that through my oncologist and the surgeon...that's their area of expertise. The liver is a tricky place with all of the veins and arteries and blood vessels involved and such - it's dependent on tumor location (if they are near any of those structures) as to whether they can get close to those for resection.

    Keep in mind that RFA (radio frequency ablation) can be used as an alternative to resection and has very good results, equal to or better than resection. This is a process where a multi-forked prong is inserted into the tumor and is heated to a very high degree and kills the tumor in question.

    CyberKnife is also another treatment option that can be used on the liver. Marker seeds are implanted into the liver in and around the tumor. Surgeon and radiation oncologist determine the tumor location and work out the X and O's and program those coordinates into the software of the CyberKnife so that it knows which path to follow. The patient is outfitted in a special vest hooked up to the machine and this allows the CyberKnife beam to keep on working and it adjusts as the patient breathes in and out.

    CEA's are tricky - alot of folks in this group say their CEA is no indicator at all if they had cancer or not - for others it is is a pretty effective marker on where you are at.
    178 could be considred high although I've heard of much higher. The good thing is if the CEA level drops then that is where you want to be.

    Now technically, here are the CEA values:

    0-3 Normal for non smoker
    3-6 Normal for smoker
    Above 6 is an indicator of cancerous activity.

    This should give you some info to get rolling - hope this helps you and please keep us all posted.

    -Craig :)

    My CEA was 150 after my
    My CEA was 150 after my colorectal surgery with 3 mets to the liver, my CEA level came down with every chemo and liver resection, it has been under 5 for about 5 months. 1.85, oh jeez chemo brain......I believe that was my last number, without have to go look. I know that some folks can have their CEA level in the thousands......it all depends on the individual.

    God Bless!
  • lostit2003
    lostit2003 Member Posts: 53
    #4
    Nana b said:

    My CEA was 150 after my
    My CEA was 150 after my colorectal surgery with 3 mets to the liver, my CEA level came down with every chemo and liver resection, it has been under 5 for about 5 months. 1.85, oh jeez chemo brain......I believe that was my last number, without have to go look. I know that some folks can have their CEA level in the thousands......it all depends on the individual.

    God Bless!

    Thanks
    Thanks for the help.
  • geotina
    geotina Member Posts: 2,111 Member
    #5
    lostit2003 said:

    Thanks
    Thanks for the help.

    We did not get copies of reports and scans because quite frankly we were not proficient at the time as to what we were reading and looking at. As a Stage IV, with liver and lung involvement we knew it was bad. When we go to the onc, his physician assistant goes over them in detail with us before ever seeing the doctor. If we want them, they are available to us with no problem. She always asks if we want copies. George has had an excellent response to chemo. When starting, his cea (if memory serves) was 584 and after completing the first 6 months of chemo was down to around 20 and continues to drop, onc walked in last visit with a big grin, he was very pleased so we are staying the course and continuing chemo without the oxy. Hopefully, when the next visit comes around we can start talking about some of the radiation options. I don't think liver resection is an option at this point. George is 60 and continued to work throughout treatment. He had his down days, but was able to tolerate the side effects quite well. Neuropathy in fingers got him down, things like buttoning a dress shirt he would call me to help, taking the top off a jar, things like that. He had the cold thing and slight metal taste and fatigue but he was one of the lucky ones regarding side effects. He never had the mouth sores or bad nausea. Everyone reacts different to the chemo combo so once you start, just come on the board to ask questions. It takes the anxiety level way down when you know what side effects to expect and know that is a normal side effect. Take Care - Tina

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