Not so good news today on Jim :-(

Hugs
Hi,

All I can say is I'm sending cyberhugs to you and I am praying right now for any cancerous growth to stop- also that doctors will be positive and proactive in finding the best treatment approach.

Take care-
Lisa

Nana2 said:

Just got a copy of the
Just got a copy of the radiologist's report and I won't read all the ugly details, but the IMPRESSION at the end of the reports list
1. Worsening hepatic metastasis
2. Areas of nodularity demonstrated within the lung, also suspicious for worsening metastatic disease.
I just keep remembering Doctor Shoup at Loyola saying last time, "they (the radiologists) just don't understand what we do here." So I hope she will have a more positive outlook on this.
Thanks for your Hugs and Prayers Pepe

April

The Report
Deep breaths. Both of you. Breathe in... breathe out. There ya go. Keep reminding yourself to do this... and once you have a couple of deep breaths under your belt, let's look at that report again... keeping a few things in mind:

1) Think of Radiologists as scientists. They rarely have to actually communicate with patients (that's what our GPs and Oncologists are for), even if they end up being the ones that do a procedure on a patient. The patient is only there for the procedure... radiologists do not carry patient "caseloads". So the reports are not written with the patient in mind... if it were, it would be written in layman's terms with more thought going into describing what they've seen. So they are talking in scientific data terms --- "worsening hepatic metastasis". Well, it's true, the spots on the liver (hepatic) are larger, the spots are there because of a spread of colon cancer (metastasis), so since the spots are larger than they were in a previous scan (which they compare current scans to previous ones), then the cancer is worsening. Well, if the spots are growing, then you know growing is not a good thing... but it's not up to the radiologists to determine (or even know) if this is a treatable thing. Their job is just to read the scans and report what they see on the current scan and in comparison to previous signs. What this will mean to your oncologist is "Ok, the spots in the liver aren't shrinking, so we have to change our treatment plan" and that's when she will probably discuss the different treatments/chemos/plans that are out there. She will pick one and tell you why she thinks this is the best one for Jim right now and if it doesn't work, then will change to another. The bottom line, the plan is to shrink those puppies until they either are small and stable, or they can be removed.

2) "Areas of nodularity demonstrated within the lung, also suspicious for worsening metastatic disease". Again, there they go with the scientist vocabulary. I'm not sure if they mean existing nodules are showing signs of growing, or if there is new growth in the lungs, which would indicate worsening metastatic disease. Either way, it means the chemo Jim was on obviously was/is not being effective, so it will be time to change chemos.

I think up further, you were asking about Erbutix . That is definitely one of the chemos that is used for us with tumours in the liver and/or lungs. I'm not sure which chemos Jim has been on, or whether or not his oncologist has a specific plan in place. For instance, I did 12 cycles of Folfox (well, actually 10 with the oxyliplatin... couldn't do the last two cycles of that nasty oxy), then I was good for about 2 1/2 years with no chemo... even though I did have nodules in my lungs (nothing in my liver). This past spring, those darn nodules decided to start growing, so my onc put me on Xeloda (pill form of the 5FU part of the Folfox I was on before). She thought that I had been off chemo long enough that my system might have responded like this was a new chemo. It started to. After 3 months, the largest tumours had shrunk by 33%. This past 3 months... nada. Not only have they not shrunk any more, a couple of them started growing, even with the chemo!! Grrrrr!

So, we are on to another plan. I'm on a break from chemo right now to give my system a rest... but starting in Feb, I'll be going on Irinetocan and we'll see how that works. If it eventually stops working, then we move on to something like erbutix, and then we'll try some of the combos.

So, from an oncologist point of view... there are lots of combos and things to try. From a radiologist's point of view... they can only report what they see... not what they think the treatment should be or whether one chemo would be better than another for no reason.

I know it's hard... but try not to read into what the radiologists say... and then assume the oncologists are going to say the same thing. Enjoy the holidays and know that when you go in to see the oncologist, you will be told what's next on the agenda. Meanwhile... Jim should rest, relax and refuel so that his energy and immune system will be ready for the next plan

Cheryl