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re: HELP! Colorectal AND lung cancer?

musiclover's picture
musiclover
Posts: 242
Joined: Oct 2005

Hi, I'm new to this group. I've been posting on the colorectal group for the past many months getting encouragement for my friend Mark who has Stage IV rectal cancer, mets to liver and lungs. After six months on a clinical trial things have taken a turn for the worst. His last scan showed new cancer growth in the lungs. They are saying it "may" be lung cancer, took him off his present trial immediately (Avastin, Oxyplatin, Xeloda) and have presented two options: a traditional regimen of two colorectal chemo drugs which the doctor has pointed out is only 10% effective and a new freaky clinical trial that noone knows anything about. He's pushing the trial.

If it turns out that Mark does have lung cancer in addition to his rectal cancer, shouldn't that be ruled out before ANY treatment is administered? Would any regimen do any good if there is lung cancer present?

I'm at my wits end. He's being treated at a county hospital. Getting records is damn near impossible - I've not been successful in getting anything except copies of the written report of the CT. I put a request in four months ago for records at that time and still have not received anything. Getting the current CT films for a second opinion is fruitless. He does still see his original oncologist that he could get some feedback from. She is asking for the films and I've explained my dilemma. She has not been successful in retrieving records either. Damn county hospital!!

How does one determine if these new spots are lung cancer? Would a PET scan reflect that? A biopsy? I don't think Mark would do well with a biopsy. He's so thin - I'm afraid a surgery would be dangerous for him. Any thoughts, suggestions would so helpful and appreciated.
Thanks! Kathryn

Lyndawithay
Posts: 14
Joined: Mar 2005

Hi, I'm phil my wife has NSCLC and is on Avastin. First of all why are you at the county hospital? If you have POA you should be able to get all the records and his doctor should also be able to get them with his permission. My wife also has chronic leukemia and the oncoligist tells us that the lung cancer treatments may also work for the Leukemia. I think that all a pet scan will tell you is that it is cancer not the type and you may need a biopsy. If you have good doctors they will not do a biopsy if it puts your friend at risk. Depends where you are and if he is on state or county aid but I would try for a Cancer Clinic that concentrates on Cancer Treatment if I were you. There is always hope and the cancer doctors today can do wonders with the drugs they have to work with. Hope you find a solution. PHIL

cabbott
Posts: 1048
Joined: Aug 2006

Hi musiclover,
I don't have colorectal cancer, but I do have two different kinds of cancer: breast cancer since 2002 and lung cancer this August. The lung cancer was discovered as an isolated nodule on an xray taken to "prove" I didn't have pneumonia. Well, the xray didn't show pneumonia, but they said they had to follow up on the nodule and a CAT scan and a PET/CAT scan later, I was diagnosed with pneumonia and probable cancer. The PET/CAT scan (only available at a large teaching hospital in a nearby state)could only show that the nodule absorbed radioactive sugar in a way that made it suspicious for cancer. As the previous message indicates, they can't tell what kind of cancer it is without looking at it under a microscope. The oncologist I had decided that since it was just one suspicious nodule and not several spots, there was a chance it could be lung cancer and recommended a biopsy. If it had been several spots in the same vicinity, it would have looked more like mets. In the case of lung and breast cancer, the same treatment will not work on both. They are both cancer, but not the same disease. So we had to find out first what it was. (You would have to talk to a knowledgeable oncologist to find out if lung and colerctal cancer use the same meds.) He recommended a surgeon who was skilled in something called a VATS procedure. It is a little like laproscopic surgery. Instead of cutting one big hole to go in for a biopsy, they just made 3 one inch cuts. A little scope goes in one hole to help the surgeon look around on a big screen and tools to do surgery go in the others. The first day or so I needed IV pain meds, but I was back on my feet by the end of day two, only on ibruprofin after that, and jogging a little after just 2 weeks. The VATS procedure is MUCH easier on the body than traditional surgery, but it can only be done well by someone who does a whole lot of it. Traditionally you get a ten inch cut, they spread your ribs (or remove one even), and you have a longer recovery time. They made me do a pulmonary function test before they would allow any surgery. They didn't want surgery to incapacitate me and reduce my ability to regular activites. I asked what they do for folks with poor health. My surgeon explained that there were lots of options. If the position of the cancer is right, sometimes they can biopsy with a special scope down your throat. Sometimes a sputum test will tell a pathologist that it is lung cancer. Another option is a special dye that is attracted to lung cancer cells and kills the cells it enters when hit with a special light. This can be repeated as needed. Lots of these things are not available at local hospitals and need to be accessed at the best university teaching hospital you can access. The web also describes some of these state of the art techniques. By the way, if the cancer is advanced, further surgery is usually not done and chemo is the best choice. Again, a teaching university hospital or cancer center that specializes in lung cancer can guide you to the latest treatment developments. Good luck!

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