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stage 4 colorectal cancer (9mm polyp on liver and 15mm polyp on Spleen)

Posts: 3
Joined: Oct 2012

My father had the symptoms of blood in stools and a feeling that he has not completely emptied his bowels. He consulted a surgeon who said that it could be internal piles which can be healed with tablets. Since the above symptoms continued to be there we consulted some other doctor who did colonoscopy, Biopsy and CT scan and confirmed that he is in stage 4 colon cancer since they found two small polyps in other organs one small 9mm polyp in liver and one more 15mm polyp in spleen.

Docs said that we don't have any other treatment option except chemotherapy and that too it is for prolonging the life and not for curing as the cancer is in 4th stage. Docs have advised 6 cycles of Chemo with an interval of 15 days between successive Chemos. 1st Chemo for three days on 25th Oct 2012 and Second on 10th Oct 2012.
Chemo medicines used:- 5-Fluorouracil,Leucovorin,Oxaliplatin

Just few days back i consulted one more oncologist who told us to get the PET scan done since he is not sure whether the polyps on liver and spleen are cancerous.

Please advise the best treatment option.

Sundanceh's picture
Posts: 4408
Joined: Jun 2009

Hi, he's doing the heavy hitter right now with the 5fu and Oxy...

I'd have to disagree with the statement "only option" being chemotherapy. While it is true, that with the cancer spread, the role of chemo would be to try and shrink the tumors in hopes of a surgical procedure to remove as much as cancer as possible.

The spot on the liver is not too large...you don't mention the location, but it is quite possible that RFA - radio frequency ablation, could be used to burn that lone tumor out.

As for the spleen, don't know if RFA would qualify, but they might could do a spleenectomy, where the spleen would be removed. I'm sure that would be contingent on the liver spot being eradicated first.

But, still these are questions you can ask...

While it's also true that Stage IV is a serious condition, there are many, including myself who are either Stage IV's...or metastatic stage IV's that have beaten long odds and still live a pretty decent life.

I've had cancer 3x now in 8-years and still work and do the things that are needed...I've been pronounced dead a couple of times during those eight years - but have extended out far past the original prognosis.

So, don't assume anything...

His chemo plan sounds like standard protocol and I can't see anything wrong with it....chemo every two weeks for six months...

PET scan now would be another diagnostic tool to go in hand with the CT you must have just done showing you the new spots.

The PET will measure the metabolic activity of those spots to see how much uptake they are registering...the higher number can indicate cancerous activity - or it could be a false positive test.

We'd like to hear back when you get the PET results...this will give us an indication of what is going on.

Of course, we are just people with cancer or have had cancer and our experiences are no substitute for medical advice from your doctors...

Our role here is to give you ideas and questions you can ask so that you can help direct the care needed....we're a sounding board of sorts, because of our experiences and the things we have done and taken.

So, right now, I can't disagree with what the doctor is doing...he seems to be following protocol here.

Keep us posted and if you have more questions, please ask.


Posts: 3
Joined: Oct 2012

Hi Sundanceh

Once my father is diagnonised with IV stage colon cancer docs advised the 6 Chemos in 3 months.
Ist Chemo given on 25th Sep 2012.
2nd Chemo given on 10th oct 2012.

Then on 18th October 2012 we consulted an Oncologist(in HCG Bangalore, India)who initially advised PET scan (as he is not sure whether the polyp on liver is cancerous) but when i informed him that two Chemos have already been given he advised PET after 4th Chemo.

Please advise when to take PET scan.
Also wanted to know whether avastin needs to be given along with 5fu and Oxy.

Sundanceh's picture
Posts: 4408
Joined: Jun 2009

It would not be prudent for me to specifically advise anyone on what should be done...that's tough enough for doctors...and I'm just a man who has had cancer.

When doctors order PETs seem to vary among each doctor. I've had one oncologist who ordered CTs and PETs routinely all year long...up to 4 a year...even when I was in treatment.

At the facility I go to now, I've only done 1 in 3-years...and never any DURING treatment.

The theory is that as the chemo is killing off the cancer cells, they emit a protein into the bloodstream, which can elevate CEA levels during those cycles. Anyway, because treatment is in progress and cancer cells are dying etc., my facility feels that a PET would just lead more towards a false/positive test than not.

This is just their practice...

I've had false/positives before on both CT and PET...where it looked like cancer, but that episode turned out benign...others weren't but this one was.

I would summize that they decided to do 3 chemo treatments and then scan to see if there has been positive response.

I talked about this with my onc on the 3 month or 6 month plan...again, they lean towards six-months because their research has shown that is more effective at breaking up the DNA life cycle of a cancer cell.

They are all at varying growth stages in our bodies...and they have seen more positive response by going six-months over the three-month plan...they have tried both.

So, them wanting to do one after just 4 treatments? I can't say that's wrong - I can't say it's right. It seems a little too soon...here in the U.S. it takes insurance approval to have a PET done...CT generally has to precede it...

If we did one here at that juncture, it would probably be a little more difficult to get one again quickly...would need justification.

It's always a judgment call, but a standard course of action for the U.S., would be to finish six-full months of chemo....give the body a chance to recoup for a month or two...and then scan.

But, that might not be right for you...

As for Avastin, yes, many folks have used that as an adjuvant to their chemo regimen, myself included. If you've had surgery recently, there is a waiting period for that - about 8-weeks I believe.

But, if your onc thought it were warranted, that would be an effective cocktail...I did the same one...Xeloda instead of 5fu, but it could have been 5fu...Leucovorin, Oxaliplatin.

Remember, take what I say with a grain of salt...I am absolutely no substitute for sound medical advice from licensed doctors.

I just don't want you to hinge everything on what I've said. This is just an opinion and helps you bring up these topics to discuss with the doctor concerning the care.

I wish I could be more definitive, but I lack medical training and these are just my own personal experiences and things I've learned about cancer. But the human body is different for everyone, and as such, responds differently to treatments and stuff, so it's very hard to predict for someone else what is the correct course of action for them to take.

We help to bring questions to the table though...and open discussion with your doctor is what it's all about.

Keep us informed:)

Take care.

herdizziness's picture
Posts: 3642
Joined: Apr 2010

Just wanted to chime in, that I just started my chemo on October 12th, (oxyplatinin, xeloda and avastin)and that I too will be having another ct scan after the third treatment, they want to see if this combination is still working for me and if I can have surgery (again)if enough have shrunk or hopefully calcified.
While they might say chemotherapy is only choice for right now, please keep in mind, that many doctors have told a few of us that same thing. Chemo worked so well for me that I did get the surgery that they said I would NEVER get, and that has happened for others as well. Also your father's tumors (if they are cancerous)in the liver and spleen are still quite small, one of the ones in my liver at this moment is 5cm and another mass I have is 4cm's per last PET Scan, hopefully chemo will shrink these guys once again.
Keeping your father in my mind, and hoping the chemo does very well for him,
Winter Marie

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