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so confused

Posts: 3
Joined: Oct 2013

My 79 year old mother was diagnosed with rectal cancer last month.  She has seen the radiology oncologist to discuss the 6 weeks of radiation she will have prior to surgery.  She had a PET scan on Monday.  They saw a "spot on the lung" and now want her to see a thoracic surgeon to have a biopsy done.  They won't start the radiation for the rectal cancer until they know what they are dealing with.  My mom is a basket case....so nervous, can't sleep, etc.  She can't see the thoracic surgeon until next week. If the spot is cancer, then what?  Won't they still want to get going on the radiation for the rectal cancer? 

Posts: 157
Joined: Jul 2011

hi there - just a lay person here ... but my guess is they would like to determine whether that spot in the lung is a met or not so as to decide on best course of treatment. If cancer, priority shifts from addressing primary to metastatic tumor. Often times, the metastatic tumors can pose bigger challenge and need more immediate treatment. What might change as a result is the course of chemo your mother will receive ... likely, she'll receive combination chemotherapy (Folfox of 5FU + Avastin, etc.) instead of single-agent which is customary with radiation. It may be that her docs decide on surgically removing the lung met or radiating or ablating it before starting chemo ... so many possibilities ... but very likely, the most immediat change would be to her chemo.

I recently read that Xeloda & Avastin is a very effective treatment for elderly patients with metastatic colorectal cancer ... discuss these concerns and your questions with her oncologist.

Posts: 2215
Joined: Oct 2011

They might want to deal with the lung surgically first before any treatments. When I was diagnosed they found a spot on my liver and the earliest available date for surgery was 6 weeks. I freaked out and asked my onc if we could do some chemo in the meantime. He said chemo would further delay the surgery and 6 weeks wait would not put me at any further risk. I had 2 more liver surgeries since then. Each time taking about 6 weeks from when thespot showed up until surgery and I am still here 8 years later.


Posts: 1019
Joined: Aug 2013

You will get great advice on here. I wish I had listened to some of the advice when we started out, but my brother was gung ho on doing what the oncologist told him. He ended up with a lung biopsy first which ended up showing that it was cancer, but the nodule was too small to tell if it was metastic rectal cancer. They saw a shadow on the liver when they did the CT scan so they did an MRI, it showed a mass so they biopsied that too. It was metastic rectal cancer. They told us that they had to biopsy the tumors to make sure that it was the rectal cancer that metastasized and not a new primary lung or liver cancer because they would be treated with different chemo meds. I felt like we wasted a lot of time doing that (as well as being risky that the biopsy might help spread it), but my brother is on chemo now and his CEA numbers are going down. It's hard to know what is right to do. BTW, my brother's rectal cancer was stage 2a in 2011, but he was one of the unlucky ones who had it metastasize a year after chemo ended for him. Originally, they did radiation and chemo first to shrink the tumor, then they removed it. he had a temporary ileostomy but that was reversed in a couple of months. He is slow, so he had lots of issues with that. Then they did radiation and it was gone for almost a year, but then the process started with the lung nodules. Hopefully they can go in, get out and get it done quickly. I know the family is just as anxious as the patient.

Here are the drugs my brother is on, in case you're interested: 5 -FU every 14 days, irinotecan every 14 days, leucovorin every 14 days, 5-FU over 2 days (infusion pump) and erbitux weekly . He is also on diphenhydramine and famotidine, zofran, and dexamethasone. Also atropine for irinotecan. The erbitux caused a nasty rash on his scalp and face, looks like acne. It's better today, we're getting it under control. The doctors told us it's a good sign, it means it's doing its job. He also had diarreah in the beginning and had a rash from the chemo, but that's under control too. The people on here gave me great tips and now my brother is doing well. They had great suggestions on washes for his skin and told me what would be a good antibiotic as well. I see great improvements, so Thanks guys!


Posts: 3
Joined: Oct 2013

Thank you for your posts.  It does help to hear from others.  I spoke to my mom's oncologist today to get a little more info. before going to the thoracic surgeon for the biopsy.  He said that the "spot on the lung" is actually a lymph node near the carina?  He can't tell if it's just one node or several......or if it's rectal cancer spread or a new cancer.   I guess we just have to wait ...........but waiting is the absolute worst. 

maglets's picture
Posts: 2596
Joined: Jun 2006

waiting is the worst! and when you are at the beginning it seems like all you and your mom will do is wait and wait and wait. I think all the oldsters here would agree.  Cancer treatment is a long slow process and sometimes it feels like waiting will never end.

Good for you for talking to the oncologist.  I am sure they want a complete picture of what you are all up against before a plan is drawn up for treatment. 

Welcome to the board.....and let us know how you make out with the surgeon. 


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