Suggest Treatment For Cancer In Colon Metastasized To Lungs

Posted on Tue, 17 Mar 2015

Question: Hi if no chemotherapy taken in a colon cancer pt, was stage 3 but recent scan shows

A liver met
1 aorticaval node
1 sub pleural nodule

Irinotecan and xeloda so far failed . What is approx survival if no chemo taken?
What are other options ,

Answered by Dr. Monish De (21 minutes later)

Brief Answer:
Regorafenib

Detailed Answer:
Hi

Recent scan is showing the colon cancer has spread to lungs and liver and it has metastized and has become stage 4.

If no chemotherapy is given average survival time is aroung 6 months.

As irinotecan and xeloda has already failed second line chemotherapy with Regorafenib can be tried.

Side effects of this drug is decreased appetite, diarrhea, dry mouth, hair loss, headache, muscle stiffness, nausea, tiredness, voice changes, weakness and weight loss.

Regards

DR DE

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Monish De (2 hours later)

The mets are 3 at present and under 2 cm. in liver, node and sub pleural.would it still b 6 month?

Sub pleural is not lung right? The radiologist has said nodule- does that mean a met?

Also is it good to also ablate these 3 by nano knife with chemo?

If chemo works and thrse ablated would then survival b how long

?

Answered by Dr. Monish De (10 hours later)

Brief Answer:
pet scan

Detailed Answer:
Hi

I would advise you to do a Pet scan to find the nature of the nodules whether it is malignant or not.

As the mets are small if chemotherapy works then these can be ablated.

If these can be ablated then average survival time will be more than 5 years.

Regards

Dr De

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Monish De (4 hours later)

The interventional rafiologist says all 3 can be ablated , but the worry we have is others will kerp
Coming ic chemo does not work.

Does chemo fail in
Lot of ppl?

The sub pleural nodule is the new one. Is there any reason y the rafiologist has not put the size of it?

Y would he say nodule and not metastic lesion?

Answered by Dr. Monish De (6 hours later)

Brief Answer:
Fine Needle Aspiration Cytology

Detailed Answer:
Hi

As the lesions are small all 3 can be ablated.

After ablation Regorafenib chemotherapy needs to be taken for 6 months so that new metastatic lesions do not come back.

The sub pleural nodule could be a benign lesion as the size has not been mentioned and a Fine Needle Aspiration Cytology test can be done from it to prove that it is not a metastatic lesion.

Regards

DR DE

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Monish De (12 minutes later)

Thanks ,

Can there be a case where no chemo works?

Im worried as 2 has not worked so far. The onco has suggested oxyplatin.

Also im confussed abt 1 thing. Ct report does not mention petitonial disease but letter ftom
Oncologist says possible petitoneal disease ? Ive attachwd both for u to se
e

Answered by Dr. Monish De (13 minutes later)

Brief Answer:
8 months chemotherapy

Detailed Answer:
Hi

I will advise you to do a pet scan to find the extent of the disease.

Oxaliplatin chemotherapy may work as it has not been used yet.

Minimum 8 months chemotherapy is needed.

Regards

DR DE

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar