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This is Dr. David
colon cancer can spread to adrenal glands.
If u recall about my dad .... I have few queries .
He had a scan after 4 rounds irinitecan .
Following noted :
Increase in the previous liver lesion and aortocaval node, new nodule in left adrenal gland, new nodule in sub pleural left lower lobe.
it sounds like the irinotecan didn't work.
and the cancer is growing and spreading.
They started folfiri first but then after 1 round just started irinotecan as he had chest tightness
Is folfiri better?
What u think we can do ? Are these nodules mets then ?
folfiri has irinotecan in it.
the I in folfiri is irinotecan.
those nodules are most likely metastatic colon cancer.
he had a adrenal gland nodule on previous ct too but that was nothing .
The lung nodule is 0.5 cm and the adrenal gland one is under 1 cm
yes, those nodules can be signs of the colon cancer spreading.
I know this may sound silly but could chemo be actually causing mets ?
no, chemo will not cause mets.
his cancer is spreading.
What should be the next steps ? Should they change chemo as we are thinking of nano knife procedure
there is no one right answer.
can the nodules b killed as they are tiny?
they can change chemo.
they can try focused radiation thearpy.
the nodules can be killed.
but it won't prevent other new spots from growing.
let me know if you have other questions.if done for now, please leave positive rating below the chat box so I can get credit for helping you todayyou can always reach me with "a question for Dr. David" if you have any other questionshere is my website if you need to reach me again:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com
exaxtly these an be targeted but what's best way to prevent further spots ?
chemo is the only thing which can be tried to prevent future spots.
but his cancer is acting aggressively.
and even further chemo may not work.
Could it be that fact that they left the liver met in that causes further spots ?
the cancer came from the colon cancer which spread to the lymph nodes
so the cells have spread through the blood system to get to the liver and lungs and adrenal glands.
cells can take months to slowly start to grow and show up on CT scan.
The thing is he had no distant mets until he first started chemo ( xeloda) back in June .
So the cells escaped during the surgery ? As all 3 cans prior were fine
he most likely did, they were probably just too small to see on CT scan.
How many mets u need to have and how big should they be to class the cancer as terminal ?
that varies from patient to patient
but his cancer now is metastatic and is not curable in the long run.
he can continue to get treatments to try to slow down his cancer, but most likely with enough time, he will pass from his metastatic colon cancer
so you can say his cancer is now terminal and he will eventually pass from his colon cancer.
it could take 6 months or 12 or 24 months, or longer, no one can know for sure how long he will live
If these current spots get ablated then does a person have few years ?
As a oncologist wha would u advise as a treatment plan
ablation of those spots will not prevent new spots from growing and most likely will not help the patient live longer.
the patient needs to be involved with the treatment plan.
one option is no chemo and no treatment and hospice comfort care.
if he has been having bad side effects from the chemo, it is up to the patient to decide if they want to get more chemotherapy.
there is no one right treatment plan in this situation.
I can't see him and talk to him so therefore I can't advise a treatment plan.
He has no symptoms , tolerated chemo well . Only chest tightness with folfiri .
Which chemo would you recommend that could help ?
he has tried xeloda already.
he can try avastin.
what would you say to German cancer clinic ? They d. Dendetric cell, hyperthermia etc ?ive read alot of positive stories for ppl in far worse cases
the prey on desperate patients willing to pay cash for experimental therapy with very little proven results.
Sorry folfiri only 1 round .
If further mets can b stopped that is the key right. ?
chances are very small that they can be stopped.
As these current ones can be ablated right ?
they can be
With a lot of ppl chemo controls it right ?
we have talked about all of this already.
no, for many patients, their colon cancers continue to grow
most patients chemotherapy eventually doesn't work and the cancer continues to grow.
An he still have up to 5 years ?
he needs mutation testing of his colon cancer to check for KRAS mutation.
if he has no KRAS mutation then Erbitux is an option.
most likely he will not live 5 years.
We don't know what it is
ask his doctors about KRAS mutation testing.
What about uft pills ?
I read about them from japan
Ok so can they start folfiri ?
for lung cancer.
yes, they can start folfiri.
please leave positive rating below the chat box so I can get credit for helping you todayyou can always reach me with "a question for Dr. David" if you have any other questionshere is my website if you need to reach me again:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com
if the cancer didnt spread this many years and was grade "2, how can it b aggressive ?
it is slowly spreading now
and has not responded to xeloda and other chemotherapy agents.
and it had spread to many lymph nodes at the time of the surgery.
They have not really bothered to advise anything to b honest. Do you agree there are few more optionS? He has been approved for
nano knife . Is this a good one ? Only 1 uk hosp has it
Can I send you the reports as I am confussed . Can you please advise what are the new mets . It just does not make sense
Can I email report to you ?
When I click paperclip
icon just a blank page come up
The only issue is which I'm confussed .
in new report says new left adrenal gland node but on old report that was also noted . So can't be a new funding right
Also it says , upper lobe nodule remains unchanged . But a upper lobe nodule was never mentioned in any previous report .
U see I'm a lawyer and I do medical negligwince work therefore I'm aware of a few things.
the onco sat and went thru the scan with my dad .this was the first time she looked at it too and she did not even have the previous report . She said some more nodes are seen .
i was not there.
but then when I read both repost I thought that a nodule is not a lymph node.
also radiologist put new nodule on adrenal but that was already in previous report as a non met
What would this mean to you .
old report - small nodule on left adrenal
new report - new nodule on left adrenal
it woould be the same spot right?
He's not even put whether it's large or smaller . As far as ww know that previously was not a met according to the team.so it may be the same one .
is a 0.5 cm lung nodule very small n can it be ablated ?
Is the neo 2 treatment any good?
Ok.shoukd we go for IRE (nano knife).? Wiuld
it be best to ablate all the tumors as they are tiny. There are 3,4 altogether I think.
Ok what would u advise for new spots ? As an oncologist which chemos do you think will
help to try stop the spots ? I know there are many still to try
I far he has tolerated all chemo well and a bloodwork has been fine each time .
i think he's KRAS wild .
one last quesion , could this be a mistake as radiologist says
new report - upper lobe nodule remains unchanged
old report - has no mention of a upper lobe nodule
what at could this mean to you
I see . It is mentioned on this one but says unchanged . So not likely to be a met right ?
U will b surprised bur we saw a registrar who didn't even I know what nodules are as she said they are lymph nodes ! It's only after I read report I thought nodules are not lymph nodes
Ok. The previous ct says no lung lesions . But this new report says ANOTHER upper lung nodule but remains unchanged.so it this a new finding ?
hi we got told today that the only extra spot is on the lower lobe which is. Under 0.5 cm.
prob they r having is with 5 fu he had muscle spasm on chest . so don't wNa risk any 5fu chemo .
what alternatives are there that are affective
Is it better that only 1 tiny nodule has appeared?
is zaltrap any good ?