Just diagnosed: Surgery not an option, looking for hope

Posted by vcsongradi @vcsongradi, Feb 8 10:11am

Went in for my first colonoscopy in December, F age 58. Had negative Cologuards for the last 4 or 5 years. My PCP gave me a FIT test in September which came back positive. Colonoscopy revealed a rectal mass (close to the sigmoid colon junction) she said was typical cancer presentation. Had some abdominal pain and went to ER. PET scan found mets to liver and both lungs, stage IV. Colorectal surgeon told me that surgery, "would not benefit me." Oncologist gave me 2 to 3 years prognosis, said treatment would be palliative and not curative, and surgery, "would never be an option." Started FOLFOX + Mvasi in January; just finished my 2nd round. CEA was initially 58, and is now 46, so that is good news I think. Don't really have a question, just looking for some hope from the stories of other people.

Interested in more discussions like this? Go to the Colorectal Cancer Support Group.

Hi. I am 49 years old and I was diagnosed with a colon tumor and metastases in the liver and a couple of lymph nodes. There is a small chance of surgery if the metastases give in. I have gone through 6 chemotherapy cycles and once in Germany for TACE treatment. The trip to Germany was really tough and I wonder if I got too many toxins into my body for one day. The day after tomorrow, 2.12, I will have another scan and I hope it has not spread. The result of the previous scan was a decrease in the tumor and metastases and that gave me hope. I have also tried to exercise when I can, eat a keto diet, take cold baths, and have high-pressure oxygen treatments. Whatever was done, I hope that we all get at least a little good news in the future and that we can live a long life with our families.

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I put a link to the article from which I got the quote. I don't understand your problem.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1354809/full

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Profile picture for vernscw @vernscw

Vernon Zigler

Nobiletin (NOB) is a flavonoid derived from citrus peel
NOB was found to have anti-tumor efficacy. The present studies on the anti-tumor mechanism of NOB mainly focus on inhibiting the growth and proliferation of tumor cells, inducing accelerated apoptosis of tumor cells, inhibiting metastasis of tumor cells, inhibiting tumor angiogenesis, and regulating the tumor cell cycle and protein expression (Goh et al., 2019). NOB can inhibit human nasopharyngeal carcinoma cell growth and apoptosis through the PARP-2/SIRT1/AMP-activated protein kinase (AMPK) pathway (Zheng et al., 2019). NOB can regulate Src/FAK/STAT3 signaling, reduce VEGF production, and inhibit angiogenesis in breast cancer cells (Sp et al., 2017). Most recently, it has been shown that NOB can combine with chemotherapeutic drugs to enhance the sensitivity of chemotherapeutic drugs and play a synergistic anti-tumor effect. Li et al. (2019) investigated the efficacy of NOB on oxaliplatin using colorectal cancer cell lines.
They revealed that NOB increased the sensitivity of colorectal cancer cells to oxaliplatin chemotherapy through downregulation of the PI3K/protein kinase B (AKT)/mTOR pathway, and NOB promoted oxaliplatin-induced apoptosis in colorectal cancer cells.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1354809/full

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@vernscw
Thanks for your writing: It is imperative to provide authoritative references which assist individuals in balancing their options. Knowing, even just a little of referenced materials, can relieve anxiety and help individuals with conversations with each potential care provider. Jofree

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Profile picture for vcsongradi @vcsongradi

Thanks for all the responses. I enjoy reading about the experiences of others. It does inspire me and gives me hope. I have an appointment for another opinion/possible treatment options at MD Anderson in Houston in March. They only do in person appointments (I live in Indiana) so I will have to go there, but spring is a great time to go to Texas. I lived in Beaumont, TX, for about 5 years during Hurricane Harvey and the subsequent hurricane when I decided I needed to relocate to Indiana for better weather. I am able to enjoy all four seasons here which is fantastic for my state of mind. Before my last scheduled maintenance chemo, it was discovered that I had a lung infection so I was started on antibiotics and the chemo infusion was cancelled. I go in tomorrow for lab, oncology appointment AND infusion on the same day! So thankful for that change in schedule so that means only two days of appointments instead of three like it had been previously.

In answer to some questions above, I have had my tumor genotyped, and it is nothing that can benefit from targeted therapy as the microsatellite instability is low. I was told by the nurse at MD Anderson that their CT scan equipment is much more sensitive and can pick up things that others do not. He also told me that many times cancer is misdiagnosed (?) and it is actually some other type of disorder, virus or cellular disease. Not sure that is the case, so I will find out more in March. He also said there are other possible treatment options, so I'm hoping for positive news there.

I'm in a better state of mind today than I was when I wrote the previous update. I still feel like I'm in limbo when it comes to end of life planning. I don't feel it's urgent to get things in order completely, but it is in the back of my mind. I know many people who die in accidents that don't have any thoughts about their life ending, so in that way I do feel fortunate.

Thank you for your support and encouragement. Your strength and positive attitudes are definitely inspiring to me and hopefully to others at the same time.

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@vcsongradi I have KRAS G12S so there are few options except clinical trials. I may get the genotyping redone and get second opinion also because this mutation is quite limiting for treatment.

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Thanks for all the responses. I enjoy reading about the experiences of others. It does inspire me and gives me hope. I have an appointment for another opinion/possible treatment options at MD Anderson in Houston in March. They only do in person appointments (I live in Indiana) so I will have to go there, but spring is a great time to go to Texas. I lived in Beaumont, TX, for about 5 years during Hurricane Harvey and the subsequent hurricane when I decided I needed to relocate to Indiana for better weather. I am able to enjoy all four seasons here which is fantastic for my state of mind. Before my last scheduled maintenance chemo, it was discovered that I had a lung infection so I was started on antibiotics and the chemo infusion was cancelled. I go in tomorrow for lab, oncology appointment AND infusion on the same day! So thankful for that change in schedule so that means only two days of appointments instead of three like it had been previously.

In answer to some questions above, I have had my tumor genotyped, and it is nothing that can benefit from targeted therapy as the microsatellite instability is low. I was told by the nurse at MD Anderson that their CT scan equipment is much more sensitive and can pick up things that others do not. He also told me that many times cancer is misdiagnosed (?) and it is actually some other type of disorder, virus or cellular disease. Not sure that is the case, so I will find out more in March. He also said there are other possible treatment options, so I'm hoping for positive news there.

I'm in a better state of mind today than I was when I wrote the previous update. I still feel like I'm in limbo when it comes to end of life planning. I don't feel it's urgent to get things in order completely, but it is in the back of my mind. I know many people who die in accidents that don't have any thoughts about their life ending, so in that way I do feel fortunate.

Thank you for your support and encouragement. Your strength and positive attitudes are definitely inspiring to me and hopefully to others at the same time.

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I'm sorry to hear about your diagnosis. I am 56 and first was diagnosed with stage I colon cancer in 2021 at 52. I got surgery Jan 2022, which was optional (to be sure it was gone) and all lymph nodes negative. About a year and a half later, I had a recurrence in my peritoneum. After another colectomy in 2024 and CAPOX chemo after, they told me I had stage IV. They would not give me a prognosis because they said my recurrence was so rare. This was frustrating because we had hoped we took care of it with radical surgery the first time. I have had surveillance every 3 months with scans, bloodwork and Signatera (which I had done research on and wanted to add). I have had normal scans and signatera for a year and 5 months now I suddenly have a positive Signatera (minimum residual disease) Test. This means I have a 97% chance of another recurrence and there is cancer DNA in my blood that matches my original tumor. My type of gene mutation (KRAS G12S) is only found in 1.86 percent of colon cancer patients and does not respond to immunotherapy. I am looking at clinical trials now. I wanted to post because I feel your frustration and struggle to find hope during colon cancer and can understand your fears. I think there is a lot of good research going on for cures. I will be praying for healing and peace for you. My faith is what helps me. The emotional toll of cancer is something that is often overlooked and is, for me, the worst part. I am adding you to my list of daily prayers. I not only wish you time, but time with minimal feeling sick and free from having to only eat bland, lukewarm things. That was the hardest part of chemo for me...and always being tired. I just wanted you to know that you are not alone. The signatera test has given me some peace of mind for about a year, but now it is positive. So I am hoping for some clinical trial treatment before the mets recur again because we know it is already in my blood. Just found this out so waiting to see what the onco says...hes on vacation so I am left waiting...that alone should not be a thing..someone should be discussing my test results with me by now.

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Profile picture for sbelyea @sbelyea

My wife was diagnosed with Stage 4 Colon Cancer with a large tumor in that same location and significant mets to her liver.
She was told she had 12 months and to go home and make her arrangements. We didn’t like that answer so we obtained second opinions from well know colon and liver surgeons.

Colon surgeon removed her tumor with ‘curative’ surgery and six months of chemo later her liver tumors had reduced to the point allowing a 50% liver resection four weeks ago. Liver surgeon believes she is now cancer free and doesn’t require any more chemo.

Takeaway is be relentless in looking for alternative options. It’s a ton of work and possible expense but in our case it appears to have saved her life.

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@sbelyea
Keeping abreast of other options always is a wise decision. Taking a proactive part in your search may rattle some physicians; pass these folks on by. It is your body and your life so seeking out additional therapies and enlisting a trusted person to keep you in good perspective's is also beneficial.
jofree

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Profile picture for wku @wku

In my third year of chemo for stage 4 colon cancer. Same location as yours. Originally mets were in peri and other places along outside of colon. Told not operable. Cea started in mid 40s now in single digits. Chemo consisted of 5 floro and another drug. Last scan showed only liver tumors but they have shrunk. Suddenly surgeon says Im now operable (although high risk of returning). Bottom line chemo has improved significantly. It’s still a chore but not like it was even a few years ago. Be heartened. The best defense to what lies ahead is a good attitude.

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@wku
So True: Attitude with gratitude for just seeing another morning, a bird landing in a tree and chirping, a red velvet ant crosses your path' usually considered a good omen. Facing any unknown is unraveling but a good and grateful attitude usually stays one's course. Hang in there,.
jofree

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Profile picture for wku @wku

In my third year of chemo for stage 4 colon cancer. Same location as yours. Originally mets were in peri and other places along outside of colon. Told not operable. Cea started in mid 40s now in single digits. Chemo consisted of 5 floro and another drug. Last scan showed only liver tumors but they have shrunk. Suddenly surgeon says Im now operable (although high risk of returning). Bottom line chemo has improved significantly. It’s still a chore but not like it was even a few years ago. Be heartened. The best defense to what lies ahead is a good attitude.

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@wku I have stage 3 CRC . I've done chemo and radiation.Look up Chris Wark he is a Colon cancer survivor, his square one program is inspirational. God Bless

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My wife was diagnosed with Stage 4 Colon Cancer with a large tumor in that same location and significant mets to her liver.
She was told she had 12 months and to go home and make her arrangements. We didn’t like that answer so we obtained second opinions from well know colon and liver surgeons.

Colon surgeon removed her tumor with ‘curative’ surgery and six months of chemo later her liver tumors had reduced to the point allowing a 50% liver resection four weeks ago. Liver surgeon believes she is now cancer free and doesn’t require any more chemo.

Takeaway is be relentless in looking for alternative options. It’s a ton of work and possible expense but in our case it appears to have saved her life.

REPLY
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