Liver Lesion might postpone chemo for Colorectal Cancer

Posted by pjebp @pjebp, Nov 12, 2021

Hey everyone, so here's the latest update. My CT scan that I had yesterday shows a lesion on my liver that wasn't seen on the CT scan I had in August. My doctor wants to postpone chemo until hopefully they can figure out what the lesion is. So I will have an ultrasound Monday to determine if I can have a biopsy to figure out what it is. If they can't find it on the ultrasound then I'll have an MRI. I am going to remain optimistic that it was simply just missed on the first CT scan because the cuts are at different levels between studies. The old me wants to curl up in bed, cry and think the worst and have a crap weekend. I know too much now to go to that place. I just got back home now, so I'm going to get my workout done and carry on with my day like usual. As usual, I physically feel great and I'm almost 6 weeks post surgery.

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This is unsettling news to get, especially on a Friday. As you probably already know, "Liver lesions are abnormal clumps of cells in your liver, and they are very common. They will be detected in as much as 30% of people over 40 who undergo imaging tests.1 The majority of liver lesions are benign (not harmful) and don't require treatment." excerpt from https://www.verywellhealth.com/liver-lesions-5077003

Your doctor wants to be sure your getting the right treatment.

Can you remind me, what stage is your colorectal cancer? When were you supposed to start chemo?

REPLY

Thank you for your reply.

My tumor was discovered during a colonoscopy on July 21, 2021, 5 years after a "clean" colonoscopy on September 2016, which was 3 years after a colonoscopy in May 2013, in which 3 polyps were removed.

I was thought to be a Stage 2b. There were no lymph nodes even visible on my CT Scan or MRI. There was a questionable lesion on my liver that was determined to be a hemangioma. It appeared that the colon was 1 mm away from my rectal wall.

I went with Mayo Clinic's treatment approach of 1 week proton beam radiation (August 28-October 1) followed 3 days later (October 4) with a proctosigmoidectomy with anastamosis and temporary ileostomy.

The surgeon got all clear margins, however 7 out of 29 nodes has some cancer cells, and there were 2 microscopic "nests" in the fat around my rectum, which was all removed during surgery. I had a total of 13 inches of rectum and sigmoid colon removed.

So my oncologist wanted another CT Scan to reassess my stage, as the first CT Scan was back in August. I had this CT Scan Thursday November 11, approximately 5.5 weeks after my surgery. The plan was to start chemotherapy on Friday November 12.

This new CT Scan showed a lesion, approximately 1 cm (.39 inch) on my liver in a different place. This lesion was NOT seen on my CT Scan in August. So now my oncologist has decided to hold off on the chemo until it is determined whether or not this new lesion is a metastases. He is concerned because the lesion was not visible on the earlier CT Scan in August. He has ordered an ultrasound, to see if it will be possible to do an ultrasound guided biopsy of the lesion. If that's not possible, then he will order an MRI.

My ultrasound is scheduled for Monday, November 15.

I am hoping for the slight possibility this new lesion was missed on the first CT Scan due to the "cuts" being at different levels on the two studies, and that is not cancer.

REPLY
@pjebp

Thank you for your reply.

My tumor was discovered during a colonoscopy on July 21, 2021, 5 years after a "clean" colonoscopy on September 2016, which was 3 years after a colonoscopy in May 2013, in which 3 polyps were removed.

I was thought to be a Stage 2b. There were no lymph nodes even visible on my CT Scan or MRI. There was a questionable lesion on my liver that was determined to be a hemangioma. It appeared that the colon was 1 mm away from my rectal wall.

I went with Mayo Clinic's treatment approach of 1 week proton beam radiation (August 28-October 1) followed 3 days later (October 4) with a proctosigmoidectomy with anastamosis and temporary ileostomy.

The surgeon got all clear margins, however 7 out of 29 nodes has some cancer cells, and there were 2 microscopic "nests" in the fat around my rectum, which was all removed during surgery. I had a total of 13 inches of rectum and sigmoid colon removed.

So my oncologist wanted another CT Scan to reassess my stage, as the first CT Scan was back in August. I had this CT Scan Thursday November 11, approximately 5.5 weeks after my surgery. The plan was to start chemotherapy on Friday November 12.

This new CT Scan showed a lesion, approximately 1 cm (.39 inch) on my liver in a different place. This lesion was NOT seen on my CT Scan in August. So now my oncologist has decided to hold off on the chemo until it is determined whether or not this new lesion is a metastases. He is concerned because the lesion was not visible on the earlier CT Scan in August. He has ordered an ultrasound, to see if it will be possible to do an ultrasound guided biopsy of the lesion. If that's not possible, then he will order an MRI.

My ultrasound is scheduled for Monday, November 15.

I am hoping for the slight possibility this new lesion was missed on the first CT Scan due to the "cuts" being at different levels on the two studies, and that is not cancer.

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Please let me know what you learn after discussing the ultrasound with your doctor.

REPLY
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