Some Advice Please

[kimmywah]

Hi,
I hope you can help.
My friend was told yesterday that she has Colon cancer.  Apparently her family has a gene that is positive? for Colon cancer and she has always been diligent in having checks and in fact had a colonoscopy at the beginning of this year which was clear.
A few weeks ago she began to have pain and was finally admitted to hospital.  they did a cat scan and mri and have diagnosed a tumour in colon and say that she has mets to liver and lungs! Of course this has been a huge shock especially since there were no other symptoms (although she has reported feeling very tired).  
They have suggested a colostomy bag and radiation.  Can you please tell us what is the best form of treatment and what questions she needs to be asking as she is really not sure.  We are in New Zealand.

Thanks
Kim

[kimmywah]

Morecambe - Thank you very much for your reply.  No Huntly has no medical facility just a small place in NZ but will definitely pass on your advice to travel around and get another opinion.
Thanks again.

Kim

[Morecambe]

I am really sorry to read of your friend's predicament.  I was also surprised to read that a colon cancer growth has been identified after only 9 months prior to which a clear colonoscopy test was achieved.  I think that you should probe this further.

Surgery is also a possible treatment for colon cancer and this is supposed to be effective as long as the cancer has not spread.  I underwent a total colectomy almost five years ago - not for colon cancer - but for torrential diverticular bleeding.  I described it to another Medhelp patient who was interested.  Log on to:-

http://www.medhelp.org/posts/show/523166

I think that you should ask your specialist whether surgery is an option.

The whole tenor of your posting and the replies given by others leaves in my mind a suspicion that the correct diagnosis may not have been reached so far and I would also agree with the suggestion to seek a second opinion.  Are you satisfied with the expertise of the hospital that your friend has visited.  If not, then do seek "the best" even if it means travelling to ??Auckland??/OZ/or even the Mayo Clinic in the USA??  I don't know exactly where Huntly is in NZ - of course the medical facilities may be second to none - but, if not, then do search more widely.

Good luck
Morecambe

[kimmywah]

Thank you for you replies.  
I too wondered about the diagnosis being given before anything has been biopsied??  I have told her to go and get another opinion of course but when she has been really diligent with her checks perhaps this could be a secondary tumour?? and not colon??

Thanks I appreciate your help.
Kim

[suntower]

I'm so sorry to read about your friend. I'm praying for her. Hang in there.

A couple of questions, though, to Dr. Paul...first, how could a clean colonoscopy at the start of this year be followed by a dx of colon cancer w/mets only 9 months later??? I thought the progression of polyp->cancer took years! Also, I didn't realize a CT or MRI could dx colon cancer, or even really detect anything in there. Am I mistaken?

Thanks!

[PaulMD]

Hi there.

I believe that the colostomy is for palliative purposes as well as the radiation treatment to probably relieve the obstructed bowel.  All of these are aimed just to control symptoms, minimize pain, and the intention is not curative.

After the radiation, she may undergo systemic treatment with chemotherapy to control the other tumors in the liver and lungs.  Chemotherapy would prolong overall survival, but at this stage of the disease, total cure seems unlikely.

She should ask her doctors the different chemotherapeutic drugs available, and also the possibility of molecular targeted treatment (such as Avastin).

Regards and God bless.