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Suggest Treatment For Stage 4 Rectal Cancer

Posted on Mon, 21 Apr 2014

Question: My father has been diagnosed with Colon Rectal Cancer, stage 4. He is only 47 years old. His height is 5'10. He has not had had any medical history ( no medical record). The doctors have said that he has a few spots on his liver which have recently shrunk with chemotherapy (he only had two Chemotherapy's so far). My doubt is does my father really have colon rectal cancer stage four because he has never had any pain or nausea. Yes, he has started having pain ever since Chemotherapy started, but before he did not have any. Chemotherapy is making him weaker (losing weight and hair fall). More information about his Colon Cancer: His sister had it, but besides his sister no one has ever had it in his family, ever. He only has a few spots on the liver for which doctor recommended Chemotherapy. For the rectal cancer, they said Surgery would be the best option. The cancer that was spread to the liver only was NOT spread through the blood. Everything else is fine in his body. His liver has no pain, never had any, ever. Now, it is shrinking. My question: Does he really have rectal colon cancer stage four. We have not received second opinion yet, but we would like to. Can there be mistakes in diagnosis? How serious is his cancer? Is this curable. Furthermore, his WBC, all of sudden shrink whenever Chemotherapy is given to him- otherwise, they are fine. Is his Chemotherapy killing him more? If his liver has shrunk, then can doctors take the rest off via surgery? Please explain his staging and whether it is curable.Also, advice on a second opinion.

Answered by Dr. Robert Galamaga (7 hours later)

Brief Answer: Consideration Detailed Answer: hello and thank you for sending your question. Regarding the information you have provided it does seem like your father has stage 4 rectal cancer. this really means that the cancer has spread beyond its location of origination to other organs including the liver. It is unlikely that what they see in the liver is anything but cancer. This is especially true if it seems to be responding to chemotherapy. as you have mentioned, chemotherapy has a multitude of side effects. It does certainly cause fatigue and hair loss as well as decreasing white blood cell counts. This is known as bone marrow suppression. This often occurs during the course of treatment. The bone marrow would usually recover without a problem after treatment is completed. unfortunately this is not a situation with which we can provide cure. Surgery is generally not an option unless the surgeon can completely remove every bit of cancer that is left in the body. when disease has spread to deliver in multiple areas of the liver surgeries generally not possible. i'm sorry your father is dealing with this stressful situation. I am glad he has good supportive family like yourself. Please let me know if you have any additional questions or concerns you would like to review. Dr. Galamaga

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

Follow up: Dr. Robert Galamaga (20 hours later)

Thank you for your response. His doctors have said that they will do surgery because the liver only had a few spots. (the rest of his body unaffected). I am worrisome because I understand it is not curable. However, it is treatable. Given that it is treatable, he can take medicines and improve his life span right? I have been reading that stage 4 rectal cancer patients usually get through about 2 to 5 years with Chemotherapy. However, are they not any cases that fully recover at this stage or even people that live much longer after Chemotherapy. Given my father's scenario, within only two Chemotherapy's his liver shrinked which the doctor had said he did not expect. As a family, we are willing to get him treated anywhere in the world.

Answered by Dr. Robert Galamaga (2 days later)

Brief Answer: Treatment. Detailed Answer: good systemic treatment is available and I am sure the doctors there are giving him excellent chemotherapy. time will tell how sensitive the tumors are to treatment. regarding surgery this is a major type of surgery and they would have to give you some statistics regarding expected outcome before you expose him to an operation. If he is at a regional cancer center he should have access to the best systemic treatment. Dr G

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