Expert: Claes-Gustaf Nordquist, M.D. - 11/5/2009

Question
hi my husband was diagnosed stage iv colon cancer in December 2005 histology showed 6 out of 11 lymph nodes cancerous,in January 2006 he had 8 cycles of 5FU/oxalyplatin and one 5FU as oxalyplatin crippling him with neuropathy on hands and feet.  Scan in November 2006 showed spread right lung, removed by cardio thoraxic surgeon scanned again found small spread to left lung 2007. In November 2008 scan showed spread to groin and pelvic area which is inoperable and enlargement of spread to left lung.  Offered irinitecan and 5FU six cycles which was administered with hair loss and not too much side effects, although after these six cycles repeat scan showed no change in pelvic or groin area but no further spread, do you think a further six cycles which have been offered or quality of life without chemo.  My husband wont speak about life expectancy or whats in front of us in terms of his affairs and I cannot speak to anyone about this or ask can you help please.  My husband is 54 years of age and agrees with everything the doctors says and does not ask questions as he is frightened of the answers.  He passed out when he was told his last scan results and I am not coping he will not go to GP or let me contact hospice or cancer organisations.  I cannot speak openly with my questions to his oncologist either.

Answer
Well that therapy can of course be tried but I certainly can not guarantee any results. I do know of cases of stage 4 (IV) colon cancers (like here) that have been kept alive for more than 6 years with regularly repeated sessions of chemotherapy. But the situation does not look that promising here - mainly due to the side effects that interfere with his treatment. On the other hand I can not rule out the possibility that this chemotherapy will work - at least to some extent and for some time. AND both cancers and patients are individuals, not identical copies/clones. So predictions are always uncertain. So in the end this must be his decision. But you must be prepared for the eventuality that it will not work - which is rather probable actually. Even in that situation though the process may take many months even possibly more than a year. That is as far as I can come based on this information.