Expert: Claes-Gustaf Nordquist, M.D. - 4/11/2004

Question
My father,a healthy 68 year old, has stage IV colorectal cancer.  It has metastasized to his liver and 13 lymph nodes tested positive.  We were told it is in his blood. He has an ileostomy and they did remove a large portion of his rectum.

We realize he probably won't beat this.  We are wondering if he should go through with the scheduled radiation and chemo or if he should live out his time as healthy as possible.  He has his chemo pump installed and is scheduled to start chemo and radiation tomorrow (April 12, 2004).  He will get avastin and 5FU.  I know these are the best and latest, but will he be so sick to the end from the treatments?

If he decides to discontinue the treatments (He has not at this point) how will the end of his life be?  Does his liver eventually quit?  Generally how will this play out? What are the pros and cons and quality of life issues we are facing?  I realize this is a personal choice, but what are the factors we should consider?

We are all very scared and hoping for the best but needing to understand the situation and prepare for the worst.

Thank you so much for your time and this site,
Nicole

Answer
I'm sorry to read about your father! Unfortunately I can not give you any happy tidings. A cancer of this sort is not curable and will eventually kill him. What the planned therapy can do is to reduce his symptoms to some degree and prolong his survival time to some extent. This at a cost of some sometimes severe side effects. Whatever you do the end will probably be rather messy with a number of clinical problems - which will dominate is impossible to say, it is to a large extent governed by chance. I am rather brutally frank in this reply as I sense that you just want to hear the true facts. For any inconvenience that may cause I apologize.
However, if it was my father I would probably suggest to him to try to take the treatment. But in the end it is your father's decision! Nobody else's! I'm sorry I have nothing better to tell you!