Expert: Claes-Gustaf Nordquist, M.D. - 8/29/2006

Question
My mother-in law was diagnosed with rectal cancer in the early stages in march this year. She was told that the CT was 100% clear of any liver mets and that surgery to the rectum would therefore be curative although she would require a permanent colostomy. The surgeon advised that radiotherapy and chemo should take place prior to surgery to try to shrink the tumour.  Unfortunately there was a ten week delay in this starting. She went in for surgery last Monday only to be told that the CT scan done the previous Friday showed extensive spotting on both lobes of her liver and that surgery is now no longer an option for her. She has since seen the oncologist who did not advise on life expectancy but remained very positive with various options of chemo.  She has opted to take part in the 'coin trial'.  So to get to my question- Do you think the ten week delay in treatment could have caused the spread to the liver? Also what is your opinion on this trial? What would you guess to be a rough life expectancy for her?  

Answer
No I think her cancer had spread already 10 weeks ag but then only microscopically. I'm too unfamiliar with that particular trial (I have retired after suffering a stroke). Unfortunately it is impossible for me to give you any kind of time table. Obviously it depends at least to some degree on how well the trial works - of which we at the moment know nothing. A cure seems however at the moment far from possible unfortunately.