Expert: Claes-Gustaf Nordquist, M.D. - 4/14/2007

Question
A dear friend, woman 51, has been diagnosed with signet cell carcinoma of the colon or intestines. She's had surgery on the 2nd of april (thought to be for ovarian cancer). One ovary was removed and a part of the omentum. Removal of colon was impossible, because the cancer was everywhere, right up to the stomach. The stomach itself and the liver were not metastasized. The colon is blocked, so her nutricion is intravenous. During surgery the bowel filled itself with fluids, so she is suffering from ascites. The prospects are very bleak, but she started yesterday with chemotherapy (5FU, Leucovorin, Oxiplatin). The doctor wanted to do this because my friend "looks otherwise too well". Personally I have great doubts about this treatment. Her husband is frantically seeking out information and I try to help wherever I can. We are both aware of the situation, but of course he clings to any hope that can be offered. My questions are:
Can the chemo really help her (if only to be rid of the pain)?
Do we have to think in weeks or months or is a longer survival possible? At the moment she just doesn't want to know, but I am trying to get her to speak about it and to talk to her husband and children (16 and 22 years old). I know time is short and I won't tell her. It is more for her husband and children, so they know when they really need to talk to her about their and her feelings.
I really appreciate if you will answer me. I am from the Netherlands. English is not my native language. so I do apalogise for any mistakes in my use of it.

Answer
Unfortunately I have to be very pessimistic in this case. This is clearly a very aggressive cancer and at the moment there are no possibilities of curing her!  Unfortunately the only thing her chemo therapy can do is to prolong her survival time to some extent and hopefully to relieve her symptoms to some extent and for some time. To estimate survival times is very difficult, but at best I think you can only expect months but it may be much shorter. I'm sorry I have nothing better to tell you!