Colon Cancer/tumor size

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Expert: - 12/4/2007


Question
I was diagnosed with stage IV colon cancer in Oct two years ago. I had the colon tumor removed, and they found ten small lesions on my liver, and 4 lymph nodes hot. I've been under bi-weekly chemo, my lesions have decreased by about eighty percent. But a very small growth in the largest lesion last month. My cea went from `150 two years ago to 15.1. It rose to 31 in Sept. My oncologist measures the largest dimension of the largest tumor. Would it not be more accurate to measure the total AREA of the tumors on my liver? I feel great, and have one more chemo before a new cea and CT scans.I have no side effects, no further spreading. Would an AREA measurement more accurately reflect my disease? What am I missing?

Answer
You may very well have a point there. I think your dr. has just simplified his work - maybe too much, but I'm not sure. He may argue that he gets as much practical information out of that simple measurement. To be precise the whole tumor VOLUME should be measured. For that you would need at least 2 different picture projections of your lesions at right angle to each other to get an estimate of all their dimensions in 3 dimensions. On the other hand your CEA value is roughly proportional to your total tumor volume so he has an independent value there to compare with.

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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience with regards to this cancer.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.

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I'm a medical doctor and a specialist in medical oncology & radiation therapy.

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