Possible Mets To Lungs After Rectal Cancer

Hi everyone,

My name is Ruth and I have had rectal cancer, stage II with three positive nodes. The rectal cancer is clear, but on a routine CT scan, several nodules showed up in my lungs. The doc ordered a PET scan and one of the nodules glowed on the screen. We then waited 4 weeks and did another CT scan, and now some of the nodules have changed in size. They are very small about the size of the ink end of a ball point pen. My doc said they are too small to biopsy. My CEA level has also almost doubled between blood tests.

Now, the doc wants me to have a port put in this next Monday and start chemo (three rounds with a three day infusion pump) this next Tuesday. This is all so sudden, I just finished chemo up this last January for the rectal cancer. Any thoughts or ideas would be appreciated, thanks and take care, Ruth

On 11/22/2007 Ruth Ann wrote:

Hi everyone,

My name is Ruth and I have had rectal cancer, stage II with three positive nodes. The rectal cancer is clear, but on a routine CT scan, several nodules showed up in my lungs. The doc ordered a PET scan and one of the nodules glowed on the screen. We then waited 4 weeks and did another CT scan, and now some of the nodules have changed in size. They are very small about the size of the ink end of a ball point pen. My doc said they are too small to biopsy. My CEA level has also almost doubled between blood tests.

Now, the doc wants me to have a port put in this next Monday and start chemo (three rounds with a three day infusion pump) this next Tuesday. This is all so sudden, I just finished chemo up this last January for the rectal cancer. Any thoughts or ideas would be appreciated, thanks and take care, Ruth

Ruth,

 First off, if you had three positive nodes when they did the surgery, you are not stage II, but rather stage III.  With stage I and stage II, there are no nodes.  As soon as positive nodes enter the picture, there is definately more chance for the cancer to spread.

Unfortunately, it sounds as though something is going on with you.  Since the nodes have changed in size, as you say one "glows" AND your CEA has doubled, all those clues together definately say that there is probably a recurrence of the cancer somewhere in your body.  I know that having chemo again doesn't sound like fun, but particularly if these nodules are tiny right now, then attack them while they are this size and not any bigger. 

If the idea of the pump bothers you for the 5FU, talk to your onc about going on Xeloda which is the oral form of 5FU.  You would still have to have the infusion for the other drugs (presumably oxaliplatin and possibly Avastin) but you would not need the pump.  You MIGHT be able to get away without a port but you would have to discuss that with your onc also.

I am sorry that this news certainly isn't what you wanted to hear but I think the best thing to do is go for the chemo and try your best to get rid of those nasty little nodules as quickly as possible.  Take care and please let us know what you decide.

Jaynee

Hi Ruth:

Your situation is common but being that it's your situation, it's VERY critical to you. I always advise a 2nd opinion because all docs are not equal. My choice is CTCA (Cancer Treatment Centers of America) because they have the most advanced technoogy on any cancer. They treat you as a real person - wih no strings attached. Cancer patients have a great reluctance to travel for some reason and most elect to stay with the doc they started with. This is all too often not a good decision. My wife (and I) traveled and got the best care available - far from home but with miraculous results.

It is true that while the lung nodules are tiny (less than 3 mm), they are not life threatening - but treat them now while they are vulnerable, small, and non-aggressive. Xeloda is a good choice for this (an oral chemo that you take at home). It will also attack any other 'live' cancer cells in your body.

Moving to standard chemo, absolutely get a port installed. It is effcient, unnoticed, and can stay in for years without side effects. It saves your veins and unnecessary needle pricks. At CTCA, the port installation procedure is 45 minutes and can be scheduled within hours of your arrival.

The docs there are caring, available, friendly, and extremely experienced at treating all types of cancer at all stages. At no cost to you, it is an option you must consider. 800-FOR-HELP

Caregiver Dave  

Hi Ruth,

I'm sorry to hear that more seems to be going on with your cancer.  I'd tell you that I would go with getting a port put in vs. not.  I'll warn you (although not everyone I know has experienced this), I was extremely sore for a good two -three weeks following the port being put in & thought I'd never adjust to it being there.  However, it's now been 4 months and I'd say it was after about a month that I no longer even noticed it at all.  At first, I wasn't able to wear my seat belt properly because it went right on top of the port, but that doesn't last forever & it feels totally normal now.  I believe having an IV inserted in me each time I got chemo would have been far worse than having it put into my port.  I don't even know if having an IV with my regimen (Folfox + Avastin) would be possible or not- the nurse said it could harm that vein & that they really need a larger vein, which is what the port is connected into.

Stay strong & pray for strength- your mental and emotional outlook on it all greatly affects how well you do and fare through all the treatments. I'll be praying for you!

Take care,

Lisa

Hello, Yours sounds just like my dads.  He finished all treatments Dec. 06.  He had 13 positive nodes.  Now, since July he had 3 nodes to show up on ct scan.  They were salt and pepper size.  In November, two of them grew very little and one did not.  He goes back 1st of Feb. for another ct.  I don't know what they will recommend.

Cynthia

On 11/22/2007 Ruth Ann wrote:

Hi everyone,

My name is Ruth and I have had rectal cancer, stage II with three positive nodes. The rectal cancer is clear, but on a routine CT scan, several nodules showed up in my lungs. The doc ordered a PET scan and one of the nodules glowed on the screen. We then waited 4 weeks and did another CT scan, and now some of the nodules have changed in size. They are very small about the size of the ink end of a ball point pen. My doc said they are too small to biopsy. My CEA level has also almost doubled between blood tests.

Now, the doc wants me to have a port put in this next Monday and start chemo (three rounds with a three day infusion pump) this next Tuesday. This is all so sudden, I just finished chemo up this last January for the rectal cancer. Any thoughts or ideas would be appreciated, thanks and take care, Ruth

Hi Ruth,

My name is Jeff and I was diagnosed with rectal cancer in Nov 2005 at the age of 36.  When they did a CT scan they saw numerous small nodes (about 50+) in both lungs but were not sure if it was cancer or not.  I had the rectal tumor removed and did 6 months of follow up chemo.  The nodes did not grow when I was undergoing chemo.  2 months after chemo they did another CT scan and saw that the nodes were growing.  They were also too small to do a needle biopsy but could do a lung biopsy to remove a small portion of lung tissue.  My oncologist did not recommend this because it was invasive but I wanted to know what it was so I chose to have it done.  The biopsy revealed it was cancer.  I just finished another 6 months of folfuri regiment with Avastin.  After the first 3 months, half the tumors were gone and the other half were showing signs of shrinkage and hollowing out from the inside.  The past 3 months show no change, but no new growth or new nodes.  They are giving me a 2 month break from chemo but I am still taking avastin every 2 weeks.  The last CT scan shows there are holes in my lung tissue that are left behind after the tumors die.  He says the tissue will not grow back.  I have some congestion in my lungs and do get winded if I do some strenuous activity but I hope that the Avastin will keep the tumors from growing.  The docs are very impressed with the effects of Avastin and since it is so new on the market, there is not alot of data yet from mass use.  My doc gave me 6-9 months to live 6 months ago before the chemo regiment started because if the chemo didn't work, I wouldn't have much time.  I am feeling better now than before chemo and look forward to the next 2 months to build back up my immune system without the chemo breaking it down.  My doc is now much more optimistic about my outlook and mentioned that hopefully they can keep the cancer in check with periodic treatments until some new drugs in the pipeline come out that look very promising.  He said that I may have a terminal disease but can hopefully turn it into a chronic disease that I will have to treat but can still look forward to years instead of months to live.  I know what you are going through and all the anxiety that you are feeling.  It is scary not to know what to expect.  It seems to me though that your docs are doing the right thing and going after what seems to be metastatic cancer. I have a port in my chest and don't even think about it anymore, it is just a part of me now.  Maybe one day it can be taken out, but until then it is serving it's purpose well.  Hang in there and keep us updated and let us know how you are doing.

Sincerely,

Jeff

can someone tell me what the symptoms were for rectal cancer?  What was the first clue you had a problem?  I have been seeing doctors for 5 months with no explanation to my tailbone pain and I was curious if tailbone pain was a symptom.

Thanks,
Carol

On 1/7/2008 cowgirlsmom wrote:

can someone tell me what the symptoms were for rectal cancer?  What was the first clue you had a problem?  I have been seeing doctors for 5 months with no explanation to my tailbone pain and I was curious if tailbone pain was a symptom.

Thanks,
Carol

Hi Carol,

My first symptons was bloody stools.  I thought it was just hemorroids flairing up again because I have had them in my early 20's.  I went to the dr. and he prescribed me some suppositories which didn't help so I just lived with it for about 6 months.  I then started having a difficult time in passing stools and they became narrower and pencil thin.  I went back to dr and he referred me to a surgeon.  The surgeon didn't see anything so he recommended I had a colonoscopy even though I was only 36 yrs old. They found the tumor growing about 4-5 inches above the rectum.  The tumor was growing into the intestinal wall so they took out about 10 inches of intestine.  I didn't have any spinal or tailbone pain, just stool passing problems.  If in doubt have a colonoscopy done.  This is the best way to find rectal tumors.  If they find it early then chances of survival increase substantially.

Hope this helps and God Bless,

Jeff

On 11/22/2007 Ruth Ann wrote:

Hi everyone,

My name is Ruth and I have had rectal cancer, stage II with three positive nodes. The rectal cancer is clear, but on a routine CT scan, several nodules showed up in my lungs. The doc ordered a PET scan and one of the nodules glowed on the screen. We then waited 4 weeks and did another CT scan, and now some of the nodules have changed in size. They are very small about the size of the ink end of a ball point pen. My doc said they are too small to biopsy. My CEA level has also almost doubled between blood tests.

Now, the doc wants me to have a port put in this next Monday and start chemo (three rounds with a three day infusion pump) this next Tuesday. This is all so sudden, I just finished chemo up this last January for the rectal cancer. Any thoughts or ideas would be appreciated, thanks and take care, Ruth

Hi Ruth

I was diagnosed with Rectal Cancer in June this year. Had an operation to remove the cancer in July. I had one lymph node returned as positive and also tiny nodules have shown in my lungs in my CT Scan. The oncologist is still uncertain if they are cancer. In October I started on the oral chemo called Xeloda and it seems from a more recent CT Scan that the nodules have reduced slightly in size which they say could indicate that the nodules are cancer.

It is all so uncertain and difficult to tell what is going on with the lungs. I'm now 1/2 way through the chemo treatment having done 4 cycles with 4 more to go. It is very convenient being able to do it at home although not a walk in the park for there are also side effects. Before my operation my CEA was 13. Since starting the chemo it has come down to 2.5

Will be interested to hear how things are going with your treatment and pray you are doing well. Walking this cancer journey is not easy but I'm putting my trust God for guidance and giving thanks to Him for strength for each new day. I am sustained and so thankful for all my family and friends prayers.

May God bless and encourage you.

Janet

Jeff,

How are you doing right now?  Hope well. Please let me know.

Cynthia