Progress vs. Stage IV GEJ Cancer

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Progress vs. Stage IV GEJ Cancer

by DragonBoater on Sat Feb 09, 2019 02:11 PM

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I just got my first CT Scan to check on progress, 9 weeks into chemo, in my 5th cycle.

Some comments from my oncologist:

"The cancer has responded to the treatment.

Your response is very good

....normalized lymph nodes suggest cancer regression at least at the near term

1. Interval significantly improved thickening of the proximal gastric wall with mild residual wall thickening consistent with improving disease.
2. Several small scattered subtle hypoattenuating lesions within the liver corresponding with previously visualized hepatic metastases on prior PET/CT, better evaluated with PET/CT.
3. Previously visualized enlarged gastrohepatic lymph nodes are now normal in size.
4. No evidence of metastatic disease within the chest."

When I started chemo, I was a mess.  My stomach wouldn't hold food and was dumping it into my intestines, where excessive amounts of bacteria were producing large amounts of gas, keeping me awake and night, causing constant nausea and frequent vomiting if I tried to eat much.  I was losing weight at an alarming rate and figured I'd probably die of starvation before the cancer got me (in an estimated 6 to 24 months).

I started feeling much better during my third chemo cycle, and was able to eat full meals. Most of that was probably due to the chemo beating back the disease, but I supplemented it with a few alternative therapies that I believe also helped.

Now I'm hopeful that the disease can be contained indefinitely.  I'll get a PET scan sometime in the near future which will give a much more accurate picture of what's been happening in my stomach and liver.

It appears the GEJ has been beaten back significantly, the local lymph nodes aren't stressed anymore, and there isn't any sign of the disease spreading in my liver or to other organs.

Full CT Report below:

** HISTORY **:
52 year old man, metastatic gastroesophageal cancer, evaluate for disease depression.
CT images of the chest, abdomen and pelvis were acquired with 150 mL Omnipaque 300 intravenous contrast.
CTDI: 11.5 mGy
DLP: 754.05 mGy-cm
COMPARISON: PET/CT on 11/19/18, Chest CT on 11/14/18 an abdominal CT on 11/7/18
HEART AND GREAT VESSELS: Heart size normal.
LYMPH NODES: No suspicious lymph nodes.
OTHER MEDIASTINUM: Right-sided chest port with the tip in the superior vena cava.
LUNGS: Normal.
SOFT TISSUES: No significant abnormality.
BONES: No suspicious lytic or sclerotic lesion.
LIVER: Several small scattered subtle hypoattenuating lesions within the liver likely corresponding with hepatic metastases, better evaluated on prior PET/CT.
GALLBLADDER/BILIARY TREE: No calcified gallstone within the decompressed gallbladder. No biliary dilation.
SPLEEN: Normal.
KIDNEYS: Cyst within the superior pole of the right kidney. No hydronephrosis.
GI TRACT: Interval significantly improved thickening of the proximal portion of the gastric wall along the lesser curvature with mild residual wall thickening and mild adjacent inflammation. No dilated loops of large or small bowel.
MESENTERY/LYMPH NODES:  Previously visualized enlarged gastrohepatic lymph nodes now appear normal in size. No enlarged lymph nodes visualized.
PERITONEUM: No free air or fluid.
AORTA/VESSELS: Normal abdominal aortic diameter (<3cm).
BLADDER: No significant abnormality.
PELVIC STRUCTURES: Enlarged prostate.
ABDOMINAL WALL/SOFT TISSUES: Small bilateral fat-containing inguinal hernias.
BONES: No new suspicious lytic or sclerotic lesion.

RE: Progress vs. Stage IV GEJ Cancer

by Time2live on Wed Feb 13, 2019 01:10 AM

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Congratulations on the report! Responding to chemo is a great sign. It doesn't always go so well. Thinking it can be contained is a great attitude. Keep fighting. I was in a similar condition. Tumor near GI junction. Mets to brain instead of to the liver. We attacked it head on. Folfox 9 cycles, herceptin continues to this day 4 years later. Some doctors thought surgery for stage 4 would not help. But we removed the tumors in the brain upfront then after the chemo cycles had surgery to remove stomach and with it the primary tumor. I was in good health other than the cancer. I too responded well to chemo, tumor shrinkage no new mets. To this day I believe cutting it out was necessary. Talk to several doctors at different hospitals get a view of your options. I wish you continued improvement and treat this as aggressively as you can. Miracles happen give them the best chance of coming through. Chin up, fingers crossed. Pray for more time. Best wishes for a full recovery.

RE: Progress vs. Stage IV GEJ Cancer

by DragonBoater on Wed Feb 13, 2019 01:17 AM

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Thanks, Time2live.

I've been reading up on Cancer Stem Cells (CSCs):

My take is that chemo is good for beating down tumors but not good at killing off the CSCs, which are responsible for metastacis and regrowth of tumors.

It's a newer area of research and so far the best ways to attack them are with certain fruits and vegetables and supplements.

I'm hoping the Artemisinin I've been taking has been working on them, and I'll step up my fruit and vegetable intake.

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