My sister-in-law who is in her early 40 was diagnosed a few days ago with colon cancer which has spread to her lower extremities. She was at Johns Hopkins Hospital since last Saturday and was discharged on Monday of this week with a team of doctors informing her that there was nothing else they could do for her except offer chemotherapy, which she has refused. Her father died of cancer a few years ago due to asbestos. She and my brother have 3 children. They are devastated. Do you have any recommendations? We tried to reach a naturopath physician in Baltimore City but he is booked for 6 months. Noel is his first name. Please respond as soon as possible. My name is Lesley Thompson. I was referred to you by my co-worker, CiVonnia Harris, who is a vegetarian and nutrition major at Morgan State University.
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Welcome to EmpowHER. We appreciate your friend's referral. I am truly saddened to hear of your sister-in-law's diagnosis.
With stage 4 colon cancer, the cancer cells have spread from the colon to distant organs and tissues. Colon cancer most often spreads to the liver, but it can also spread to other places such as the lungs, peritoneum (the lining of the abdominal cavity), or to distant lymph nodes.
Lesley, did the physicians at Johns Hopkin Hospital recommend surgery?
In most cases surgery is unlikely to cure these cancers. However, if there are only a few small areas of cancer spread (metastases) in the liver or lungs and they can be removed along with the colon cancer, surgery may help you live longer and may even cure you. This would mean having a partial colectomy to remove the section of the colon containing the cancer along with nearby lymph nodes, plus surgery to remove the areas of cancer spread. Chemo is typically given as well, before and/or after surgery. In some cases, hepatic artery infusion may be used if the cancer has spread to the liver.
If the metastases cannot be removed because they are too large or there are too many of them, chemo may be given before any surgery (neoadjuvant chemo). Then, if the tumors shrink, surgery to remove them may be tried. Chemo would then be given again after surgery. For tumors in the liver, another option may be to destroy them with ablation or embolization.
If the cancer has spread too much to try to cure it with surgery, chemo is the main treatment.
Surgery might still be needed if the cancer is blocking the colon (or is likely to do so).
Sometimes, such surgery can be avoided by inserting a stent (a hollow metal or plastic tube) into the colon during a colonoscopy to keep it open. Otherwise, operations such as a colectomy or diverting colostomy (cutting the colon above the level of the cancer and attaching the end to an opening in the skin on the abdomen to allow waste out) may be used.
Most patients with stage IV cancer will get chemo and/or targeted therapies to control the cancer.
Lesley, why is she refusing chemotherapy?April 29, 2016 - 9:56am