Cancer Treatment Options Forum - May 23rd, 2010 - 8 Comments

My husband was just diagnosed with metastatic liver cancer, will chemo help?

He begins 12 weeks of TAXOTERE on Monday, and has been warned he will be very sick. I’m worried that the treatment will do him more harm than good, and destroy completely any quality of life he has at present. The primary cancer was base of tongue, and the cancer is also now in his lungs as well as liver. Would they give chemo if they thought it was hopeless? Or do they just give it anyway regardless.

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There are 8 comments for this post.

  1. quijibored on May 23, 2010 7:42 pm

    I think you and your husband need to have a discussion between yourselves as to whether you really want to do the chemotherapy and what you would like to do in the time he has remaining. If that choice is to fight the cancer to the end, then you need to make an appt. with the oncologist for a very frank risk vs benefit discussion. What benefits will this treatment bring vs the physical problems caused by the treatments.
    Just because your husband was offered a treatment option does not necessarily mean he should take it or that the treatment would be beneficial. Some aggressive treatments can actually shorten survival because the lowered WBC hastens the chances of developing opportunistic infections which can kill you before the cancer would have. I would consider getting a second opinion from a different oncologist before starting any very aggressive treatment program that you know can not be curative.

    Here is a set of questions written by a Canadian oncologist and oncology professor that were designed to be asked by the patient when they need to decide whether ot not to pursure treatment. I hope this is helpful to you both.

    "Patients with cancer have to make very significant decisions about which, if any, treatment to take. The aims of treatment are often rather "woolly", and "success" is measured in things like reduced tumour markers or decreased size of abnormalities on CT scans.

    These things MAY be associated with improved outcome, but not necessarily so. The fact is that although technically treatments are complex and require skilled supervision, the decision to embark on a treatment should be, if not simple, at least amenable to being assessed logically and objectively.

    This is the way I get my patients to look at the cost-benefit analysis when deciding on a course of treatment I have suggested would be right for them. The "algorithm" isn’t specific to cancer, or even orthodox medicine, but most patients find it useful, and I hope some people on this NG may, too.

    Question 1
    Does the cancer I have pose a threat to my life or health?

    If the answer to this is "No", then you probably shouldn’t be taking treatment.
    If "Yes", consider treatment by going to the next question.

    Question 2
    Does the suggested treatment have any realistic chance of curing me, and if so, are the side-effects and risks acceptable to me?

    If the answer to either part of this is "No", then you probably shouldn’t be taking treatment.
    Otherwise go to the next question.

    Question 3
    Although the treatment stands no real chance of curing me, does it stand a realistic chance of extending my survival by some worthwhile amount, and are the side-effects/risks acceptable?

    If the answer to either part of this is "No", then you probably shouldn’t be taking treatment.
    Otherwise go to the next question.

    Question 4
    Although the treatment stands no real chance of curing me, or of extending my survival, does it stand a realistic chance of improving my quality of life, after I have taken into account the side-effect/risks?

    If "Yes", go for it.
    If the answer is "No", then you probably shouldn’t take the treatment.

    A patient’s quality of life is not measured by PSA levels (prostate) or CEA (colon) or CA27-29 (breast), but by how they feel and how well they are able to carry on with their life. Improvement in a patient’s quality of life is not measured by whether the oesophageal cancer looks smaller on the CT scan, but whether the patient can swallow better. A patient with bone pain is not better because the bone scan is better, but because the pain is better.

    Think about it. (end quoted questions)

    All the best to you both in making a very difficult decision.

  2. gary h on May 23, 2010 7:42 pm

    His gift is having time to get his affairs in order, make plans for you and say good-bye.

  3. David B on May 23, 2010 7:42 pm

    these questions need to be asked of the oncologist before the therapy begins, and your husband needs to want to ask them. One tends to just go along for the ride with these people…they generaly know their biz, and if they think that chemo will give him a year or two after the pain, they’ll tell you that.

  4. huggz on May 23, 2010 7:42 pm

    Chemo can be a double edged sword! It can help get the cancer under control, decrease tumour size and number of metastases BUT its pretty unpleasant while actually on the course of drugs. Your husbands doctor must think he will benefit from the treatment so support your husband as best you can during the weeks of treatment.
    Good luck with it, my prayers will be with you both.

  5. Alexis on May 23, 2010 7:42 pm

    It very hard to say but chances is there.Hope he will be one of the luckiest guy.

  6. Royal Falcon on May 23, 2010 7:42 pm

    Unfortunately your husband is suffering from stage IV-C , cancer of base of tongue . Regarding to the staging , his cancer is inoperable! and chemotherapy here ; is a palliative measure only , I’m sad to say : there is no cure in the present situation! . God bless all the cancer sufferers . Best regards and bye .

  7. Panda on May 23, 2010 7:42 pm

    If he is being offered treatment that is a positive sign. He will need your complete support however with no negative comments. He has a stage IV disease and it is treatable. There are many advances in eliminating tumors from the liver and lungs, but he needs to have his primary cancer under control. One way to try and get control of the disease is with chemotherapy. Chemo is a systemic treatment that will follow the same pathways that the metastatic cancer has followed. The idea is to kill off the small and microscopic disease before it begins to grow more tumors. Chemo may also affect the large visible tumors by shrinking or killing them. If the tumors shrink than he will become a candidate for surgery and/radiation and possibly chemoperfusion, gamma surgery, or radiofrequency ablation. Much will depend on how he responds to chemotherapy before you will know what to do next.

    You do not say what type of primary tumor he was diagnosed with but you can search through the National Comprehensive Cancer Network which provides detailed clinical treatment guidelines for nearly all types of cancer. These are the guideline protocols followed by many oncologists:

    http://www.nccn.org/

    NCCN: Clinical Guidelines: Head and Neck Cancers
    http://www.nccn.org/professionals/physician_gls/PDF/head-and-neck.pdf

    You should seek out a support group for his type of cancer as they will be able to share information with you. You can search the ACOR list if this one is not the right list for you:

    ACOR: The HEAD & NECK Cancers Online Support Group
    http://listserv.acor.org/archives/head-neck-onc.html

  8. jo Ann Roth on July 17, 2010 5:57 am

    Your site has helped. My husband has stage 4 metastatic colon cancer spread to the liver. He is undergoing Chemo. His quality of life is very bad and he is starting to fall. I can’t leave him alone. He is on cumudin for blood clots.
    I can’t seem to cry. I feel alone and numb. Why aren’t i SCREAMING?
    We will celebrate 54 years in August.

    I don’t know how to get him to ask these questons, The doctor said it would take a mericle and that he would eventually die of this disease. His quality of life is nothing. He sleeps 12 plus hours at night and sits in his chair and sleeps most of the day. Any suggestions. I just can’t figure out why I don’t cry. The doctor gave me a scrip for lexipor is that why, If so I am going to stop taking it.
    Thanks Jo Ann

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