It is difficult to answer this question without having additional information and being able to examine your husband. There are many causes for the type of inflammation you’ve described, including renal (kidney) failure, liver failure, nutritional deficiencies resulting in low albumin (protein) level, disruption of the lymphatic channels due to cancer, enlargement of regional lymph nodes (such as in the groin) resulting in the disruption of lymphatic or fluid flow, or other causes. The pressure from the actual inflammation on the muscle tissue can result in pain. I recommend that you discuss this further with your husband’s physician. Q2. My father was diagnosed in February of 2005 with stage IIIA colon cancer. He had a T2 tumor and one node showing micrometastasis in it. It was located in his sigmoid. He was not able to get all his chemo treatment due to diarrhea (two months’ worth). He had all of the radiation. What would his chance of survival be, and why does this stage have better survival than stage II? The five-year survival rate for stage IIIA colon cancer is approximately 94.1 percent versus 89 percent for stage II colon cancer. The reason why survival would be better for stage IIIA is not fully known, but there are several possible explanations. One explanation is that while almost all stage IIIA cancer patients receive chemotherapy, only a small fraction of stage II colon cancer patients get it. This chemotherapy may improve survival. Furthermore, some of the stage II patients could be inaccurately staged, and actually have more advanced disease. There is also a theory that there are more cases of aggressive disease at stage II, compared to stage IIIA. Any of these reasons, or a combination of them, may account for the paradoxical lower survival of stage II patients with colon cancer. Q3. I am a 57-year-old black woman. My health had been good until I turned 53. At 54, I was diagnosed with colon cancer. Now I have been diagnosed with breast cancer. Colon cancer was stage I – only one lymph node out of 24. I took chemo treatments for six months. I am waiting on what type of treatment for breast. I had a simple mastectomy done. Did the breast cancer come from my colon, and will I have to worry about it appearing somewhere else in my body? What are the chances of it recurring anywhere in my body? First of all, based on the information that you have provided, the colon cancer was stage III and not stage I – whenever there is involvement of any local lymph nodes the cancer stage increased to stage III. Six months of chemotherapy after surgery (adjuvant chemotherapy) is the standard of care for stage III colon cancer. Without having additional information and, most importantly, without having the pathology report I cannot say whether the breast cancer is a new cancer or if it’s related to the colon cancer. It is very rare, however, for colon cancer to spread to the breast. The risk of the breast cancer coming back also depends on the pathological features (such as size, the number of involved nodes, and other factors) and without that information, risk assessment is very difficult. Q4. My father is 65 and has stage II colon cancer. There are two more sessions left to finish his chemo. He is suffering from pain on his left hand. I have never heard about this side effect. Any information regarding this side effect will be greatly appreciated. I am going to guess that your father is receiving either intravenous 5-FU or oral Xeloda chemotherapy for his stage II colon cancer. Both these agents can be associated with abnormal tingling and burning in the hands and feet. However, why he might be having pain in one hand only is unclear to me. 5-FU is infrequently associated with coronary vasospasm, the tightening of blood flow through blood vessels supplying oxygen and nutrients to the heart. Coronary vasospasm can cause left chest pain, arm pain and possibly hand pain. If he has a port or catheter for infusion therapy, blood clots, air bubbles or other clumps of material (embolus) can lodge in a single extremity and cause pain. Either way, these are all very serious conditions and should be reported immediately to his oncologist or internist. There are also many other less serious causes of hand pain, but either way a thorough examination is in order. Q5. My father has been diagnosed with stage IV colon cancer that has metastasized to his lung. They removed the mass from the sigmoid colon but were unable to remove all of the cancer from the pelvic area. He has decided to have radiation to reduce the 13 cm tumor in the lung so that they can do chemotherapy for the remaining cancer. We were given the impression that these procedures will only add about one year to his life. Is this accurate? If so, why so little time? Stage IV colon cancer — or metastatic cancer – is not a curable disease. It is, however, treatable. With the recent advances in therapy for colon cancer and the use of newer agents such as Avastin (bevacizumab) and Erbitux (cetuximab), the median survival of stage IV colon cancer patients has significantly increased. Whereas these patients previously were expected to live one year on average, their life expectancy has increased to two years and even longer. Having said this, I must add that each case is unique and it is difficult to ascertain exactly how much prolongation of life can be expected for each individual. Despite advances in therapy, cancer cells eventually become resistant to the available therapies. Moreover, depending on the pattern of spread, the overall health of the patient, and the ability to tolerate the chemotherapy, not all patients are able to get all types if treatment. As such, the life expectancy can become limited. Q6. I had stage III colon cancer, and my lymph nodes were clear. What are the chances now (4½ years later) of it returning? One cannot have stage III colon cancer and clear lymph nodes. By definition, stage III colon cancer is a lymph node-positive disease. Regardless of what stage you have, if you are without evidence of disease 4½ years after the surgery, the odds of your cancer returning are very low. Nonetheless, you should have periodic examinations because your risk of developing a second cancer is higher than it is for someone who hadn’t had such a cancer. Q7. I was diagnosed with stage IV colon cancer in August 2005. I had a colon resection, followed by seven months of Xeloda (capecitabine), Avastin (bevacizumab) and oxaliplatin. I had a liver resection removing all of the right lobe and part of the left in May 2006. All cancer was removed from my liver, per my surgeon. I will be following up with another four months of chemo as a preventive measure. My CEA (carcinoembryonic antigen, a blood test for recurrence) is now at 0.5 prior to starting back on chemo. Is it really possible that a stage IV can be cured, or am I just being too optimistic that I may beat this? I am 45 years old with no family history of this disease. Patients who have a limited amount of disease with their stage IV colon cancer, which can be resected surgically, may live longer than patients who have more diffuse disease. In rare cases, a cure may be even achieved. If you have been lucky enough to have disease that was limited and resectable, there is a chance that you may have been cured. It’s important, however, to have close follow-up with your oncologist. Q8. I was diagnosed with stage III colon cancer in March 2006. The tumor did not go through the wall, but I had six out of 13 nodes positive. My surgeon felt very positive I would be okay. I went through 12 treatments of chemo — 5-FU (5-fluorouracil) with oxaliplatin — in case there were any microscopic cells. What I would like to know is whether stage IIIC colon cancer is different than stage IIIC for other cancer – breast cancer, for example. Are survival rates different for every type of cancer? Cancer staging system is based on the size of the tumor, the presence or absence of regional lymph node involvement, and the presence or absence of distant metastatic disease. In general, stage I cancer refers to cancer that is highly localized, meaning that it is confined to one certain area or part of the body. It does not involve lymph nodes or distant sites. Stage II cancer refers to larger tumors that do not involve distant organs, but may or may not involve the local lymph nodes. Stage III tumors always have lymph node involvement, and in stage IV there is evidence for distant metastases. While the characteristics of a stage of tumor may be similar between colon or breast cancer, or other cancers, the prognosis and survival rates are different for each cancer and hence one cannot compare cancers stage by stage. Q9. My wife, 51, has been diagnosed with stage IV colon cancer that has spread to her lungs. The recommended treatment is chemotherapy with 5-FU (5-fluorouracil) and oxaliplatin. This will be followed with Avastin (bevacizumab). Why not operate on the colon tumor and fight the lung tumors after that? When a patient has stage IV cancer, it means that the tumor has spread beyond its original site. In order for tumors to spread, tumor cells have to travel through the body via the blood vessels and lymphatic channels and then grow again in distant organs. In the case of your wife, the tumor has spread to the lung; but this also means that the tumor cells are circulating in her body and can therefore attack other organs. At this point, removing the original tumor will have no impact on reducing the further spread of cancer. Unless there is a specific reason, such as obstruction of the bowels, the colon tumor should not be removed. Chemotherapy will help shrink or completely remove all the tumors in her body. Q10. I had surgery for rectal cancer in 2002, followed by chemotherapy and radiation therapy. Later, the cancer metastasized to my bones. I completed a chemotherapy regimen in December 2004, and the only treatment I have had since is a monthly infusion of Aredia (pamidronate). I am doing quite well. Would you say that I am in stage IV of rectal cancer? Yes. Patients with metastatic disease to the bone are stage IV, but it is unusual for colon cancer to go to the bones exclusively. Treatment with Aredia is reasonable, although it has not proven to be of benefit in colon cancer patients. For this reason, continued close observation is recommended. Learn more in the Everyday Health Colon Cancer Center.
