Stomach cancer spread.

sturose · Guest

Hi all.

My sister in law has recently been diagnosed with gastric cancer. She had a CT scan recently to see what stage it was at. She has now been told it has spread throughout her stomach and into her intestines, the initial concern for the doctors was if it had spread to her liver but it hasn't.
The details are rather vague as they don't explain properly, just ask if we have any questions. Under the circumstances we usually can't think of the right questions to ask at the time as this has come as a great shock to us, (she is only 41 years old).
The reason I am writing this is because they have decided to start her on chemotherapy next week but have told her that her condition is uncurable, on top of this they have also stated that they are just trying to ensure her survival for the next few months. Could this be the case that she may only have a short time left or is it possible that the hospital is being unneccessarily negative, also are there any other avenues we could explore for treatments which could help her, we are prepared to consider anything at the moment.
I understand that without seeing the results from the tests she has had it would be impossible to make a judgement but I can't help feeling that the hospital is judging the situation rather prematurely as no treatment has started yet.

Your opinion on this would be most appreciated.

leo · Contributor Joined: 23 Sep 2004 Posts: 1575

Hello

I am deeply sorry to hear about your relative. Stomach cancer is unfortunately very difficult to treat, and the rule of thumb is that if you can't operate and remove all the tumor, it is uncurable with chemotherapy. I think the overall prognosis that they mentioned is correct, unfortunately. There are chemotherapy regimens available, but they have limited efficacy. She may also look for clinical trials in case she is interested.

regards,
Leo
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sturose · New User Joined: 02 Nov 2004 Posts: 4

Thank you for your reply Leo.
I have some more information as I have been talking to Jane's doctors and nurses, (Jane being my sis in law).
She has now started on her chemo treatment, the drug combination she is on is ECX, (epirubicin(E), cisplatin(C) & Capecitabine(X)).
I have asked various questions but I can't bring myself to ask anything that may lead to a negative response. The doctors can only tell me that Jane's life is in Gods hands now, only God can decide the outcome. As I am not particularly religious (although if I believed that someone was listening I would be on my knees praying as I write this), I do not find this a great comfort in this difficult time.
Jane will be on the treatment for 18 weeks continuously, every third week she will spend a day in the hospital to receive "E" & "C", then 12 150 mg "X" tablets every day until her next hospital appointment.
After the treatment finishes they have stated that they can only monitor her condition, they do hope to reduce the size of the tumor but still can't offer anything further regardless of the outcome.
I have researched as much as I can about the drugs she is on but the information available is either limited or written so that only a professional such as yourself can understand.
Is there the slightest chance that we could eventually opt for surgery to remove this from her or are we beyond that point altogether, I have promised my family that I will find any solution available for Jane if possible.
I will keep you informed of any more information I receive and I would like to thank you once again for taking the time to respond to my query.

regards

Stuart.

leo · Contributor Joined: 23 Sep 2004 Posts: 1575

Hello

Unfortunately even if she has a good response to treatment, trying to resect the tumor will not help, as it is almost impossible to get all the tumor. In the end, surgery may be worse for her, that's why chemotherapy is only palliative in her case.

regards,
Leo
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Disclaimer: this information is for informational purposes only. It is not medical advice.

Mentor1st · Guest

To Sturose,
I just came across this site and felt the need to respond.

I was diagnosed with esophageal cancer in early August of this year. I was told that the treatment was chemo/radiation and then removal of the esophagus. I sought a second opinion.

A different oncologist connected with Rush Medical Center in Chicago looked at the tests I had done. He referred me to the chief of surgery at Rush North Shore who operated on me to place a feeding tube in my small intestine, a port in my upper left chest for administering chemo, and I gave permission for him to perform a laproscopic exam of my abdomen. He came back with the diagnosis that it was not what my first exam said. The stomach was fully involved in cancer and it was starting to go past the GE junction.

I underwent surgery on Sept. 2nd. The surgeon took the whole stomach, the spleen and 60% of the pancreas. He was unable to get a "clear margin" in the esophagus. The surgery took almost 4 hours and the surgeon later said it was for him -- and me -- the equivalent of a heart transplant. He connected the small intestine to the esophagus. I spent five weeks on my back, three in surgical ICU and the next two in telemetry. I was discharged on Oct. 5th.

I am now a diabetic relying on two injections per day. I have to eat 6 meals or snacks per day and be careful not to eat too much or too fast at any time.

The week before last I underwent my first week of chemo. It consists of Fluorouacil a/k/a 5FU, Leucovorin (a type of vitamin) and Heparin. The chemo was 5 treatments. On the Monday after Thanksgiving I will begin a radiation series which will be once a day, five days a week for five or six weeks. The first and last weeks will be a chemo treatment 24/5 using a pump. We will see what happens then.

The last 8 days I have had some pretty severe mouth sores from the chemo as well as a rash. Nothing I can't withstand. The symptoms are easing at this point. My oncologist will not give me a percentage chance of survival, possibly because I could sue him if he's wrong. One study I read gives it at 3% if chemo only is used, and 23 to 30% if chemo is combined with radiation. If I fall in that range then for me it is 100%!

I don't know if your friend's circumstances are close enough to mine to be comparable. I offer my circumstances only as a guide. Make up your own mind. Who knows for sure, I could be dead in six months, or I could live another 20 years (I am 62 now). I intend to fight with all my resources, however, including any forms of "alternative" medicine I find appropriate. There are a lot of alternative treatments out there, some of which have been well researched. I would suggest you investigate them if and when the doctors have given up.

I am not a physician and am not trying to give any more than some information you could use as "talking points" with your doctors. I don't want to imply you go against the advice of your doctors, but if they are out of treatment options it is time to look at alternatives.

Hope this helps, and best of luck.

Bob

sturose · New User Joined: 02 Nov 2004 Posts: 4

Your replies are very much appreciated Leo & Bob.

I don't know if the circumstances are the same or similar to your own Bob but thanks for the thoughts and I will be looking into any area of medicine that may help, (in addition to the treatment she is currently receiving not instead of).
I sincerely wish you all the best in your battle, you sound very determined.
One more point I would like to mention and if possible get some advice about is the problem started with an ulcer, at the moment Jane is having extreme difficulty eating. Not because she has lost her appetite but she can't manage to swallow food.Is this the ulcer or the cancer causing the problem or maybe both?
She is hungry most of the time but after eating a small quantity she feels full. This has led to a severe loss of weight.
She does have a problem with feeling sick but we have been told that this is a normal side effect from cesplatin so we did expect this.
My question is this:
She obviously needs to eat and drink to build up her strength, also because some of the medication requires food or a quantity of fluid. We have tried various foods which should be easy to swallow as well as a variety of prescribed high calorie drinks but she can't even manage these. Is there anything that could be done to help her eat and drink? Her doctors are not offering anything but is that because nothing can be done at present or are they just waiting to see if the chemotherapy will eventually help in this matter?

Regards

Stuart

Mentor1st · Guest

Hello again,

I am not a doctor, as I said in my previous posting. About 10 days prior to the surgery my surgeon (who actually looked at the stomach laproscopically) inserted a feeding tube into my left side. It is called a J-tube because it entends into the jejunum (sp) of the small intestine. It has a valve on the external end and I was fed through that because I could not eat or drink anything. I was losing 1 to 1 1/2 pounds per day before he did this. I don't know what Jane's doctors feel her condition is -- maybe they can't feed her that way.

I can't address the issue of the ulcer.

It seems that the doctors have to answer your questions in some detail, and they aren't. You (and Jane) have a right to know what the reality of the situation is. That includes how she is going to live long enough to have the chemo work.

My intention in addressing you is that I feel it important not to "give in" or give up. I also feel you have to use a multi-level approach to beat this. Positive attitude plays a part. I wanted to share my experience because you have to know there are others fighting their own cancer (misery loves company). Also, I don't know what Jane's faith is, but it is very important to pray and solicit prayers from friends and relatives. Finally, look at alternative treatments so, if the doctors give up, you have something else to try.

Bob

leo · Contributor Joined: 23 Sep 2004 Posts: 1575

Hello

What is currently accepted is that peptic ulcers, the common ulcers we get in the stomach do not become malignant, what happenrs is that they start as cancers and look like ulcers.

In terms of nutrition, if necessary feeding tubes can be placed that bypass the tumor, so nutrition can be given directly into the small intestines. But that is not always an option. Her early satiety is problably caused by more than one reason: the tumor mass, chemotherapy are all playing a role.

regards,
Leo
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Disclaimer: this information is for informational purposes only. It is not medical advice.

sturose · New User Joined: 02 Nov 2004 Posts: 4

Thank you for your replies, your comments are very helpful.

I think that, based on the information you have given me, we now have to wait and see how the chemo works. I am not a great believer in miracles but I certainly hope I am proved wrong. I will never give up hope, who knows what will be discovered in the next few years.

I shall come back here to keep you posted about Jane's progress, I only hope I can give some good news and a story to give other people hope in this situation.

regards

stuart

leo · Contributor Joined: 23 Sep 2004 Posts: 1575

Stuart,

A good attitude towards this terrible disease certainly helps. We will be available here.

regards.
Leo
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Leonardo F - Webmaster Cancer Forums
Disclaimer: this information is for informational purposes only. It is not medical advice.

sturose · New User Joined: 02 Nov 2004 Posts: 4

Hi all.

Thought it was about time I came back to give you an update on how Jane is progressing.
After a couple of hiccups which resulted in delayed treatments she is now halfway through her course of chemotherapy.
Last week she went for a CT scan to see how she had responded to the treatment so far, we were given the results today. Janes consultant is extremely surprised by the way she has improved, the cancer that had spread from her stomach has now gone and the original tumor has shrunk in size more than the doctors thought it would.
We have put this down to not just the combination of drugs she is on but her determination to beat this disease.
She has improved within herself dramatically, she can now eat almost normally and has regained most of the weight she had lost.
The doctors still remind us that this will not go away but the improvements in Janes health have given us all fresh hope.
So to anyone who has the misfortune to encounter this terrible disease I hope this story can give just a little hope for the future. No matter how bad things seem at the moment, never give up fighting.

Regards

Stuart

sertimins · New User Joined: 16 Jun 2005 Posts: 1

Hi Stuart,
I have a question about your previous messages. My mother has the same cancer. It's been about a month since her surgery but she can not hold any food or fluid down. I'm concerned that the surgery was not done right so she cannot digest any food. My question is, How long was it before she started eating normally.
Thank you very much and appreciate your time.
Tim

asmodeanz · New User Joined: 10 Jan 2006 Posts: 1

[quote="sertimins"]Hi Stuart,
I have a question about your previous messages. My mother has the same cancer. It's been about a month since her surgery but she can not hold any food or fluid down. I'm concerned that the surgery was not done right so she cannot digest any food. My question is, How long was it before she started eating normally.
Thank you very much and appreciate your time.
Tim[/quote]

My father is in the same situation. The doctor seemed old, so I don't know if he just plain messed up or not. Are there any alternatives that I can provide for my father? A recent CT scan showed that cancer has grown back in the cavity area but not the liver. I've been looking up shark cartilage and glyconutrients. He's not getting enough nutrients to get his health into a state where he can undergo chemo or radiation. I'm wondering if some biological theraphy will be more endurable? Or if there are any clinical trials going on for post-surgery cancer patients.

Any information would be greatful.

Steven

EvieBaby · New User Joined: 07 May 2006 Posts: 1

i am 26 now, still undergoing chemo for stomach and esophageal cancer when i was diagnosed at the age of 24. i have a really long story to tell, so if anyone would like to hear it, please post a reply.
_________________
I have gastric/esophageal cancer at age 24

uncle jojo · New User Joined: 15 Jul 2006 Posts: 1 Location: Canada

Please do tell your story.

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