primary or metastatic?/treatment options

gertie · New User Joined: 28 Nov 2004 Posts: 1

My father, 75 yo w 60 pack year smoker, quit 3 years ago, COPD, recently had a colonoscopy. 18 benign polyps were removed but it was determined one was to big to be removed without surgery. The gastroenterologist was not concerned and the surgery was scheduled for approximately one month later. Prior to surgery he had a chest CT scan that revealed a 2 cm nodule in his lower lobe of his left lung. This nodule was not present 10 months earlier in a lung cancer screening CT scan. A PET scan revealed a positive high metabolic rate in that nodule, revealed another pea sized "glowing" nodule in his middle lobe of his left lung and "glowed" in the colon polyp. According to his second hand account to me there were no lymph nodes. His physician did not speculate whether the lung lesions were primary or metastatic from the colon. He has an appointment with a thorasic surgeon next week. He has a friend, a retired nephrologist, who recommended he avoid surgery at all costs, predicting a less than 3 month prognosis following any surgery, and opt for very conservative treatment. Do you have any thoughts as to: 1) how often colon carcinoma metasticizes to the lungs, 2) which should be treated first, 3) overall prognosis and 4) surgery/treatment recommendations.

Thank you.
V/R

leo · Site Admin Joined: 23 Sep 2004 Posts: 1574

Hello

Thanks for posting. You certainly have a lot of questions.

There is no established diagnosis yet, so you can not say for sure that it is cancer. For that it is necessary that he gets a biopsy. For the lung, he might get an open biopsy (wedge biopsy), which may determine then what type of lesion it is. Pathologists often are able to establish if a tumor is primary from the lung, but not always. The other option is to biopsy the colon polyp, and that may determine if that lesion is malignant or not. This is a very complex situation, and you should talk to a good pulmonary doc, a thoracic surgeon and a GI doc about all this. But try not to jump to early conclusions, the best thing is to gather all the information first.

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

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