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This question was answered on Sun 23, Mar 2008 06:53am by Dr Bobby V, MD

Stage 2 colon cancer with mestasize to the liver - What is the best treatment?


    
Asked by romanok57 (Male ) on Sun 23, Mar 2008 12:19am

My brother in law just had surgery to remove a lemon sized tumor in his colon stage 2 colon cancer. While the surgeon was in there he said he could feel 4 or 5 spots on his liver. Could you please give an answer to what the best treatment would be? Thank You
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Answer by Dr Bobby V, MD  on Sun 23, Mar 2008 06:53am:

Hi, The initial step is to correctly determine the stage of colon cancer. This can impact the treatment decisions. You have mentioned that the initial (pre-operative) stage was 2. His surgeon found some doubtful lesions in the liver during surgery. It is vital that he undergo tests to determine if cancer has spread to his liver. A CT scan can help to ascertain this. In case the liver has metastasis, the current stage will become Stage 4. Your brother-in-law needs to undergo treatment with combination chemotherapy. For stage 2 colon cancer, standard treatment would consist of a combination of 5-FU, Leukovorin, and Oxaliplatin in different schedules. Oncologists refer to these regimens as FOLFOX-4 or FOLFOX-6. Some studies have shown equal results with 5-FU, Leukovorin, and Irinotecan (FOLFIRI). Some oncologists like to use the oral drug Xeloda (Capecitabine) instead of 5-FU and Leukovorin. The combination regimens with Oxaliplatin and Irinotecan are called XELOX and XELIRI respectively. If liver involvement is proved, then additional drugs called monoclonal antibodies may be needed. These include Avastin (Bevacizumab). Other drugs like Vectibix (Panitumomab) and Erbitux (Cetuximab) are awaiting approval for this indication.

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