Stage 4 bowel cancer with partial bowel obstruction - treatment options?

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Hello. My dad was diagnosed with stage 2 bowel cancer last year and had surgery in May 2023 to remove the tumor. The surgery was a success, however he was only able to complete 2 out of 4 rounds of chemo due to his atrial fibrillation getting worse at the time. He's been experiencing worrying symptoms (including a growing, painful lump on his stomach) over the last 6 months and has had numerous visits to the GP, hospital and oncologist and multiple scans and tests all promising there were no concerns. Recent tests in the last month have revealed the cancer has returned to numerous parts of his small intestine, and spread to his stomach and abdominal wall. He also has a partial blockage in his small intestine, and so his oncologist has stated that all chemotherapy, radiotherapy, immunotherapy and targeted therapy is not possible. I just wanted ask whether there were any alternative treatment options available and worth considering, as unfortunately surgery to remove or bypass the blockage is too risky for us to consider. Also are you able to advise why all types of medical therapy seem to be off the table please? 

  • Hi Sabs.

    Thanks for getting in touch and welcome to our online community. My name is Sherrye and I’m one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

    I’m sorry to learn that your dad’s bowel cancer has returned to his small intestines, stomach, and abdominal wall, this understandably must be a shock and a stressful time for you all.

    At Macmillan Cancer Support we are separate from the NHS so have no access to any of their systems or anyone’s medical records and without this whole picture we are not best placed to say why all types of medical therapy are not possible in your dad’s individual case.

    When deciding on treatments for an individual the medical team look at several factors such as the type of cancer, the position of the cancer, the stage and grade, the persons age and general health, previous treatments, and personal preferences.

    When bowel cancer has spread to other parts of the body there are still some treatments that can be offered, or the team can look at possible clinical trials.

    I would encourage another talk with dad’s consultant or clinical nurse specialist (CNS) to explain why these treatments are not possible with more context to dad's individual situation. You mentioned that dad had to stop his previous chemotherapy treatment due to his atrial fibrillation getting worse, this is a factor they would have thought about this time too along with the partial bowel obstruction. If dad has not already, he can ask to be referred to a dietitian to help support him with his diet to try and prevent the bowel obstruction getting worse.

    If dad is not happy with his consultants decision he can ask for a second opinion from a different consultant or at an alternative hospital.

    I hope this information helps. Please feel free to get back in touch if you want more information or support.

    Best wishes,

    Sherrye H,

    Cancer Information Nurse Specialist 

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm), send us an email or contact us through webchat.

    Ref SH/HC