Why does it keep spreading?

Hi I wish I knew the answer to your question . My own mum has had a spread in two other organs . 

The lung surgeon probably explained it best to us . My mum had her primary tumour removed in 2009 ./10 . The dates are getting hazy! Not until 2016 did they confirm a lung met . It certainly was not showing in the first few years . My question was where has it been all these years and was her immune system keeping it in check .

He explained that it was all part of the original spread . At what point it spread remains unknown but obviously before the primary was removed some cells broke off and traveled. She did not have a PET scan before first round of chemo but had reactionary lymph nodes on CT scan . After chemo there was no live cancer cells in her lymph nodes . Not sure if there were any dead ones or if it broke off and traveled in her blood to her liver and lung . Grew in the liver fast but very slow in lung . The micro disease seemed to then grow or be controlled by my mum’s immune system . Who knows. . So I can only imagine that the spread takes time for the micro disease to grow into visible tumours .

On a more positive note , as it felt a bit like whack. a mole to begin with , but it honestly became less and less over time and the amount of spread lessened until it was completely dealt with . She has scanned well for the last four years .  The good scanning meant they got onto it very quickly whilst it was tiny and removed before it could grow to a problem level . 

In the first couple of years of managing a stage 4 diagnosis it was easier on my mind to consider it as lessening the tumour load and slowly working our way through that process . It did happen for her . I also felt more would continue to spring up but that actually did not happen . I think in the end it all revealed itself and was taken care of . I guess it depends on how much broke off in the first place . But with good scanning and quick intervention it can be tackled . 

Bowel cancer very rarely spreads to the brain according to the literature but there are people who have had it successfully treated . The question you raise about it continuing to grow despite being on chemo on the brain . The chemo is given to control systemic spread around the body but there is a thing called blood brain barrier . The body has the brain well protected against any assault so it is a bit more complex getting chemo to cross that protection and radiotherapy or surgery are often used as well . But it is also a situation of hope as the radiation can be very effective and has been well developed in the last few years . That is where the multidisciplinary approach to care comes in . He responds well to systemic chemo on his liver and lungs but needs the additional input of radiotherapy to control the spread to the brain . 

To be honest that is just my understanding from reading and wading around in the stage 4 world with my mum . If you asked your dads consultant I am absolutely sure you would get a better more accurate explanation but piecing together all the chats over the years that my understanding . Limited as it is .In terms of dealing with potential spread . I eventually closed my mind down to that . Only what is evidenced by scans or it just gets too draining for you . You have to protect yourself too . 

It sounds as though your dad has a good team around him and quick intervention . That’s really good . I am thankful my mum had access to people like that too.

So yes it can be effective on the liver and lungs but need other treatments to get past the blood brain barrier .

I wish him every success with his next lot of treatment and hers to killing off the last of his micro disease .

Take care of yourself too ! It’s a lot to process at times .

Court 

Hi Court.  Thank u for ur reply.  I hope you and your Mum are still keeping well and that she is continuing to keep it under control.

I was shocked yesterday when my Dad told me he had his results back and some bits were found on his brain again!  I was even to shocked to know how to respond when he told me so I changed the subject, and I'm aware he doesn't like talking about cancer. 

That makes sense the immune system is so delicate and I guess sometimes works better than others.  Those cells must of been lying dormant in your Mum for a few years!  That must of been a horrible shock after all that time! 

I wonder if inflamation has something to do with it too?  

I do worry that his team at Gloucester might have given up a bit because he is stage 4,  whenever I ring them they don't seem to tell me much they just say things such as " be there for each other" .  But hopefully things will improve again after radiotherphy.

I think as well because its spread again so soon after having it removed from his brain makes me wonder if its an aggressive cancer.  

Thank you  again Court,  so good being able to come on here and ask questions and try to make sense of it.  Hugs to you and your Mum and hope your both doing well xx

Hi ,

There are so many mysteries with cancer . My mum had a very quick recurrence but I think it was probably there all the time in the liver , just decided to grow . However her second liver resection was more extensive and I can only assume they cut all the offending cells out at that point .

You do wonder what suddenly starts them growing but she has had a good few years without treatment and doing fine . Thank you for asking .

My mum never actually spoke too much about it either . Maybe a form of defence . Actually she still treats it like that ! 

Hope this helps your dad get to a more stable situation.

Take care ,

Court 

Thank you xx