Colon Cancer - Quick Question

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iRyan

Pre-takeoff checklist
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Ryan
Hi all,

I was hoping to get some info/advice from you all on this topic. As you might remember, my sis in law got diagnosed with Stage 4 colon cancer that spread to her liver on Jan. 1. The treatments were working until the last scan; the lesions grew. She was taken off the original chemo b/c of the neuropathy in August. Tomorrow she begins a different, stronger cocktail, so we have our fingers crossed.

Problem is she is an alcoholic and continues to drink. Her doctors to our knowledge do not know she is an alcoholic and my wife has pleaded with her to stop drinking. Common sense sense says drinking while chemo is a no-go, but I am not a dr. Could alcohol negate the chemo and cause the lesions to grow? Would you confront her again? My wife and mom in law are devistated and feel they are watching her kill herself.

Thanks all.
 
I've survived cancer, but not colon cancer. The survival rate of stage 4 colon cancer is already low, I wouldn't be drinking. Most doctors will say a glass of wine or two won't hurt and can even help with nausea, but heavy drinking isn't recommended. With the fact that it spread to her liver, well, you know the answer... she shouldn't be drinking.

Personally I wouldn't confront her. It doesn't mean you shouldn't, but I figure she's an adult and knows what she's doing. Sometimes the patient accepts the ultimate outcome before the family does. It's hard to fight and it wears you out mentally and physically. The odds of surviving stage 4 colon cancer for 5 years is only 7%. I would make sure you're ready to support you wife and MIL through some rough times. Sorry you're going through this horrible situation with the monster that is cancer.
 
Sorry for your situation. If she is an alcoholic she started killing herself a long time ago. Given survival rates, bad patient behavior and family dynamics quality of life wise for everyone is probably best just to let the party go on. Support your wife, she is your family. Her sister and mom are not(directly) your problem. You will hear about them of course, don't engage with them. Sounds cold but that is the way it is, support your wife, leave the rest to fall where it may.
 
The addict cannot/will-not control their behavior. It does not matter if the addiction is booze, drugs, nicotine, sex, or food. The pleasure center will over ride any intellectual activity.
I have had addicts lay right there in the hospital knowing they will die if they do not stop, beg me to discharge them so they can have one last binge of whatever.
I had an attorney who lost everything to booze. He looked me in the eye and said I'm a drunk. I want to be a drunk. I do not want to die sober. And he didn't. Dead at 42.

Now, on your SIL, her siblings should confront her (not you). If she blows them off then everyone can have a clear conscience that they did their best and simply hold her hand at the end.
 
As pointed out, Stage IV is a dismal prognosis. Frankly, having a friend who went through Stage IV colon cancer and the chemo and all entailed with it, I'd not get worked up over them drinking, smoking, or eating anything they can manage to stomach during the process.
 
Thanks everyone. The replies are sobering as we all expected some miracle. I will take the advice given. Thanks again.
 
If the cancer has already spread it is metastatic, and the likelihood for a survivable prognosis is low. Says me let her drink. Let her spend the last of her life doing what she wants, especially since the chemo will be harsh. Might tell her docs about eh alcohol though, so they can take it into account.
 
Very sorry to hear about this. My wife is a colon cancer survivor but she was fortunate enough to have gotten the diagnosis early. My best wishes to you and your sister. Note to others: heavy/longterm use of alcohol increases risk of alimentary forms of cancer.
 
flyingron said:
As pointed out, Stage IV is a dismal prognosis. Frankly, having a friend who went through Stage IV colon cancer and the chemo and all entailed with it, I'd not get worked up over them drinking, smoking, or eating anything they can manage to stomach during the process.
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Agreed.....

If the end is near... Drinking will help the dying deal with the situation better.... IMHO....
 
A drunk is a drunk, some will never get better, many will. She should be confronted and someone should drop a dime to the doctor, that's what I would do, but you can't fix this ( the alcohol problem), only she can, but you can provide motivation. Don't engage a drunk when they are drunk.
 
Thanks everyone. I read my wife all of the responses and although she cried, the responses helped her not feel guilty. I appreciate all of you, this forum and the wisdom of the members. Thanks again.
 
And another reminder to all to get a colonoscopy every 10 or 5 years, depending on family history. It aint that bad, folks. Just stay home for the 24 hours prior.
 
steingar said:
If the cancer has already spread it is metastatic, and the likelihood for a survivable prognosis is low. Says me let her drink. Let her spend the last of her life doing what she wants, especially since the chemo will be harsh. Might tell her docs about eh alcohol though, so they can take it into account.
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iRyan said:
Thanks everyone. I read my wife all of the responses and although she cried, the responses helped her not feel guilty. I appreciate all of you, this forum and the wisdom of the members. Thanks again.
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Very sorry for your wife losing her sister, and you just cut and paste the good Professor's response as my own.

Stage 4 of pretty much any cancer by definition is a "how much time you have left and what do you want to do with it", moment. If you can do anything at all.

We've had a couple family members taken by cancer, by the hardest was an aunt from a melanoma that wasn't caught until Stage 3 in her 40's, and then immediately jumped to her brain.

She ended up being better about accepting it and doing what she wanted in between some nasty treatments, than many of the rest of the family were.

She knew the gig was up. Her sisters, including my mom, took longer to come to the same conclusion that she did. It's hard.

The treatments extended her time a little and she hung out with us through the Christmas holidays in her particular timeline.

She sat and enjoyed it while in and out a bit dozing and then awake and smiling but not saying a whole lot. I got a chance to ask her if she was doing okay mentally and she shrugged and smiled and said "it is what it is... and I know [insert uncle's name and cousin's names here] will be okay." Not too long after, she passed, at 49.

I think the hardest part for most families is when parents outlive their kids. My grandmother outlived her and that's just rough no matter how you slice it.

Deepest condolences and empathy. Cancer is rough.
 
murphey said:
And another reminder to all to get a colonoscopy every 10 or 5 years, depending on family history. It aint that bad, folks. Just stay home for the 24 hours prior.
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I'm glad you said that. My dad died of colon cancer, and I've had to have colonoscopies since age 40. The cleansing is awful. Bet it's better than the alternative.

OP, don't let your wife put off a colonoscopy if her doctors concur that she should have one.
 
My wife had her colonoscopy not long after her sister's diagnosis; our PCP is really on the ball. Right now it is every five years for her.

One thing I am curious about re: her cancer diagnosis. Sis in law is an organic chem professor and she does all of her labs herself. Is there a link between lab chemicals and cancer?

Her oncologist has her in a study with vitamin D so maybe it will help. Besides being so young with kids, the scientific community might lose a brilliant mind. It stings knowing she had this disease while she was visiting me in the hospital while I was fighting for my life.
 
iRyan said:
My wife had her colonoscopy not long after her sister's diagnosis; our PCP is really on the ball. Right now it is every five years for her.

One thing I am curious about re: her cancer diagnosis. Sis in law is an organic chem professor and she does all of her labs herself. Is there a link between lab chemicals and cancer?
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Oh yes. Many, if not most organic chemists die get some sort of cancer. Occupational hazard.

iRyan said:
Her oncologist has her in a study with vitamin D so maybe it will help. Besides being so young with kids, the scientific community might lose a brilliant mind. It stings knowing she had this disease while she was visiting me in the hospital while I was fighting for my life.
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Every one we loose is a loss to the community. But there's no helping it, folks die of nasty diseases. Best she can do is put here affairs in order, make certain her students are graduated or get them to someone who will.
 
How old was your sister-in-law when she was diagnosed? Has she been referred to a Genetics clinic?

Alcohol overuse is not ideal of course during chemo. Encourage her to share that with her oncologist.

If the current regimen doesn't work, and if she is still strong enough, encourage her to look for clinical trials, especially any that involves anti-PDL1/PD1 antibodies. Her tumor must have certain characteristics.

Tough cancer, but don't lose hope. Not all stage IV colon cancers are the same. (I'm an oncologist.)
 
CrimsonFlyer said:
How old was your sister-in-law when she was diagnosed? Has she been referred to a Genetics clinic?

Alcohol overuse is not ideal of course during chemo. Encourage her to share that with her oncologist.

If the current regimen doesn't work, and if she is still strong enough, encourage her to look for clinical trials, especially any that involves anti-PDL1/PD1 antibodies. Her tumor must have certain characteristics.

Tough cancer, but don't lose hope. Not all stage IV colon cancers are the same. (I'm an oncologist.)
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To take this advice a bit further - check out this website. I met this guy last year - he took the bull by the horns (working with his family doctor) and found a clinical trial that saved his life. Not always possible (or even frequently) but it doesn't hurt to try. http://www.epatientdave.com/
 
She was 43 when diagnosed. I know she has had genetic testing done (she is at Dana farber-forgive the spelling) and her dr has her enrolled in some trials with vitamin d. I will fwd your posts to her; maybe she will listen. Thanks doc!
 
iRyan said:
Thanks everyone. The replies are sobering as we all expected some miracle. I will take the advice given. Thanks again.
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To your original question - my understanding is that alcohol itself generally does not interact with the drugs used for chemotherapy, it doesn't make them stronger or weaker. She didn't make the chemo not work by drinking. But both alcohol and chemo drugs are cleansed by the liver, meaning they're sticking around longer because her (already damaged) liver is doing overtime.

There are two mechanism for cleaning toxins out of your body - your liver and your kidneys. Excessive drinking effectively stresses both of them. Over a few decades, eventually one, the other or both give up.

I'm sorry for your troubles. Adults sometimes make decisions that don't make sense to others but I believe everyone chooses the path toward their optimal happiness...even if it's painful for us to see.
 
iRyan said:
Hi all,

I was hoping to get some info/advice from you all on this topic. As you might remember, my sis in law got diagnosed with Stage 4 colon cancer that spread to her liver on Jan. 1. The treatments were working until the last scan; the lesions grew. She was taken off the original chemo b/c of the neuropathy in August. Tomorrow she begins a different, stronger cocktail, so we have our fingers crossed.

Problem is she is an alcoholic and continues to drink. Her doctors to our knowledge do not know she is an alcoholic and my wife has pleaded with her to stop drinking. Common sense sense says drinking while chemo is a no-go, but I am not a dr. Could alcohol negate the chemo and cause the lesions to grow? Would you confront her again? My wife and mom in law are devistated and feel they are watching her kill herself.

Thanks all.
Click to expand...

Shes an adult. Shes facing a life threatening illness. Metastatic cancer tends to be looked at in "median survival since diagnosis" rather than "average cure rate". She is allowed to make her own choices.. good or bad...

You dont have to accept those choices, but they are hers and hers alone to make. She's the one living with/dying of cancer. Your family members have said their piece... I'd let it be. Nagging her about it wont make her live longer.
 
I've had two friends die of cancer this year. One was an alcoholic, and had recovered (AA) right before her diagnosis. She fought until they said there was no more fighting that her body could take. Had it not been for her stopping drinking, she wouldn't have gotten that last year (say her doctors), which was very important to her and her husband.

Another one had cancer for several years, and ended up deciding to just quit fighting - the chemo was too hard on him. He had lung cancer, was a smoker. Smoked pretty much up until he died. Figured he'd go out living life the way he'd lived it. Can't blame him, and that's what he wanted. His kids were angry/upset he didn't fight more, but it was his life to choose - they're all grown.

I say the drinking is her choice. If I was diagnosed with cancer today, I'd be fighting with every ounce of strength in my body and then I'd keep on fighting more, and do whatever it took to win. I also have 3 small kids who I need to see through their childhood and many more years to spend with my wife. 40-50 years from now, I might think differently.
 
To echo earlier posts, this diagnosis of Stage IV colon cancer, although horrible, is not necessarily a death sentence. A median survival time since diagnosis number means that half of the people with the diagnosis live a shorter time than the median, and half live longer. Some live significantly longer. There’s no reason to assume that the OP's sister-in-law won’t be one of the people who lives longer than the median.

Genetic testing is, in my view, essential for almost any cancer patient. The genetic testing can identify potential treatments that are specific for the particular genetic mutation that is driving the patient’s cancer. There are many exciting new treatments now in clinical trials, and knowing the driving mutations can direct a patient to a clinical trial that has the best possibility of success. I work for a company that did genomic sequencing for a cancer patient. The sequencing led to the identification of a treatment that put the patient into remission in a matter of weeks. Without the sequencing, it is doubtful that the particular treatment would have been tried.

I highly recommend a blog by a former colleague who was diagnosed with Stage IV colon cancer at age 40. Now 43, he is still “LIVING WITH” cancer (his words). Ironically, he himself is an oncology researcher. In his blog, he provides an excellent explanation, in layperson terms, of the scientific basis of cancer and potential treatments. His blog also provides living proof of the power of an optimistic attitude in battling cancer (or any disease). The blog is called adventuresinlivingterminallyoptimistic (sorry, I'm not yet allowed to post links).
 
Lots of great info, thanks all. I know she had the genetic testing done but I don't known the results except she tested positive for something. I'll have to ask my wife when I see her.

It seems there are a lot of young people getting diagnosed with colon cancer from talking to my SIL. Is there an uptick? I was wondering if it is our diets with processed foods or are we just better at detection?
 
Hey Ryan, not much to add but to express my sorrow that you and your family have to go through this and to let you know ( I'm sure you do already) that if she needs transport for treatment. Angel Flight East will do what it can.
 
Thanks Adam! it is appreciated.
 
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