Brief Answer:
Chemo decided by oncologist. Chemo & Sx needed

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.
The best chemotherapy will be decided by your oncologist.
However, for a single metastatic nodule in liver excision of the nodule will be effective.
Bowel cancer has fairly good prognosis even in the presence of liver metastasis provided the metastatic nodule is single.
Further prognosis is also decided by involvement of lymph nodes draining the bowel.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
Kindly, see the detailed answer below.

Detailed Answer:
Hello and welcome again,

Detecting a metastatic focus in liver after surgery does not mean that the chemotherapeutic agent did not work.
The pathogenesis of metastasis is such that clinically evident metastasis is detected long after primary tumor is removed. This is due to micro-metastasis or microscopic metastatic foci.
CEA is a sensitive marker to assess the recurrence and metastasis of primary tumor.
The focus which is not taking up FDG is not clinically active so it can be ignored.
The metastatic focus can be removed surgically.
A chemotherapeutic agent has to be given along with surgery because chemotherapy acts to kill the tumor cells which may be left behind after surgery.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
Chemo has definite role here

Detailed Answer:
Hello and welcome again,

The chemo has to be given.
Chemo has a role in reducing the size of metastatic focus, so surgery thereafter is easy.

There is also a possibility that the metastatic focus may completely disappear.

Response to chemotherapy has to be monitored.

Aortocaval lymph node cannot be surgically removed due to its strategic location.

However, chemo will be effective in treating it.

Theoretically, liver metastasis should have not occurred when chemo is given. However, pathogenesis of metastasis is complex.

Only a fraction of malignant cells are responsive to chemotherapy at one time.

This is the reason why chemotherapy is given in cycles at intervals.

Some of the cells called resting cells escape effect of chemo at one point of time.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
Kindly, refer to detailed answer

Detailed Answer:
Hello and welcome again,

The response to chemotherapy cannot be predicted.

The chemotherapeutic agent (Xeloda) can be taken after surgery also. Patient complaince is very important in treatment of any malignancy.

However, colorectal cancers are known to metastze to liver. So, it cannot be said that the metastasis occured due to improper complaince.
The non FDG uptake is metabolically inactive so it does not show metastasis.
This is not due to chemotherapy.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
it has to be assessed eventually

Detailed Answer:
Hello and welcome again,
Malignancy with distant metastasis has poor prognosis.
In colorectal cancer, distant metastaia to liver has fairly good prognosis if the nodule is single an is easily resectable.
Metastasis to abdominal carries is associated with bad prognosis.
The response to chemotherapy has to be assessed.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
Yes chemo will be effective

Detailed Answer:
Hello and welcome again,

Yes, chemotherapy will be effective in shrinking and killing the malignnt cells in liver and lymph node.

Thanks and take care
Dr Shailja P Wahal

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Brief Answer:
No not widespread

Detailed Answer:
Hello and welcome again,
No the disease is not wide spread.

Thanks
Dr Shailja P Wahal

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Brief Answer:
Yes, it can be cured

Detailed Answer:
Hello and welcome again,

Yes, it can be cured.

Thanks
Dr Shailja P Wahal

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Brief Answer:
Nothing can be predicted before hand

Detailed Answer:
Hello and welcome again,
It cannot be predicted about the response to chemotherapy before hand.
The response has to be monitored after giving chemotherapy.

Thanks and take care
Dr Shailja P Wahal

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