Discussions By Condition: I cannot get a diagnosis.

diagnosis of two seperate primary cancers

Posted In: I cannot get a diagnosis. 1 Replies
  • Posted By: mlph317
  • April 11, 2009
  • 03:05 AM

My father was diagnosed with stage 4 lung cancer two months ago, after suffering from a long and painful respiratory illness. His pulmonologist believed that he had sarcoidosis, but after multiple CT and pet scans and a lung biopsy they determined that it was cancer. He was referred to an oncologist, who told us that my father had a very aggressive form of lung cancer that was spreading through his lungs in a very unusual way, creating lesions all along the airway (she said it looked almost like buckshot on the scan and that the cancer was forming hundreds of tiny masses spread around througout his lungs). He was told at that time that he also had a large tumor in his colon that had spread to his liver and to multiple locations on his spine. The cancer in his colon is relatively slow-growing, while the cancer in his lungs is spreading extemely fast. Needless to say, his prognosis is not good. He has been working with a team of oncologists who have determined that he has two seperate primary forms of cancer. It had always been my undrestanding that you couldn't be diagnosed with two speperate forms of cancer, though I'm no expert, and I haven't been able to find any information on any other people who have been in a similar situation. If anyone out there has any insight on this, any info would be greatly appreciated.

I would also like to note that my father is a lifelong non-smoker, who has lived an active and healthy lifestyle. He has been working as a medical social worker in a university hospital for the better part of the last twenty years and NONE of our relatives have ever been diagnosed with cancer.
I learned recently that several of his co-workers have also been diagnosed with other forms of aggressive cancer. Is it possible that this could have been caused by some environmental toxin? If so, how can I find out for sure?

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  • Okay, I naturally don't have access to the medical data or history here to make a more definitive conclusion, but in general this would appear more like metastatic disease secondary to colon cancer. Regardless of the momentum of the colonic tumor, metastatic disease can be quite swift and proliferent in some cases. As to the question of environmental causes, it would typically be unusual for a group of people to develop various types of cancer rather than a more singular form. In other words, a group of people exposed to asbestos could all develop lung cancer, or if this group were ingesting products similar in origin that had carcinogenic properties. In order to determine whether there are any contributory factors, however, you would likely need to begin with your state EPA or other objective agency in order to seek investigation into the potential for hazardous exposure. Realize, however, that this commonly occurs in instances where illness or disease arises under circumstances that may appear contradictory to the health history of the patient. A patient need not be a smoker to contract lung cancer and because he has also been diagnosed with colon cancer, it is far more likely that metastatic disease is responsible, even though it may be demonstrating uncharacteristic or "unusual" procession. Also, family history is a strong risk factor, but not direct concordance for cancer or prevention of it. The fact that the colonic tumor is slow-progressing, but yet is large in dimensions, would suggest that it has been present for some time and that period would be wholly sufficient for metastatic disease to become fulminant. In many similar cases where treatment of the primary or chief complaint does not appear to be consistent with the pattern of usual clinical sequelae, in this instance "a long a painful respiratory illness," metastatic disease does not rise to the level of differential diagnosis or consideration until late in the course of intervention in some cases. This is why cancer screening as a preventative course is so emphasized, regardless of family history or other known risk factors. Best regards, J Cottle, MD
    JCottleMD 580 Replies Flag this Response
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