What I'm looking for is a site that can offer hope or something radical that is happening out there for this type of patient. Also I would like to know how long this disease will torture her before it shuts her down and what will be the natural order of events.

-alt.support.cancer in hopes that someone smarter than me will pick up on it. That website might be a better place to get the answers you seek but since we're here I'll give it a whirl. I'd look in alt.support.cancer to see if anyone chimes in over there.

I have no experience with colon cancer - my wife Deborah has Stage IV breast cancer. What Stage IV means in most cancer disgnoses is that the disease has metastasized (spread) from the primary site to other sites. Cancer then becomes a systemic disease - which is why the doctors won't give her a liver transplant. Since there are cancer cells throughout her body now putting her through the ordeal of a liver transplant when chances are it wouldn't prolong her life doesn't make much sense.

My wife has a dozen or so small tumors in her lungs - they're spread pretty evenly throughout both lungs so I asked the same question about organ transplants - that's when I found out they pretty much don't do organ transplants into Stage IV cancer survivors. Her disease is well-controlled right now with a drug called Herceptin - but unfortunately that wouldn't be much use on colon cancer. There are over a hundred different diseases that share a couple of common properties - we call them all cancer but they're markedly different.

I've lost a few friends to liver metastasis from breast cancer but I can't tell you how the disease will progress - it's different with almost everyone.

The altmed proponents here will probably suggest alternative treatments - and at this point I think using alt treatments as a complement to conventional treatments certainly can't hurt. You didn't mention whether your girlfriend's oncologist recommended chemotherapy - but there might be some hope there. There's also a technique called radio frequency ablation that has been used to zap liver tumors to buy some time while more conventional treatments are tried.

If Oxycontin isn't controlling her pain (I'd assume they also gave her something for breakthrough pain) then it might be a good idea to call in a pain management specialist. It's possible in a lot of cases to give someone control of their pain meds to where they can strike their own balance between being in pain and being whacked out on pain meds.

There are probably folks out there who know a whole lot more about end-stage hepatic disease than I do - so I'll bow to the experts.

My thoughts and prayers are with you and your girlfriend - if there's anything I can help with, please drop me a note at the email address in my signature.

-Unfortunately, if the liver metastases are not surgically resectable, there is very little that can be offered to prolong her life. Chemotherapy probably won't do it, once the metastases are this advanced, although often it is done for palliation of symptoms. Radiation therapy to the liver might palliate her symptoms as well, but this is of limited use for diffuse liver metastases, because the liver is pretty sensitive to radiation. Once colon cancer has metastasized to the liver, the best five-year survivals that can be expected are on the order of 30%, and these are only in patients whose metastases can be completely resected surgically, with surgical margins free of tumor. In patients whose tumors are inoperable, survival is on the order of a few months at best, and probably more on the order of a few weeks for such diffuse metastases. What you describe is fairly typical, unfortunately. The patient feels well, then suddenly deterioriates. A work-up then reveals the metastases. This is probably because the liver has a huge reserve capacity and also because it takes a lot of tumor to stretch the liver capsule and thereby cause pain. Also, just FYI, liver transplants have only very limited indications in cancer. They are generally reserved for unresectable hepatocellular cancer with no evidence of extrahepatic disease. In patients with liver metastases from other kinds of tumors, transplants are useless.

Unfortunately, it's hard to predict how long she will hold on. It could range from anywhere from days to a few weeks. If her metastases are as advanced as you describe, I doubt she'll last a few months. In liver failure, usually, eventually the patient slips into a hepatic coma and then expires, but, again, it's hard to predict individual cases. If her liver is this full of tumor, she probably has tumor elsewhere. At this stage, the best that can be done is aggressive pain management, unfortunately.