My Young Fiancee Recently Diagnosed

“My Young Fiancee Recently Diagnosed” - Hello, my 30 year old partner was very suddenly diagnosed with stage four stomach cancer mid Jan 2015. He has always been a very active (cycled 2 hours a day to a physical job) and an independent man with a healthy diet. He had been feeling slightly under the weather for a few months and started feeling bloated and full just before Christmas, his stools changed, he had night sweats, back pain and had a very swollen upper abdomen that we put down to gas. He had seen his GP but before any further tests could be done and ended up in A and E one Sunday when his back pain got so bad that he couldn't breathe properly.

The doctors felt his stomach and immediately said he had an enlarged liver, a CT scan found multiple tumours throughout his liver. We were initially told that although this was secondary, it was unlikely we would find the primary. We went for an endoscopy and colonoscopy anyway and a 5cm tumour at the junction of his oesophagus and stomach was found. His chemo regime was changed to EOX although he is yet to receive the "E" part 2 cycles in. It’s taken a6 weeks to get the HER2 biopsy staining results!! He is responding really well to the chemo and has put on weight and is in less pain.

We know it isn't curable, and despite the positive reaction to the chemo, the oncologist has given me a prognosis of 6-18 months (my partner doesn't want to know this information). I feel like a number of things aren't happening which perhaps should have? I asked about surgery and the oncologist responded 'what would the purpose of that be?', when pushed about finding out if he should be taking the 'E' part of his chemo, the oncologist seemed nonplussed and said he was responding well anyway so may as well wait until the next cycle. No-one has talked to us about H pylori etc. we only know that it is an adenocarcinoma. We see him once every 3 weeks and he gives me the impression that he has given up on Adam already - 'oh well might as well give him some chemo and see how that goes, doesn't really matter which one' type scenario!

Our wedding is going to be in July, I'm praying things will keep improving for then. Georgia, UK

Thank You For Sharing About Your Young Fiancee Recently Diagnosed With Stomach Cancer

Georgia, thank you so much for taking the time to share your fiancées diagnosis and all that you are both going through.  It really is very generous of you to have found the time to do this, when every moment is so precious – as well as a wedding to plan for!

Stomach cancer is still rare in young people, but often more aggressive in the way develops. Your fiancée is testament to this, in someone that you would say was previously so fit.

Really pleased to hear that he is responding so well to the chemotherapy and I hope that he continues to have such a good response.

Surgery isn't really an option as your fiancé has multiple tumours or “deposits” in his liver. If he had a solitary deposit, a liver resection could have been considered, but the saying “the horse has bolted” sadly applies here.

H.pylori treatment really only applies to Maltoma, a different type of tumour and would be unlikely to make a difference to your fiancés cancer.

Sorry also to hear about the attitude you are receiving from the oncologist. I hear it time and time again and it does annoy me. There is no cost to providing compassion, kindness and help which is something I have always tried to install in trainee doctors. Yes, they are busy people, but that is no excuse as far as I am concerned. All doctors are busy people!

I wish you both well with your wedding plans. Having something to distract at such an emotional time is really a positive. It is also something to live for and to provide motivation. I hope to hear about your special day in due course. I'm sure others will also be commenting about this too!

Finally, I would just like to extend an invitation to you. Do drop back and update us as to how your fiancé is doing and I will also be happy to offer any advice you might need. Good luck and take care. Peter

Update About My Fiancee

We finally received my fiancee's biopsy result two weeks ago and unfortunately his tumour is HER2 positive. My understanding is that this isn't good news in terms of the aggressiveness of the cancer and his prognosis?? I didn't get a chance to ask his oncologist if this now means we are looking at more like 6 months rather than longer end of the prognosis spectrum we were given. This has been really hard news to get. 

He has started a new regime of Herceptin/cisplatin/capecitabine and is day 8 after his first infusion. His appetite has been worse this week, the symptoms of food 'sticking' and bloating/fullness have returned, he is also cold all the time and aching everywhere. Is this a sign of things getting worse again?? 

Its very difficult not being able to talk to him or his parents about what's going on, so thank you in anticipation of your response. 

My Reply:

HER2 is associated with more aggressive disease and is quite typical in younger patients. Aggressive disease is associated with a worse prognosis, but Herceptin does have a role to play here. 

I remember when my father had the disease, it was really quite difficult to discuss all this so I know how you are feeling right now. Fingers crossed that he will have a response to the chemotherapy.

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