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53 years old. Chemotherapy done for colorectal cancer stage iii. Started bleeding heavily. Required treatment?

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My Mom is 53 years old , 72 kg, she was diagnosed with Colo-Rectal cancer Stage III a year and half back (in., Aug-2011). Her Sugar and BP levels are normal. She underwent Chemotherapy through IV - 5-fluorouracil (5-FU) using port a XXXXXXX The 6 cycles of Chemo completed in April 2012. Now that her blood count is quite normal 10.2, the CEA taken 3 months back read 2.5 and the side effects of the treatment have also been reversing.
she wasnt having periods for the last 4 years and we believed she had a menopause. But since a month now, she is getting periods not heavy flow and though not regularly, as a result, she is feeling guidy and becoming weak and the flow does not completely stop.
Please advice if this is a possible cause of metastasis? I have read that metastasis can commonly occur in liver or lungs or even bones, Please clarify if uterus is a possible site for metastasis? The doctor has adviced a PET scan of the whole body later this week and we are yet to get the blood reports.

Also please drop in your suggestions as to how to go about it in terms of treatment.
Posted Wed, 13 Mar 2013 in Cancer
Answered by Dr. Indranil Ghosh 6 hours later

Thanks for writing in.

At 53 years bleeding from uterus, especially after stopping for 4 years is certainly of concern. There are three possibilities in that order-

1. An uterine cancer or cervical cancer (new, unrelated to colon cancer).
2. Metastasis of colon cancer to vaginal vault
3. Some other uterine or cervical pathology (non-cancer).

If the PET-CT does not show any metastasis then she should see a gynec-oncologist for local examination, transvaginal USG and hysteroscopy (a camera going into the uterus) with biopsy.

As the treatment and outcome of each of the conditions is different, I would be able to guide you better if you come back to me with the results.

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