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Have colorectal cancer. Pet scan, biopsy and ihc test done. What treatment should be done?

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Practicing since : 2004
Answered : 1204 Questions
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.

since XXXXXXX this year, she had post menopause bleeding and on diagnosis, we came to know that there was recurrence in the pelvic region. I have attached the PET scan report. Our doctor advised us to have a surgery done to remove the uterus and then go in for a surgery, but on a second opinion from a different oncologist, we were advised not to go for it as it had spread quite vulnerably and the patient may become more weak. Now this second opinion suggests us to go in for a palliative chemotherapy using drugs - IRINOTECAN & AVASTIN, which could possibly shrink the tumour and on observation for a few cycles the patient can be exposed to targeted chemotherapy.

We are really worried and confused how to go about it now, since both are different approaches. We wouldnt want to delay the treatment as the patient although is normal, is becoming symptomatic.
Please suggest which one to go for.
Thanks in Advance.

PET SCAN report , IHC and BIOPSY reports attached.
Posted Sun, 14 Apr 2013 in Cancer
Answered by Dr. Indranil Ghosh 28 hours later
Thanks for writing back.
I do remember about your mom's case. Now with all the reports it appears that she has relapse of the disease (colon cancer). I would not recommend surgery given that the disease has spread to fluid in the chest.

However, chemotherapy is still an option, either oxaliplatin (if she has not received that earlier) or irinotecan, combined with 5FU, leucovorin or oral capecitabine. Also if you can afford, avastin can certainly be combined. This is not curative but to prolong her life and control symptoms. If bleeding persists even after chemo, then radiation may be considered just to control the bleeding.

Hope I have answered your query. I will be happy to answer any follow-up queries.
Best Wishes,
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