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Rectal cancer surgery done. Getting pelvic pain. Given palliative radiation and pain killers. Cure?

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i am sending on behalf of my mother who has rectal cancer and had surgery in September. She had undergone chemo Xeloda after that later had pain in pelvis. Bone scan shows skeletal secondories. is stopped chemo undergoing pain medication and zelodronic acid injection. I have attached details of medicines and latest bone scan report. They have give palliative radiation and pain medication due to pain. Could you advise how to proceed on curing the current condition.
Posted Wed, 13 Mar 2013 in Cancer
 
 
Answered by Dr. Indranil Ghosh 6 hours later
Hi

Thanks for writing in.

I have gone through all the records. It appears that she had rectal cancer, treated with pre-op RT+xeloda and then gone for chemo with xeloda. What was the rsult of surgery? Any biopsy report?
Now definitely she has bone metastases for which she is on palliative care and zoledronate.

Unfortunately the situation now is incurable. Whatever we do we cannot eradicate the disease. We can aim for better quality of life only. In addition if she is fit enough to tolerate chemo, we may consider oxaliplatin-based chemo to prolong her life. As he has received pelvic radiation, again radiating there for pain is not feasible.

Hope I have answered your query. I will be available to answer any further follow up queries.

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Follow-up: Rectal cancer surgery done. Getting pelvic pain. Given palliative radiation and pain killers. Cure? 6 hours later
thanks for your response,could you clarify the answer fit enough for chemo. What are the requisites. She is fine now except the pain. what about target therapy or any medication to slow down or cease the tumor.

Is there cases there the tumor goes by itself on the bone.

What about any surgical method.

I will check on the biopsy and get back to you.
 
 
Answered by Dr. Indranil Ghosh 1 hour later
There are many cases where the tumor spreads, which may be to liver, lungs, bones or somewhere else. This is the major cause of cancer related deaths.
Now no surgery can help her. If she is fit to do all her daily living activities, able to move around well, blood tests are ok, then we can consider chemotherapy to control it for few months. Targeted therapy may be added to chemo if you can afford it (each dose will cost 1 lakh). This may extend her life by few more months but still not cure it.
expected survival with no chemo 4-6 months, chemo 1 yr and chemo+targeted 1.5 yr.
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Follow-up: Rectal cancer surgery done. Getting pelvic pain. Given palliative radiation and pain killers. Cure? 3 hours later
Thanks for your prompt response and giving me honest opinion.

currently she is feeling pain when getting up and needs little help to get up. After that she is in her normal except she is walking slowly so that
there is no fall and fracture issue. What would be a least minimum requirement to give chemo. I was told that doctors feel that the chemo (xeloda) did not work
before, may be due diabetics.

Are there good drugs based on oxaliplatin with less side effects. Any suggestion based on your experience will be highly appreciated.
 
 
Answered by Dr. Indranil Ghosh 1 hour later
Yes, only xeloda with RT did not work but now as a palliative treatment we can certainly the combination of xeloda-oxaliplatin-avastin. Of course the final opinion lies with the treating medical oncologist.
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Follow-up: Rectal cancer surgery done. Getting pelvic pain. Given palliative radiation and pain killers. Cure? 2 hours later
thanks, i would like to know if you have any recommended hospital/doctor we can do the above treatment in kerala. currently she is undergoing treatment in malabar cancer center in tellicherry. Any doctor you know will help greatly.

Also on the bone metastases, are there cases where the tumor has been killed or growth ceased in old patients with diabetic.

Now if the cancer does not spread on other parts, is the risk now only that the bone will be weak. Can this be treated on a long term by improving calcium and avoiding fractures
 
 
Answered by Dr. Indranil Ghosh 8 hours later
You can XXXXXXX Dr VP Gangadharan at Lakeshore hospitals Kochi. He will take care of your mom.

Bone metastases are incurable as of present day.

Calcium and avoiding fractures are OK but they cannot keep the disease at bay, they are just supportive.
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