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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Stage IV Esophageal Cancer Spread To Lymph Nodes, Blocked Bile Ducts, Bilirubin 14

My brother has stage 4 esophagus cancer that has spread to lymph nodes bones etc. he now has blocked bile ducts and his bilirubin is at 14 and has been there for at least a week. He is getting worse every day,is not eating much.I think his liver is failing.He will not get better I know,but I hope he does not suffer this way for long. What can we expect to happen from this point on?
Mon, 7 May 2012
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Oncologist, Radiation,  's  Response
Best supportive case is the only answer as bone metastasis is stage 4 and , best supportive care means relieve of pain of bone spread and relieve of jaundice. for bone pain, patient can be prescribe radiation therapy of short course followed by routine NSAID Pain killer and Morphin tablets by registered Oncologist, and for relieve of raised bilirubin because of obstructed bile duct by palliative 5FU based chemotherapy after radiotherapy treatment provided general condition permits it.but in real sense its dismal disease we can only give symptomatic relief not any else except minimal 2-3 month survival with good quality of life.
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Oncologist, Surgical,  Dr. Mohammed Ibrahim M's  Response
Hi

I am very sorry for your brother. He is already in the final stages of esophageal cancer and because of it only palliative treatment is possible to reduce his symptoms. If an endoscope can be passed through the cancer mass in the esophagus then a procedure called ERCP stenting for the blocked bile duct and a esophageal stenting for the block in the esophagus can be done. But both these stenting procedures are very costly and technically very challenging.


Dr. Mohammed Ibrahim
Surgical Oncologist

mdibrahimdr@yahoo.co.in
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Stage IV Esophageal Cancer Spread To Lymph Nodes, Blocked Bile Ducts, Bilirubin 14

Best supportive case is the only answer as bone metastasis is stage 4 and , best supportive care means relieve of pain of bone spread and relieve of jaundice. for bone pain, patient can be prescribe radiation therapy of short course followed by routine NSAID Pain killer and Morphin tablets by registered Oncologist, and for relieve of raised bilirubin because of obstructed bile duct by palliative 5FU based chemotherapy after radiotherapy treatment provided general condition permits it.but in real sense its dismal disease we can only give symptomatic relief not any else except minimal 2-3 month survival with good quality of life.