Can TACE be used instead of chemotherapy for metastatic colon cancer?
yes, it can be
Thanks for your query.
TACE can be done but the disease should be preferably be limited to the liver or minimal disease outside the liver. If there is too much disease outside the liver, like peritoneum, then it won't help.
Is my father was resistant to irinitecan and also
Now they tried oxyplatin and raltitrexed .
Cea was 65 before start of chemo . However, after 1 round it jumped to 80! Plus his ALP is now
175 and was 75 before .
Does this mean this regime also not working ? As cea reduce right ?
Need some more time
Ok, I understand.
But CEA takes 2-3 cycles at least to show response. Sometimes, after cycle 1 CEA rises to some extent then start falling. So we need some more time to draw any conclusions.
ALP rise may be due to progression of metastases, biliary obstruction or even effect of oxaliplatin on liver. However, if bilirubin is not rising I would just continue with same chemo for another 1-2 cycles and then decide.
Right ? If chemo
Works islt should reduce I thought .
Is about 9 liver mets a lot , 2 are large at 9cm.
Also the ALP has risen from 75 to 175
Not really a big jump
65 to 80 is not a big rise. It may come down after 1-2 cycles.
Yes, the ALP rise is steep but it can be drug induced also. What I mean to say is that these are lab markers and not 100% sensitive or specific. We can't do CT scans after every cycle so we need to exercise some clinical judgement.
Is cea of 80 very high in a patient ?
If there are peritoneal nodes , about 4 and a aortocaval node and poss sub pleural nodule , can TACE b done ?
No CEA is not very high by itself
It depends upon the exact size and total burden of disease outside the liver. going by your statement, TACE may be possible. But one needs to ensure that the disease outside liver is small
If Germnay does , should
Go for it if chemo fails or should
We try avastin first ?
very difficult decision without seeing the scans
If german doctors agree to do it then I assume that it will be worth doing. Avastin can be tried even after that. But avastin needs some chemo along with it to work. Chemo options are getting exhausted slowly. So TACE may be better.
Is TACE or SIRT better ?
It may work still
There is still chance that it may work. If it doesn't then after 3rd cycle you may consider TACE
yes you can try avastin
If avastin is considered, then now is the best time. If this chemo fails, getting a suitable chemo partner for avastin will be difficult.
TACE has good success
But only if it is liver localized or minimal disease outside the liver. It will not affect the peritoneal or lymph nodal disease. They will continue to grow as per their course.
hence TACE is usually reserved when standard chemo options fail.
for those chemo and avastin to be used
Liver is a vital organ and for your dad it appears to be the chief site of metastasis. Hence it needs attention. But we can't ignore the other sites. Over time they may increase significantly.
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