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Suggest Treatment For Colon Cancer

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Posted on Mon, 16 Jun 2014
Question: My father had surgery in march to remove tumor in the bowel which was dukes c1. He does not want the chemo for 6 months. Are there other options?
doctor
Answered by Dr. Dr. Ivan Romich (55 minutes later)
Brief Answer:
Hi and welcome to HCM

Detailed Answer:
There is only one other option and this is radiotherapy but radiotherapy has much lower efficiency in preventing recurence and side effects may be more serious than those in chemo.
Chemotherapy,especially in dukes c is proven to reduce cancer recurrence rate and improve overall survival. Today, its benefit is confirmed even in dukes b stages.
Statistically, it will increase his chances for 5 year survival for 17%( from 35% without chemo to 52% with chemo). You decide are these odds good enough for you and him, and is chemo woth of it.
So, modern oncology recommend chemotherpy despite its side effects since this benefit is significant. Of course, it will be his decision, but I am sure that he will feel better if he knows that he is giving his best to treat such serious disease.
Wish you good health. Feel free to ask. Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (2 hours later)
So if he does not have chemo , would he def gets mets?
doctor
Answered by Dr. Dr. Ivan Romich (1 hour later)
Brief Answer:
hi

Detailed Answer:
I dont think I understand what "def gets mets" means? could you explain your question? thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (34 minutes later)
I mean if he refuses chemo will he get spread to liver lungs etc?his last scan was feb
doctor
Answered by Dr. Dr. Ivan Romich (2 hours later)
Brief Answer:
hi

Detailed Answer:
if he refuses chemo it doesnt neccesary mean that it will spread ,but also if he accept chemo it still doesnt mean that he will be cured. cancer prognosis is always unpredictable and we can only calculate survival based on scientific evidence.
Postoperative chemotherapy is not used for direct cancer treating,but it is used for killing possible tumor cells remnants and preventing tumor recurence. in stage c it is still possible that whole tumor was removed and in this case chemoth isnt neccessary but practically it is impossible to be sure that whole tumor is resected since there may be microscopic cancer cells in lymphnodes which will spread in this case.
So I wrote that 5 year survival for operated stage c cancer is 35% (it means that 1/3 of patient will live 5 years and more) and for operated stage c cancer chemotherapy is 50%. it is up to you to decide about further treatment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (4 hours later)
He had 28 nodes removed of which 10 near the tumor had cancer cells . Can a pet scan if we request detect microscopic cells ?

Is there no way of detecting microscopic cells ?
doctor
Answered by Dr. Dr. Ivan Romich (2 days later)
Brief Answer:
Hi

Detailed Answer:
If there was 10 positive lyphd nodes then this is stage c2 and I really recommend chemotherapy in this case. You should advise him to do it since there is no doubt about benefit of chemo in c2 stages. Microscopic cells cant be detetcted,but PET scan can detect positive lymph nodes an dif there is no positive lymph node or distal metastases 2-3 months after surgery then you can be almost sure that cancer is removed.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (7 hours later)
Thats what i was confussed with how hes a c1. But they have confirmed in report and letter its a c1.

He has agreed to try out the chemo tablets atleast. So lets see.

He had surgery in march so XXXXXXX we are thinking req a pet scan ?

Wat would happen if he has more lymph nodes showing up?

They have ready removed 28 , 10 were affected so cud their still b more ?
doctor
Answered by Dr. Dr. Ivan Romich (15 hours later)
Brief Answer:
hi

Detailed Answer:
It is hard to know without more details about surgery.
Usually it is not possible to remove all lymph nodes in abdomen but those close to tumor and involved colon are removed. If 10 were positive then there is some chance that some other could be affected, but you should be optimistic. PET would show if I am right. But I would still recommend chemo,this is too serious disease and everything must be done to prevent fatal consequances. If pet shows positive lymph nodes,it still can be cured with chemo, but prognosis is much worse in this case.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (8 hours later)
Yea ur right its not s minor disease- too serious.

Well we have convinced him to have chemo tablets i think he has to start in two weeks.

I hope side effects not so bad
doctor
Answered by Dr. Dr. Ivan Romich (11 hours later)
Brief Answer:
hi

Detailed Answer:
it depends from man to man. most people can stand it with no significant problems. usually moderate nausea is present but this is not very problematic
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (2 hours later)
If more lymph nodes are Afftected does that patient get symptoms ? Would the cea be raised ?

My dad keeps getting sore throats so i get worried.
doctor
Answered by Dr. Dr. Ivan Romich (1 hour later)
Brief Answer:
hi

Detailed Answer:
not necessarily. CEA can indicate tumor recurence in bowels and it is not correlating with lymph nodes involvement. Unfortunately,symptoms are noticed later, after metastases occur. so it is advisable even in asymptomatic patients, to do pet scan or regular ct scan to detect disease spreading. i dont think taht sore throat is related to his primary disease,but it can be sign of weak immune system.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ivan Romich (1 hour later)
Would weak immune system b due to a reoccurrence?

doctor
Answered by Dr. Dr. Ivan Romich (5 days later)
Brief Answer:
hi

Detailed Answer:
not likely. it can be sign of terminal malignant disease but it would not be first sign of it.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13886 Questions

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Suggest Treatment For Colon Cancer

Brief Answer: Hi and welcome to HCM Detailed Answer: There is only one other option and this is radiotherapy but radiotherapy has much lower efficiency in preventing recurence and side effects may be more serious than those in chemo. Chemotherapy,especially in dukes c is proven to reduce cancer recurrence rate and improve overall survival. Today, its benefit is confirmed even in dukes b stages. Statistically, it will increase his chances for 5 year survival for 17%( from 35% without chemo to 52% with chemo). You decide are these odds good enough for you and him, and is chemo woth of it. So, modern oncology recommend chemotherpy despite its side effects since this benefit is significant. Of course, it will be his decision, but I am sure that he will feel better if he knows that he is giving his best to treat such serious disease. Wish you good health. Feel free to ask. Regards