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What Are The Symptoms Of Metastic Colon Cancer?

Posted on Wed, 29 Apr 2015

Question: How effective is avastin if added with chemotherpay than chemo
Alone in metastic colon cancer ?

Is it worth taking ?

Male
Aged 66.

Answered by Dr. Indranil Ghosh (21 minutes later)

Brief Answer:
yes it prolongs survival

Detailed Answer:
Hi

Thanks for your query.

Avastin on an average adds six months of life to that obtained by chemo alone (say 2.5 year vs 2 yr). But this is for the general population. Some patients do well than others and can survive 3-4 years. But for that avastin needs to be continued as long as disease is under control. If you take it only for six months and then stop, benefit may not be as much.

Hope this helps. I will be available for followup.
Regards

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

Follow up: Dr. Indranil Ghosh (9 minutes later)

We are stuck
As my dad was initially stage 3 and now stage 4. Please see letter attached .

Prob came as first chemo irinotecan failed when there first was a liver met discovered in AUgust 2014.

After bowel surgery he was on adjuvant xeloda but that failed too as he developed a liver met .

Does this mean no chemo
Will work ?is the cancer chemo resistant ?

Answered by Dr. Indranil Ghosh (40 minutes later)

Brief Answer:
There are options

Detailed Answer:
If he has never received oxaliplatin, I would recommend capecitabine (xeloda) +oxaliplatin +bev if feasible. If KRAS mutation absent then cetuximab/panitumumab another option along with chemo.

If failed oxali and irinotecan bioth then regorafenib may be considered.

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

Follow up: Dr. Indranil Ghosh (54 minutes later)

He's just started oxyplatin and ralitetrexed he's had 1 session so far. Not 5 fu and initially had muscle spasm in chest with it

We are pushing to Add avastin .is this a good combination ?

Can this also fail ?

Answered by Dr. Indranil Ghosh (11 minutes later)

Brief Answer:
yes this will be a good combination

Detailed Answer:
Any combination in metastatic cancer is trial and error and can fail. But there is chance of working also.

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

Follow up: Dr. Indranil Ghosh (8 minutes later)

What percent chance would u say there is of this combo worlkjng ?

Can avastin be added to this combination ?

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Good response around 20%

Detailed Answer:
Another 20-30% stable disease for certain period. If you add avastin, then response rate may increase by another 10-20%

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

Follow up: Dr. Indranil Ghosh (9 minutes later)

But can
Avastin b given with 5fu or xeloda only . Can it be combined with ralititrexed ?

Also if he had history of minor attack and blood clots in 2013 is avastin safe still?

U think it's worth it in this situation ?

Answered by Dr. Indranil Ghosh (5 minutes later)

Brief Answer:
yes it can be

Detailed Answer:
It can be combined with 5FU or xeloda as well as raltitrexed alone. There are small studies for the same.

Minor clot in 2013 should not be a problem.

I think it should be given a try

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

Follow up: Dr. Indranil Ghosh (17 minutes later)

Thx so much

So if these with avastin works can he have good survival ?

Are 8-9 mets in the liver a lot ?

Answered by Dr. Indranil Ghosh (44 minutes later)

Brief Answer:
yes he can

Detailed Answer:
8-9 is a lot in the sense that surgery is not feasible but chemo should work an all of them if it does, at all.

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

Follow up: Dr. Indranil Ghosh (26 minutes later)

Ok so would chemo shrink the mets ?

Do we have any option if chemo fails ?

He's KRAS mutant , are here ppl with this where no chemo
Works ?

Answered by Dr. Indranil Ghosh (7 hours later)

Brief Answer:
yes chemo can shrink the mets

Detailed Answer:
In kras mutant patient avastin can work.

If chemo and avastin does not work we can try regorafenib. If that too fails then palliative care.

Unfortunately there are many patients where nothing works.

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

Follow up: Dr. Indranil Ghosh (2 hours later)

Ok . Does the cea depend on how many mets he has ?

His is 65. Do some ppl have high than this ? Is this high for metastic colon cancer ?

Answered by Dr. Indranil Ghosh (3 hours later)

Brief Answer:
yes it can be higher

Detailed Answer:
CEA levels vary widely. I have seen in thousands also.

But in one patient its values over time suggest disease response to chemo ( if it goes down) or disease growth ( if increasing)

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

Follow up: Dr. Indranil Ghosh (1 hour later)

What diffetence is there from a cea of 65 and a cea of say 500?

Answered by Dr. Indranil Ghosh (55 minutes later)

Brief Answer:
in two separate patients it does not matter

Detailed Answer:
But if in one patient it increases from 65 to 500 then definitely chemo is not working

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

Follow up: Dr. Indranil Ghosh (37 minutes later)

Ok my dad's was 12 in dec and by march end was 65

Answered by Dr. Indranil Ghosh (52 minutes later)

Brief Answer:
that signifies disease progression

Detailed Answer:
This much rise suggests disease progression

Note: For further queries related to kidney problems Click here.

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