What causes severe fatigue while treating metastatic colon cancer

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Posted on Fri, 5 Jun 2015 in Cancer
Question: Very bad fatigue in metastic colon cancer pt. so far has three rounds of oxyplatin and raltitrexed .

Is this cancer related ?
doctor
Answered by Dr. Monish De 33 minutes later
Brief Answer:
Take tablet zincovit

Detailed Answer:
Hi

The bad fatigue is due to the 3 rounds of chemotherapy you have taken for metastatic colon cancer

Oxaliplatin and Raltitrexed causes fatigue in 85% of patients as its side effect

I would advise you to drink 4 litres of water per day and take tablet zincovit one tabet once daily after breakfast till your chemotherapy continues


Regards

Dr DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De 27 minutes later
Is the bad fatigue dangerous ? Is if worth continuing? Plus his bp is 90 and heart rate was 50 ?
doctor
Answered by Dr. Monish De 12 minutes later
Brief Answer:
Stop chemotherapy

Detailed Answer:
Hi

Yes the fatigue can be dangerous

As his blood pressure is 90 and heart rate is 50 i would advise you to stop chemotherapy and reasess the disease with CT scan of whoe abdomen and blood test for CEA

If you have no more clarifications then please rate the answer and close the thread

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Monish De 46 minutes later
Well this was the cea pattern-

Before chemo - 65
After 1 round - 80
After 2 round - 55

What do I advise ?
doctor
Answered by Dr. Monish De 7 minutes later
Brief Answer:
Blood test for CEA every 3 months

Detailed Answer:
Hi

After 2 rounds the CEA has come down to 55 from 65 which is a good prognosis and since already he has completed 3 cycles my advise woud be to reasess the disease with CT scan of whole abdomen

If radiologically the disease is under control then he can be followed by blood test for CEA every 3 months

Regards

DR DE
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Monish De 19 minutes later
But after 1 round it jumped to 80

Now 55 so do you count the drop from 65 before chemo or from 80?

But the drop is only 10 points right ?
doctor
Answered by Dr. Monish De 20 minutes later
Brief Answer:
Disease needs to be judged radiologically

Detailed Answer:
Hi

Chemotherapy takes time to work

Sometimes after round 1 the CEA may rise but after that from second cycle onwards the CEA level comes down

Before starting chemotherapy it was 65 and now after 2 rounds it has come down to 55 which is a good sign and that is why the disease now needs to be judged radiologically with CT scan of whole abdomen

If the disease is under control and there is response then oral chemotherapy which has lesser side effect can be given to bring the CEA level further down as he is having fatigue, low blood pressure and heart rate with injectable chemotherapy

Regards

DR DE
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Monish De 12 minutes later
Yes that was my next query that if they stop this and then does not take anything then mets start growing again right ?

He did not initially respond to
Irinotecan and xeloda though . So don't know re this
One .

Is 10 points a good drop or ?

Also other chemo may not work right ?


doctor
Answered by Dr. Monish De 9 minutes later
Brief Answer:
Oral Regorafenib chemotherapy

Detailed Answer:
Hi

Since he did not initially respond to irinotecan and xeloda whose other name is capecitabine now maintanence therapy with capecitabine will not work

10 points is a good drop

I would advise you to take oral Regorafenib chemotherapy tablets as maintenence therapy to bring his CEA level further down if his disease is radiologically stable

Regorafenib has response rate of 60%

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Monish De 10 minutes later
Okay. Can he do TaCe for liver? And he has 4 peritoneal nodules ( 7 mm).

If he respond to chemo what is prognosis like ?
doctor
Answered by Dr. Monish De 1 hour later
Brief Answer:
TACE has response rate of 80%

Detailed Answer:
Hi

Yes TACE for liver metastasis can be done

It has response rate of 80%

Peritoneal nodules will respond to chemotherapy

If he responds to chemotherapy then prognosis is good and average survival time is around 5 years

Wishing him good health

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Monish De 5 minutes later
U think chemo will shrink the peritonel nodules or get rid of them complete?
doctor
Answered by Dr. Monish De 31 minutes later
Brief Answer:
Chemotherapy can cause complete response

Detailed Answer:
Hi

Yes chemotherapy if the disease responds can shrink the peritonea nodues and if there is compete response then can get rid of them competey

Regards

DR DE
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2233 Questions

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