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What Do These Lab Reports Indicate?
Question: Ovarian Cancer Stage 4 diagnosed in February 2016. She has undergone debulking surgery in May 2016. The ovaries, uterus, omentum, fallopian tube, cervix and some lymph nodes were removed. She has undergone 4 cycles of chemotherapy per-operation and 3 post-operation. The last chemotherapy session was done in July 2016.
Based on the above details could you please analyse the attached reports for the most recent CT scans. She is currently having mild fever on and off for the last one month and was diagnosed with UTI and was treated for it. She was also disgnosed with Type 2 Diabetes and is taking some medicine for it. The most recent reports are attached. Please let me know if you need further details.
Based on the above details could you please analyse the attached reports for the most recent CT scans. She is currently having mild fever on and off for the last one month and was diagnosed with UTI and was treated for it. She was also disgnosed with Type 2 Diabetes and is taking some medicine for it. The most recent reports are attached. Please let me know if you need further details.
Brief Answer:
Metastasis likely
Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
I have reviewed all the reports.
The CA 125 levels are high and there are multiple lymph nodes present in the retroperitoneal and mesenteric areas.
This is suggestive of metastasis or spread of cancer in the body, mostly in the lymph nodes.
Moreover, the CT scan is also suggestive of the bowel perforation, the site of which is sealed by the surrounding bowel and there is infection seen around it.
She should consult her Oncologist for further management.
Chemotherapy needs to be upgraded and antibiotics are also required.
Hope you found the answer helpful. Let me know if I can assist you further.
Regards
Dr Deepti Verma
OBGYN
Metastasis likely
Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
I have reviewed all the reports.
The CA 125 levels are high and there are multiple lymph nodes present in the retroperitoneal and mesenteric areas.
This is suggestive of metastasis or spread of cancer in the body, mostly in the lymph nodes.
Moreover, the CT scan is also suggestive of the bowel perforation, the site of which is sealed by the surrounding bowel and there is infection seen around it.
She should consult her Oncologist for further management.
Chemotherapy needs to be upgraded and antibiotics are also required.
Hope you found the answer helpful. Let me know if I can assist you further.
Regards
Dr Deepti Verma
OBGYN
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
The chemotherapist is suggesting some sort of surgery for the perforated area of the bowl before doing any further chemotherapy. Is this a necessary surgery.
He even suggested upgrading the chemo drug to a platinum based drug based on BRCA 1&2 reports.
He even suggested upgrading the chemo drug to a platinum based drug based on BRCA 1&2 reports.
Brief Answer:
Surgery required
Detailed Answer:
Hi dear,
Surgery is to be done to seal the perforated area or to rectify it.
This is so because chemotherapy can aggravate the perforation causing pus in the abdomen.
As l said earlier, chemotherapy needs to be upgraded for further treatment.
Regards
Dr Deepti Verma
OBGYN
Surgery required
Detailed Answer:
Hi dear,
Surgery is to be done to seal the perforated area or to rectify it.
This is so because chemotherapy can aggravate the perforation causing pus in the abdomen.
As l said earlier, chemotherapy needs to be upgraded for further treatment.
Regards
Dr Deepti Verma
OBGYN
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you for the reply.
The chemotherapist has asked us to get this treated before any further treatment by him. He'll start the chemo sessions once the infection is cured.
Can this condition be cured through medicine or surgery is the only option?
What type of doctor/surgeon should i see to get this treated?
The chemotherapist has asked us to get this treated before any further treatment by him. He'll start the chemo sessions once the infection is cured.
Can this condition be cured through medicine or surgery is the only option?
What type of doctor/surgeon should i see to get this treated?
Brief Answer:
An oncosurgeon should be consulted
Detailed Answer:
Hi dear,
This can better be assessed by an oncosurgeon for proper further treatment.
Surgery is most likely required if there is a perforation in the bowel with surrounding infection.
You should consult an oncosurgeon for proper examination and treatment accordingly.
Regards
Dr Deepti Verma
An oncosurgeon should be consulted
Detailed Answer:
Hi dear,
This can better be assessed by an oncosurgeon for proper further treatment.
Surgery is most likely required if there is a perforation in the bowel with surrounding infection.
You should consult an oncosurgeon for proper examination and treatment accordingly.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Remy Koshy
Thank you.
I will consult a oncosurgeon. Are these procedures performed by oncosurgeons or can a general surgeon also do it.
Can colonoscopy be done for further assessment of the situation given my mother has gone through debulking surgery already.
I will consult a oncosurgeon. Are these procedures performed by oncosurgeons or can a general surgeon also do it.
Can colonoscopy be done for further assessment of the situation given my mother has gone through debulking surgery already.
Brief Answer:
oncosurgeon or gastrosurgeon
Detailed Answer:
Hi dear,
An oncosurgeon or gastrosurgeon will be appropriate to assess and treat her.
Colonoscopy can be done, however the exact location of perforation is difficult to diagnosed by colonoscopy alone.
Regards
Dr Deepti Verma
oncosurgeon or gastrosurgeon
Detailed Answer:
Hi dear,
An oncosurgeon or gastrosurgeon will be appropriate to assess and treat her.
Colonoscopy can be done, however the exact location of perforation is difficult to diagnosed by colonoscopy alone.
Regards
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you.
One of the surgeon is of the opinion that it could also be due to appendicitis. Is that a reasonable assessment?
Also, the other suggestion is to do a guided CT and brain out any residue which is causing the infection. The only risk there is that the residue might be the one thing blocking the hole and removing it would warrant immediate surgery. So we are in a dilemma.
Further, clinically she is doing fine and there is no issue in passing stool and there is no fever for last 3-4 days. She is taking antibiotics suggested by the surgeon. There is also a though that given her current state and symptoms, the hole could be healing on its own. How likely is that assumption?
Please advice.
One of the surgeon is of the opinion that it could also be due to appendicitis. Is that a reasonable assessment?
Also, the other suggestion is to do a guided CT and brain out any residue which is causing the infection. The only risk there is that the residue might be the one thing blocking the hole and removing it would warrant immediate surgery. So we are in a dilemma.
Further, clinically she is doing fine and there is no issue in passing stool and there is no fever for last 3-4 days. She is taking antibiotics suggested by the surgeon. There is also a though that given her current state and symptoms, the hole could be healing on its own. How likely is that assumption?
Please advice.
Brief Answer:
Appendicitis likely
Detailed Answer:
Hi dear,
Appendicitis with surrounding infection and inflammatory reaction is a likely possibility.
Pus drainage is not a option in the case of malignancy or post malignant condition.
I will suggest you to consult her radiation oncologist whether the drug can be continued as she is having no more fever.
If not, then surgery needs to be done.
Regards
Dr Deepti Verma
Appendicitis likely
Detailed Answer:
Hi dear,
Appendicitis with surrounding infection and inflammatory reaction is a likely possibility.
Pus drainage is not a option in the case of malignancy or post malignant condition.
I will suggest you to consult her radiation oncologist whether the drug can be continued as she is having no more fever.
If not, then surgery needs to be done.
Regards
Dr Deepti Verma
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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