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How Effective Is Irinotecan Alone In Colon Cancer?
Question: How effective is irinotecan alone?
Brief Answer:
More side effects with irinotecan alone as compared to combination of drugs
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Its understood you are inquiring about treatment of irinotecan alone in colon cancer.
Research trials conducted show that treating with irinotecan alone causes higher incidence of alopecia (loss of hair) and diarrhoea in patients that those who are treated with combination drugs like FOLFIRI.
There is no difference in overall quality of life changes, response rate or progression free or overall-survival.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
More side effects with irinotecan alone as compared to combination of drugs
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing in to us.
I have read through your query in detail.
Its understood you are inquiring about treatment of irinotecan alone in colon cancer.
Research trials conducted show that treating with irinotecan alone causes higher incidence of alopecia (loss of hair) and diarrhoea in patients that those who are treated with combination drugs like FOLFIRI.
There is no difference in overall quality of life changes, response rate or progression free or overall-survival.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He so far is tolerating well . Has had 3 sessons so far.but my concern is the cea has
Not dropped .
He had colon surgery march n tumor
Was removed and was a dukes c1.started xeloda in XXXXXXX (bit late).xeloda
Was stopped at 4 cycle as scans needed to be done and a pet scan showed a 16 mm liver met and 1 aortocaval met.
Whilst xeloda was stopped his cea from 9.8 dropped to 8 but the cea lat week is 9. Does this mean its not working ?
Not dropped .
He had colon surgery march n tumor
Was removed and was a dukes c1.started xeloda in XXXXXXX (bit late).xeloda
Was stopped at 4 cycle as scans needed to be done and a pet scan showed a 16 mm liver met and 1 aortocaval met.
Whilst xeloda was stopped his cea from 9.8 dropped to 8 but the cea lat week is 9. Does this mean its not working ?
Brief Answer:
CEA must be compared with pre operative values but its not always reliable
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
I did some review of medical literature connecting Duke C and CEA levels. One such research done in 2008 says that "Whereas postoperative CEA elevation indicates recurrence with high probability, a normal postoperative CEA is not useful for excluding the probability of recurrence."
From this it can be seen that it is not possible to comment on recurrence even if CEA levels are normal after surgery.
Regarding your specific point about Xeloda (capecitabine) it is working but responses of chemotherapy should be focused on the liver metastasis and aortocaval node. A 16 mm liver metastasis is small and can be controlled with treatment.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
CEA must be compared with pre operative values but its not always reliable
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
I did some review of medical literature connecting Duke C and CEA levels. One such research done in 2008 says that "Whereas postoperative CEA elevation indicates recurrence with high probability, a normal postoperative CEA is not useful for excluding the probability of recurrence."
From this it can be seen that it is not possible to comment on recurrence even if CEA levels are normal after surgery.
Regarding your specific point about Xeloda (capecitabine) it is working but responses of chemotherapy should be focused on the liver metastasis and aortocaval node. A 16 mm liver metastasis is small and can be controlled with treatment.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Theres 1 liver met plus 1 aortocaval node which is 10 mm. Is the
Node more of a problem ?
The cea was 9.8 while on xeloda and then went to 8 when it stoppef but nkw its 9 again. So i was concerned about the chemo not working
Node more of a problem ?
The cea was 9.8 while on xeloda and then went to 8 when it stoppef but nkw its 9 again. So i was concerned about the chemo not working
Brief Answer:
Liver metastasis is more of a problem
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Comparing liver metastasis and aortocaval node, the liver mestastasis is more of a problem. Usually the cancer first spreads locally first then spreads to nodes and liver involvement is after nodes are seen. In this way a liver metastasis is more of a concern when treating the cancer.
The CEA levels varying from 2.8 then 8 and now at 9 is not much significant.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Liver metastasis is more of a problem
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Comparing liver metastasis and aortocaval node, the liver mestastasis is more of a problem. Usually the cancer first spreads locally first then spreads to nodes and liver involvement is after nodes are seen. In this way a liver metastasis is more of a concern when treating the cancer.
The CEA levels varying from 2.8 then 8 and now at 9 is not much significant.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry i mean was 9.8 in august but when xeloda stopped it dropped to 8 and now 9. Can the fact it not going down mean chemo not working ?
Also i find this strange , they said due to the node they can remove the liver met . Its only a single met at present . Should we seek a second opinion?
Also i find this strange , they said due to the node they can remove the liver met . Its only a single met at present . Should we seek a second opinion?
Brief Answer:
CEA is mildly fluctuating
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Chemotherapy is working for your father. CEA levels are marginally going up and down and this does not make much of a difference as it is mildly changed on the upside from august and has elevated by one unit from 8 to 9. Please do not worry.
Im sorry but I have not understood your second statement entirely. Cancer treatment isnt easy and the response usually guides further treatment. There are treatments which can be focused on the liver and at 16 mm there is a chance of good response.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
CEA is mildly fluctuating
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Chemotherapy is working for your father. CEA levels are marginally going up and down and this does not make much of a difference as it is mildly changed on the upside from august and has elevated by one unit from 8 to 9. Please do not worry.
Im sorry but I have not understood your second statement entirely. Cancer treatment isnt easy and the response usually guides further treatment. There are treatments which can be focused on the liver and at 16 mm there is a chance of good response.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok. Can he till
Have a good survival then?
But can more mets appear while still on irinotean?
Have a good survival then?
But can more mets appear while still on irinotean?
Brief Answer:
Survival in Dukes C is around 40 percent
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Survival in Dukes C is around 40 percent and I wish your father has a long survival and quick recovery.
Irinotean is an antimetabolite which controls cell multiplication and growth. More metastases appearing is a matter of luck and chance. It happens when the cancer cells start spreading in spite of being under the the control of chemotherapy
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Survival in Dukes C is around 40 percent
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Survival in Dukes C is around 40 percent and I wish your father has a long survival and quick recovery.
Irinotean is an antimetabolite which controls cell multiplication and growth. More metastases appearing is a matter of luck and chance. It happens when the cancer cells start spreading in spite of being under the the control of chemotherapy
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Can the irinotean kill the node and liver met? My worry is that it still spreads with
Chemo .
He does tend to drink alcohol, can this affect the chemo
Working?
Chemo .
He does tend to drink alcohol, can this affect the chemo
Working?
Brief Answer:
Please discuss surgical options for treating liver metastasis
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Irinotecan is a potent chemotherapeutic drug and has been effective in treatment of many colon cancers with liver metastases though the best cure is achieved by surgery of liver lesion if possible. It is difficult to predict the course of disease following irinitecan treatment.
Current literature on the matter says the following.
The survival time of patients with untreated liver metastases is less than 1 year. However, survival is longer in patients with resectable liver metastases and no extra-hepatic disease. Surgical removal of metastases is the only potentially curative therapy for these patients, and resection can provide long-term survival with reports of 4- and 5-year survival rates of ~44% and 30%, respectively . The drawback is that only ~10–20% of patients with colorectal metastases are candidates for liver resection.
I would like you to discuss surgical treatment of the liver metastasis and take a second opinion on that if required as he also has a small aortocaval node.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please discuss surgical options for treating liver metastasis
Detailed Answer:
Hi XXXXXXX XXXXXX,
Thanks for writing back with an update.
Irinotecan is a potent chemotherapeutic drug and has been effective in treatment of many colon cancers with liver metastases though the best cure is achieved by surgery of liver lesion if possible. It is difficult to predict the course of disease following irinitecan treatment.
Current literature on the matter says the following.
The survival time of patients with untreated liver metastases is less than 1 year. However, survival is longer in patients with resectable liver metastases and no extra-hepatic disease. Surgical removal of metastases is the only potentially curative therapy for these patients, and resection can provide long-term survival with reports of 4- and 5-year survival rates of ~44% and 30%, respectively . The drawback is that only ~10–20% of patients with colorectal metastases are candidates for liver resection.
I would like you to discuss surgical treatment of the liver metastasis and take a second opinion on that if required as he also has a small aortocaval node.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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