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Is Folfiri Chemotherapy Effective For Treatment Of Bowel Cancer?
Question: Is it worth taking the chemo , folfiri, for bowel cancer ? Them primary tumor is removed but recently a liver met and node met was seen .
Initially he had xeloda for 4 cycles before this was detected , would this mean xeloda was ineffective ?
Initially he had xeloda for 4 cycles before this was detected , would this mean xeloda was ineffective ?
Brief Answer:
FOLFIRI is the treatment of choice
Detailed Answer:
Hi
Since the bowel cancer has now spread to liver and node FOLFIRI chemotherapy is the treatment of choice now.
Treatment with FOLFIRI will increase overall survival by 2 years.
Xeloda treatment was ineffective and after he was treated by 4 cycles the tumour still progressed and spread to his liver and nodes.
Side effects of FOLFIRI chemotherapy is diarrhea and anaemia.
Regards
DR DE
FOLFIRI is the treatment of choice
Detailed Answer:
Hi
Since the bowel cancer has now spread to liver and node FOLFIRI chemotherapy is the treatment of choice now.
Treatment with FOLFIRI will increase overall survival by 2 years.
Xeloda treatment was ineffective and after he was treated by 4 cycles the tumour still progressed and spread to his liver and nodes.
Side effects of FOLFIRI chemotherapy is diarrhea and anaemia.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi, I have provided some attachments. Please review them.
Brief Answer:
The tumour has spread to other regions
Detailed Answer:
Hi
I have gone through the report.
The bowel cancer has now spread to the liver and aortocaval nodes and are new findings meaning that the disease has now progressed.
Palliative second line chemotherapy with FOLFIRI should be started immediately to prevent the tumour spreading to more regions.
He has to take minimum 6 cycles of FOLFIRI chemotherapy at 14 days interval followed by a PET scan to see whether the tumour has been controlled and it has not spread to further regions.
If after 6 cycles disease is controlled then he will need further 6 cycles follwed by another PET scan.
If the disease remains under control after 12 cycles then 3 monthly follow up with PET scan is necessary.
If the disease progresses then third line chemotherapy needs to be planned.
Regards
DR DE
The tumour has spread to other regions
Detailed Answer:
Hi
I have gone through the report.
The bowel cancer has now spread to the liver and aortocaval nodes and are new findings meaning that the disease has now progressed.
Palliative second line chemotherapy with FOLFIRI should be started immediately to prevent the tumour spreading to more regions.
He has to take minimum 6 cycles of FOLFIRI chemotherapy at 14 days interval followed by a PET scan to see whether the tumour has been controlled and it has not spread to further regions.
If after 6 cycles disease is controlled then he will need further 6 cycles follwed by another PET scan.
If the disease remains under control after 12 cycles then 3 monthly follow up with PET scan is necessary.
If the disease progresses then third line chemotherapy needs to be planned.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Raju A.T
What I don't get is that with 1 node
And 1 met can nothing other be done ?
Eg resection or ablation ?
Is prognosis better with small
Volume ?
And 1 met can nothing other be done ?
Eg resection or ablation ?
Is prognosis better with small
Volume ?
Brief Answer:
resection after chemotherapy.
Detailed Answer:
Hi
Folfiri chemotherapy will help in reducing the size of the tumour that has spread to his liver and in turn help in resection.
As tumour volume is small, prognosis is better and after resection he will be able to live more than 5 years.
Regards
Dr de
resection after chemotherapy.
Detailed Answer:
Hi
Folfiri chemotherapy will help in reducing the size of the tumour that has spread to his liver and in turn help in resection.
As tumour volume is small, prognosis is better and after resection he will be able to live more than 5 years.
Regards
Dr de
Above answer was peer-reviewed by :
Dr. Shanthi.E
But the met in liver is only 16 mm is that not small enough. ?
They says due to node involved . There prob is cells floating about so need to target them.
Can resection not be done despite the node?
They says due to node involved . There prob is cells floating about so need to target them.
Can resection not be done despite the node?
Brief Answer:
less than 10 mm
Detailed Answer:
Hi
The metastasis in liver has to reduce to less than 10 mm for the resection to take place.
The node is also involved.
Chemotherapy will help in reduction of the size of metastasis in liver and also abolish the tumour that has spread to the nodes.
Once the liver metastasis becomes less than 10 mm it can be easily removed by resection.
Regards
Dr de
less than 10 mm
Detailed Answer:
Hi
The metastasis in liver has to reduce to less than 10 mm for the resection to take place.
The node is also involved.
Chemotherapy will help in reduction of the size of metastasis in liver and also abolish the tumour that has spread to the nodes.
Once the liver metastasis becomes less than 10 mm it can be easily removed by resection.
Regards
Dr de
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Oh ok I see . So best to get the met removed then ? Would the chemo
Completely abolish the liver met ?
Also could
More mets still
Appear while he is having folfiri or the met bad node grow more ?
Completely abolish the liver met ?
Also could
More mets still
Appear while he is having folfiri or the met bad node grow more ?
Brief Answer:
Size reduction or abolition of mets
Detailed Answer:
Hi
Yes the chemotherapy will reduce the mets size or it may abolish the mets totally.
Once FOLFIRI chemotherapy is started more mets will not appear and the existing mets will be reduced in size so that it can become resectable.
Regards
DR DE
Size reduction or abolition of mets
Detailed Answer:
Hi
Yes the chemotherapy will reduce the mets size or it may abolish the mets totally.
Once FOLFIRI chemotherapy is started more mets will not appear and the existing mets will be reduced in size so that it can become resectable.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Ok. I feel better bit now . I thought for these 2 mets survival may be around 12-24 months ?
Brief Answer:
More than 5 years
Detailed Answer:
Hi
If the mets can be resected then survival will be more than 5 years.
90% of patients respond to FOLFIRI chemotherapy.
Regards
DR DE
More than 5 years
Detailed Answer:
Hi
If the mets can be resected then survival will be more than 5 years.
90% of patients respond to FOLFIRI chemotherapy.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
What if
The mets get small with chemo but not resected yet for some or just ablated ? What prognosis then approx?
The mets get small with chemo but not resected yet for some or just ablated ? What prognosis then approx?
Brief Answer:
around 2 years
Detailed Answer:
Hi
If the mets get small with chemo and not resected but just ablated then average survival time will be around 2 years.
Regards
DR DE
around 2 years
Detailed Answer:
Hi
If the mets get small with chemo and not resected but just ablated then average survival time will be around 2 years.
Regards
DR DE
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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