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Is Chemotherapy Done For Colon Cancer Part Of Pallative Care?

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Posted on Tue, 9 Dec 2014
Question: Can I please
Have advice. If chemo is offered for colon cancer , is this considered pallative ?
doctor
Answered by Dr. Luchuo Engelbert Bain (1 hour later)
Brief Answer:
Depends on the stage of spread of cancer, and health state of patients

Detailed Answer:
Hi and thanks fort he query,

It actually depends on the stage. An early detected colon cancer, which has not spread extensively would be properly treated with chemotherapy. This is called treatment and not palliative care.

Spread or metastasis to very few sites of the body, still will have positive outcomes and the patient would live longer on chemotherapy, this again is not palliative care.

Palliative care comes in at very late stages. In this advanced disease, there is multiple sites where the tumor has spread to, the patient is almost completely dependent on external help and tired, and even with chemotherapy, it is known that chances of survival are relatively low, ranging from months to a few years. These are patients generally with constant and severe pains and deserve special care usually in special cancerology/oncology centres. At stage, chemotherapy is usually accompanied with other drugs lie pain killers, Vitamins to actually support the patient. IN this case, we talk of palliative - supportive or accompanying care.

Thanks and regards as I wish you the best of health.

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (1 hour later)
I see . Well this is 1 distant lymph node
Involved . The actual bowel cancer was removed but a scan has detected a distant maligant lymph
Node . Therefore , I was wondering .i have read that a distant lymph nodes are not a good sign .
doctor
Answered by Dr. Luchuo Engelbert Bain (1 hour later)
Brief Answer:
no worries

Detailed Answer:
Hi and thanks for the follow up query,

I understand as much your worry, which of course is justified.

Its true however that distant lymph node attainment is a sign of spread. A single lymph node affected however might need a biopsy (removal for a proper analysis).

In case this was done already, chemotherapy accompanied by removal or not of the node would yield good results of taken appropriately.

The issue becomes complicated or troublesome when multiple organs (kidneys, bones etc are touched).

Regards

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (5 hours later)
No biopsy has been done yet . The node is anout 10 mm and lit up on the pet scan .

Radiologist states it's a metastases.
doctor
Answered by Dr. Luchuo Engelbert Bain (9 hours later)
Brief Answer:
True from radiology, biopsy could still be useful, prognosis good

Detailed Answer:
Hi and thanks for the update,

Sorry for the late response. It is true from radiologic studies, we could know it is metastasis. However, when it is a single site or lymph node touched, it is most of the time preferable to do a biopsy to be sure.

In my opinion, a biopsy of the lymph node could be of interest. the opinion of your oncologist/cancerologist would really count.

With proper chemotherapy, a single 10mm metastatic lymph node, if its the case should not cause panic. I think the prognosis is good, if treatment is taken properly.

Kind regards,
Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (24 minutes later)
I see.

It's a distant node
Though . Aortocaval area. .

Also with the chemo
Can more nodes , mets still
Appear ?
doctor
Answered by Dr. Luchuo Engelbert Bain (27 minutes later)
Brief Answer:
no worries, slim chances of spread

Detailed Answer:
Hi and thanks for the query,

It depends on the stage and moment at which the chemo is started. Early initiated chemo greatly reduces chances of new metastasis. Secondly, chemo at times is more effective with associated surgical removal of the tumor.

In this case, appropriate chemo shall greatly reduce probability of spreading since the primary tumor mass has been removed. Kind regards,

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (35 minutes later)
Well the primary tumor is removed from bowel in march . The worry was he starte the oral chemo
Tabs (xeloda ) late in XXXXXXX as he was undecided if wanted them . After 2 months of taking them, cea was creeping up so we demanded a scan luckily . The scans found the node met and a met on edge of liver .

So then chemo was started .

Our worry was if xeloda failed to work this chemo could fail too
Right ?

But xeloda was stopped as scans were done and started xeloda 11 weeks after the operation. Plus as they were tabs he did I must admit some
Nights forget to take them
doctor
Answered by Dr. Luchuo Engelbert Bain (10 hours later)
Brief Answer:
No worries, encourage him, compliance, positive

Detailed Answer:
Hi and thanks for the query,

It is true compliance has a big role to play when it comes to treatment success. Persons do respond differently to different medications too. It is no guarantee that because the first treatment fails that the second will fail. I really do not think the first treatment failed neither.

I however, from your case description, suggest more compliance to treatment this time around, encourage him and outcomes for sure will be better. I think far better than what you imagine.

Kind regards,

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (10 hours later)
So helpful
You have been . So could the xeloda have worked still ?
doctor
Answered by Dr. Luchuo Engelbert Bain (6 hours later)
Brief Answer:
Yes , I think so.

Detailed Answer:
Hi and thanks for the update,

I think it should have done its part. Viewing the circumstances, we cannot for sure incriminate Xeloda of not working. Compliance, though difficult with side effects of the drug at times remains capital. But psychological support and encouragement from family and loved ones is the corner stone of treatment in these situations.

Kind regards,

Dr Bain
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Luchuo Engelbert Bain (1 hour later)
I just forgot to mention that there was another liver lesion seen via pet scan. It was a new finding however there was
No fdg uptake .

Does this mean it could have been a killed met via the xeloda ?

also the uptake for the liver met is 5.2
doctor
Answered by Dr. Luchuo Engelbert Bain (55 minutes later)
Brief Answer:
More serious, more than one drug, radiotherapy

Detailed Answer:
Hi and thanks for the update,

I think with more than on site involved with the spread (metastasis), its more serious.

It might require more than one drug for the attack phase. However, Xeloda could be used alone in a higher concentration. Compliance to therapy however remains capital.

The seriousness I am afraid is more in this case. Strict compliance and keen follow up by your oncologist is fundamental.

you might discuss associating radiotherapy with your oncologist. Not all patients will do require radiotherapy.

Kind regards

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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Is Chemotherapy Done For Colon Cancer Part Of Pallative Care?

Brief Answer: Depends on the stage of spread of cancer, and health state of patients Detailed Answer: Hi and thanks fort he query, It actually depends on the stage. An early detected colon cancer, which has not spread extensively would be properly treated with chemotherapy. This is called treatment and not palliative care. Spread or metastasis to very few sites of the body, still will have positive outcomes and the patient would live longer on chemotherapy, this again is not palliative care. Palliative care comes in at very late stages. In this advanced disease, there is multiple sites where the tumor has spread to, the patient is almost completely dependent on external help and tired, and even with chemotherapy, it is known that chances of survival are relatively low, ranging from months to a few years. These are patients generally with constant and severe pains and deserve special care usually in special cancerology/oncology centres. At stage, chemotherapy is usually accompanied with other drugs lie pain killers, Vitamins to actually support the patient. IN this case, we talk of palliative - supportive or accompanying care. Thanks and regards as I wish you the best of health. Dr Bain