On Atorvastatn 40 Mg. Had A Right Hemicolectomy To Remove A Caecal Cancer. Blood Test Done. Any Suggestion?

Posted on Tue, 31 Jul 2012

Question: I have been on statins for many years currently Atorvastatn 40 mg with excellent results

13 months ago I had a RH hemiColectomy to remove a caecal cancer detected thru the West of Scotland Bowel Cancer screening program.

Blood tests immediately before the operation showed a figure of 13 mg/mol ? [uk standard is 10 thru 20] ; by August 2011, this figure was 20, December 2011 30 and last month XXXXXXX 18 2012 it had risen to 2012 .

Ultrasound of bilial tract shows all AOK as does liver function test Recent CT pneumo Colonoscopy - all clear

Thank you

Answered by Dr. Mayank Bhargava (1 hour later)

Hi,

Thanks for posting your query.

1) Kindly mention the name of Blood test.

2) Post-operative surveillance strategy for colon cancer is :
a) History & Physical examination: every 3 months for 2 years and every 6
months for 3 year (National Comprehensive cancer network), every 3-6
months for 3 years then annually (American society of clinical oncology).
b) CEA test: every 3 months for 2 years and every 6 months for 3 year (National
Comprehensive cancer network).
c) Colonoscopy: After 1 year of surgery, then every 1 year if abnormal/ every 3
years if no polyp was found.

3) You should go for CEA test (if not performed yet) & Positron emmision test (PET) if you are in doubt regarding lung spots.

4) PET shows presence of any metastasis arising from previous site, whether present in liver/ lung/ vertebrae/ local, not detectable with CT/ MRI scan. PET also show whether lung spots are metastasis or pleural thickening/ adenoma, a benign lung lesion.(Tadataka Yamada, textbook of gastroenterology, 5th edition page 1689).

5) Raised level of CEA show recurrence of disease and close scrutiny of primary and metastatic disease.

Hope this will solve your query and put your question if you have.

Best regards,

Dr. Mayank Bhargava

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mayank Bhargava (22 hours later)

Many thanks for your comprehensive response and I answer as follows :-

1. The bilirubin results are in a group of tests called LFTS which list ALT, Gamma-GT, Alkaline Phosphatase, Total Bilirubin and Albumin. All results are in the normal range except Bilirubin at 37 umol/L with normal range being 0-20

2. b What is CEA ?

4. Not sure where or even if there is PET scanner in Glasgow

Many thanks

Answered by Dr. Mayank Bhargava (1 hour later)

Hi,

Thanks for sharing your details.

Raised bilirubin with past history of colon cancer indicates involvement of liver.

You should go for PET scan for detection of undiagnosed & hidden metastasis.

CEA is Carcinoembryonic antigen, an antigen specific for colon cancer and a test used for recurrence / spread of colon cancer in future.

Post your query if you have.

Best regards,

Dr. Mayank Bhargava

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar