Brief Answer:
Alternative combination of chemo and/or SIRT in selected patients.

Detailed Answer:
Hello and Welcome

I appreciate your concern

Metastatic colon cancer i.e stage 4 cancer has a prognosis that is poor irrespective of type with very low survival rates.

There are around 9 to 10 drugs that have been approved for treatment in metastatic colon cancer. If one combination does not work then another can be tried. Selective internal radiation therapy (SIRT) is an option that can be used in selected cases alone or in combination with the chemo. Prognosis still remains poor despite of this treatment i.e survival span of up to 6 months can be achieved at maximum. The combination chemotherapy has their own side effects and many a times patients are advised or given the option to not take any drugs if tolerance to the drugs is poor and quality of life is further affected.

I am sorry for your distress but this is the bitter truth associated with colon cancer at this stage.

Let me know if you have any query.

I will be more than happy to assist you.

Wishing you best of health

Thanks

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=68107

Dr. M.S. Khalil

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Brief Answer:
explained

Detailed Answer:
Hello again, sir.

Based on your description it appears to be chemotherapy resistance. You have two options. Either to continue chemo with a different combination or if the tolerance is low , you can discontinue the chemo.

Oxaliplatin with fluorouracil and leucovorin i.e FOLFOX is one such option for metastatic colon cancer.

The decision to continue chemotherapy with a different combination should include your expert oncologist to give you the options based on your individual case.

Let me know if you have any query.

Wishing you best of health

Thanks

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Brief Answer:
Yes enteritis is associated with these symptoms

Detailed Answer:
Hello.

Enteritis could have been precipitated by chemotherapy or the radiation if he has had any. Enteritis is the inflammation of the small intestine. The inflammation may also include the stomach and large intestine. Most commonly enteritis has an infectious cause including viral or bacterial enteritis but based on the history of the patient, chemo induced enteritis is also a possibility. Yes, it does explain the symptoms you listed. Antibiotics should be given in either case to be on the safe side especially with the added immune suppression. Fluid replacement should also be done with isotonic fluids to counter any associated dehydration.

Let me know if you have any query.

Wishing you best of health

Thanks

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Brief Answer:
Ondansetron, hepatotoxicity

Detailed Answer:
Hello.

Ondansetron can be given at regular intervals for the nausea associated with chemotherapy.

The bilirubin levels you describe show the liver being affected as many of the chemotherapeutic agents are hepatotoxic and can damage the liver.


Let me know if you have any query.

Wishing you best of health

Thanks

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Brief Answer:
Explained

Detailed Answer:
Hello.

Yes, it appears to be liver failure. Though Albumin levels, Pro thrombin levels and clinical evidence of encephalopathy also needs to be taken into consideration.


" But with this enteritis how can he feel
This much nausea plus can't eat and fever on and off "

For the second part of your question I think you mean that nausea should not occur with enteritis. On the contrary , nausea can occur with both the enteritis and chemotherapy. Kindly elaborate this point if this was not the explanation.

Bilirubin fluctuation is perhaps due to the fluid replacement that may result in temporary dilution of the levels.

Let me know if you have any query.

Wishing you best of health

Thanks

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Brief Answer:
explained

Detailed Answer:
Hello.

It is a failing liver but as mentioned in my previous reply other perimeters have also got to be deranged to be more certain about the diagnosis.

Enteritis can cause appetite loss, fever and nausea. But the nausea and appetite loss are most likely secondary to the chemo.


Let me know if you have any query.

Wishing you best of health

Thanks

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Brief Answer:
explained

Detailed Answer:
Hello.

1) PRO THROMBIN
2) ALBUMIN
3) CLINICAL EVIDENCE OF ENCEPHALOPATHY
4) BILIRUBIN


Let me know if you have any query.

Wishing you best of health

Thanks

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