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Suggest Treatment For Colon Cancer
Question: What is the percentage of chemo working in a colon cancer pt?
Brief Answer:
Please find response percentage for oxyplatin and raltitrexed chemotherapy
Detailed Answer:
Hi XXXX,
Thanks for writing back to us.
Hope your father is doing well presently.
I have read through your query in detail.
Please find my observations below.
1. In 50 percent of colon cancer patients, even if first detected at stage 3 disease and after surgery at least half the patients will have liver metastasis and stage 4 disease is seen.
2. Your father is in among the half of patients who progressed to liver metastasis.
3. Concerning the response of oxyplatin and raltitrexed chemotherapy as second line of treatment that your father is presently getting, following percentages have been found in medical research
After 3 cycles,
(i) 17 percent patients had experienced an objective response rate
(ii) 59.6 percent patients had experienced stable disease and
(iii) 23.4 percent patients had disease progression.
After 6 cycles,
(i) 3.5 percent patients had an objective response rate,
(ii) 44.8 percent patients had stable disease and
(iii) 51.7 percent patients had disease progression.
4. After a median follow-up of 48.9 weeks, median time to progression was 18 weeks and median overall survival was 54.4 weeks.
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
Please find response percentage for oxyplatin and raltitrexed chemotherapy
Detailed Answer:
Hi XXXX,
Thanks for writing back to us.
Hope your father is doing well presently.
I have read through your query in detail.
Please find my observations below.
1. In 50 percent of colon cancer patients, even if first detected at stage 3 disease and after surgery at least half the patients will have liver metastasis and stage 4 disease is seen.
2. Your father is in among the half of patients who progressed to liver metastasis.
3. Concerning the response of oxyplatin and raltitrexed chemotherapy as second line of treatment that your father is presently getting, following percentages have been found in medical research
After 3 cycles,
(i) 17 percent patients had experienced an objective response rate
(ii) 59.6 percent patients had experienced stable disease and
(iii) 23.4 percent patients had disease progression.
After 6 cycles,
(i) 3.5 percent patients had an objective response rate,
(ii) 44.8 percent patients had stable disease and
(iii) 51.7 percent patients had disease progression.
4. After a median follow-up of 48.9 weeks, median time to progression was 18 weeks and median overall survival was 54.4 weeks.
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
It's quite positive response hey but my worry is that if it does not work is there anything else ?
Problem is he's getting very tierd and exhausted just after 1 round . Is this normal ? And appetite completly lost
Problem is he's getting very tierd and exhausted just after 1 round . Is this normal ? And appetite completly lost
Brief Answer:
Weakness after first cycle is seen in many patients
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. In understand your worry. Though most cancer cells will respond to treatment with oxaliplatin combination chemotherapy, cells resistant to this treatment are responsive to treatment with paclitaxel. However avastin is an important agent that can control the disease progession when given with oxaliplatin.
2. Regarding side effects of treatment, it was well tolerated with severe toxicities seen in only 9.8 percent patients. The most common toxicities abnormal skin sensations in 62.7 percent
diarrhea in 23.5 percent,
nausea in 41.2 percent,
vomiting in 33.3 percent,
liver toxicity in 25.5 percent,
and blood toxicity in 41.2 percent.
3. Getting tired and exhausted is normal if a large amount of cancer cells have been destroyed and are in circulation, a fact that might cause the transient rise in CEA that we discussed earlier.
4. If he is unable to take solids then protein containing fluids and juices as per his taste have to be given every 2 hours and his daily protein intake has to be increased.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Weakness after first cycle is seen in many patients
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. In understand your worry. Though most cancer cells will respond to treatment with oxaliplatin combination chemotherapy, cells resistant to this treatment are responsive to treatment with paclitaxel. However avastin is an important agent that can control the disease progession when given with oxaliplatin.
2. Regarding side effects of treatment, it was well tolerated with severe toxicities seen in only 9.8 percent patients. The most common toxicities abnormal skin sensations in 62.7 percent
diarrhea in 23.5 percent,
nausea in 41.2 percent,
vomiting in 33.3 percent,
liver toxicity in 25.5 percent,
and blood toxicity in 41.2 percent.
3. Getting tired and exhausted is normal if a large amount of cancer cells have been destroyed and are in circulation, a fact that might cause the transient rise in CEA that we discussed earlier.
4. If he is unable to take solids then protein containing fluids and juices as per his taste have to be given every 2 hours and his daily protein intake has to be increased.
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 can take solids but likes less food and craves sweet n sour stuff
So exhaustion could b due to cells gettibg destroyed ?
If a person resistance to chemo can they still get lot exhausted ?
So exhaustion could b due to cells gettibg destroyed ?
If a person resistance to chemo can they still get lot exhausted ?
Brief Answer:
Exhaustion cannot effectively predict chemotherapy resistance
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. You can give him sweet and sour foods in quantities he is comfortable in taking.
2. The cells are destroyed and start circulating in blood. This causes a condition where the patient can have weakness symptoms.
3. Resistance to chemotherapy cannot be judged based on exhaustion a patient experiences. Getting exhausted is a subjective variable and every patient taking chemotherapy gets exhausted. Some patients experience more exhaustion when a new chemotherapy is started.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Exhaustion cannot effectively predict chemotherapy resistance
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. You can give him sweet and sour foods in quantities he is comfortable in taking.
2. The cells are destroyed and start circulating in blood. This causes a condition where the patient can have weakness symptoms.
3. Resistance to chemotherapy cannot be judged based on exhaustion a patient experiences. Getting exhausted is a subjective variable and every patient taking chemotherapy gets exhausted. Some patients experience more exhaustion when a new chemotherapy is started.
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
Yea it's like more weakness but our worry is the food and weight loss
Can it be a thing called cachaxia?
Can it be a thing called cachaxia?
Brief Answer:
It is cancer cachexia
Detailed Answer:
Hi
Thanks for writing back with an update.
1. By definition, cancer cachexia describes a syndrome of progressive weight loss, anorexia, and persistent erosion of host body cell mass in response to a malignant growth. Your father might have features of cancer cachexia which have become more obvious after start of chemotherapy.
2. It is detailed that cancer cachexia is a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.
3. Though it cannot be reversed completely, attempts should be made to provide maximum nutritional support to help weight gain.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
It is cancer cachexia
Detailed Answer:
Hi
Thanks for writing back with an update.
1. By definition, cancer cachexia describes a syndrome of progressive weight loss, anorexia, and persistent erosion of host body cell mass in response to a malignant growth. Your father might have features of cancer cachexia which have become more obvious after start of chemotherapy.
2. It is detailed that cancer cachexia is a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment.
3. Though it cannot be reversed completely, attempts should be made to provide maximum nutritional support to help weight gain.
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
Should we stop the chemo then as it is quite worrying ?
As he may just not eat n continue to lose more n more weight.?
So is this condition diffetent to chemo weight lose and appetite loss ?
As he may just not eat n continue to lose more n more weight.?
So is this condition diffetent to chemo weight lose and appetite loss ?
Brief Answer:
Stop chemotherapy only if he develops toxicity else let it continue
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Stopping chemotherapy would mean pushing his health in danger. The danger situation which he is fighting. Cancer treatment is challenge and every patient should fight till the end.
2. If there is severe toxicity symptoms then chemotherapy might have to be suspended.
3. This weight loss pattern is seen in many people who take chemotherapy and it happens usually at the start of treatment. Stopping chemotherapy might cause the disease to become more aggressive. This is chemotherapy weight loss and appetite loss. Its that some medicines cause more cachexia than the rest.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Stop chemotherapy only if he develops toxicity else let it continue
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Stopping chemotherapy would mean pushing his health in danger. The danger situation which he is fighting. Cancer treatment is challenge and every patient should fight till the end.
2. If there is severe toxicity symptoms then chemotherapy might have to be suspended.
3. This weight loss pattern is seen in many people who take chemotherapy and it happens usually at the start of treatment. Stopping chemotherapy might cause the disease to become more aggressive. This is chemotherapy weight loss and appetite loss. Its that some medicines cause more cachexia than the rest.
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 so it's more chemo related ? As before that his weight was always stable and was eating okay
The main issue is appetite and hence weight loss and weakness at present . No other toxity
But I'm just worried that can this kill him if he continues chemo and still drops weight as no apetite .?
The main issue is appetite and hence weight loss and weakness at present . No other toxity
But I'm just worried that can this kill him if he continues chemo and still drops weight as no apetite .?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Since he has no toxicity that is why we can still proceed with chemotherapy to extend his survival.
2. I am sorry that I cannot assess the clinical examination online and it will help to discuss in detail with his treating oncologist and then take a clear direction on his chemotherapy.
3. The blood counts, kidney function, liver function have to be repeated regularly so that we can change course should his organs show signs of toxicity.
4. You have to treat him like a child and try to give as much nutrition possible. If he refuses to take then please wait for sometime and then give him again.
5. We must note that oxaliplatin has extended life by about 54 weeks in most of the patients when given as second line treatment. Being judgemental too soon might conflict the purpose of chemotherapy and cause harm instead.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Since he has no toxicity that is why we can still proceed with chemotherapy to extend his survival.
2. I am sorry that I cannot assess the clinical examination online and it will help to discuss in detail with his treating oncologist and then take a clear direction on his chemotherapy.
3. The blood counts, kidney function, liver function have to be repeated regularly so that we can change course should his organs show signs of toxicity.
4. You have to treat him like a child and try to give as much nutrition possible. If he refuses to take then please wait for sometime and then give him again.
5. We must note that oxaliplatin has extended life by about 54 weeks in most of the patients when given as second line treatment. Being judgemental too soon might conflict the purpose of chemotherapy and cause harm instead.
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
All organs r fine so far .
Ok yea it's worth it as extended survival is good and may be even more right in each case ?
Ok yea it's worth it as extended survival is good and may be even more right in each case ?
Brief Answer:
Please get liver, kidney and blood tests repeated every 2 to 3 weeks
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Great to know that the organs are normal in function. Please get liver, kidney and blood tests done every 2 to 3 weeks and monitor closely.
2. We surely want your father to have an extended survival and all efforts are towards this.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please get liver, kidney and blood tests repeated every 2 to 3 weeks
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. Great to know that the organs are normal in function. Please get liver, kidney and blood tests done every 2 to 3 weeks and monitor closely.
2. We surely want your father to have an extended survival and all efforts are towards this.
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
Saw oncologist today did a blood test. He said the alkaline blood test is a bit raised but others are normal ?
Brief Answer:
Alkaline phosphatase rising more than 120 U/L in 4 to 6 weeks is concerning
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
1. Good to know that other tests are normal.
2. Concerning alkaline phosphatase blood test, I know of a research in patients with metastatic colon cancer. A change in alkaline phosphatase levels of greater than 120 U/L over four-to-six weeks may be indicative of disease progression.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Alkaline phosphatase rising more than 120 U/L in 4 to 6 weeks is concerning
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
1. Good to know that other tests are normal.
2. Concerning alkaline phosphatase blood test, I know of a research in patients with metastatic colon cancer. A change in alkaline phosphatase levels of greater than 120 U/L over four-to-six weeks may be indicative of disease progression.
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
Hi the alkaline level is around 175 I think ?
Brief Answer:
Please let me know the alkaline phosphatase level during the last test
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
1. Please let me know how much was alkaline phosphatase during the last blood test and when was it done.
Regards,
Dr.Vivek
Please let me know the alkaline phosphatase level during the last test
Detailed Answer:
Hi XXXX,
Thanks for writing in with an update.
1. Please let me know how much was alkaline phosphatase during the last blood test and when was it done.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Beginning of march was 74.
Brief Answer:
His alkaline phosphatase rise is in medium range
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There is about 101 units rise in alkaline phosphatase in 6 weeks from march beginning.
2. Rise in medium range (20–119 U/L) is present. A rise of more than 120 units indicates disease progression. At medium range, the cancer progress can still be controlled by chemotherapy and the disease might get stabilized for sometime.
3. Please repeat alkaline phosphatase after 4 to 6 weeks to keep track of response.
4. Diet and supportive care must be intensified to help him regain energy and reduce weakness.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
His alkaline phosphatase rise is in medium range
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. There is about 101 units rise in alkaline phosphatase in 6 weeks from march beginning.
2. Rise in medium range (20–119 U/L) is present. A rise of more than 120 units indicates disease progression. At medium range, the cancer progress can still be controlled by chemotherapy and the disease might get stabilized for sometime.
3. Please repeat alkaline phosphatase after 4 to 6 weeks to keep track of response.
4. Diet and supportive care must be intensified to help him regain energy and reduce weakness.
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
What could have caused the rise ? Can it be the oxyplatin or likely disease progression ?
Is this worrying and means chemo
Def not working ?
Is this worrying and means chemo
Def not working ?
Brief Answer:
Chemotherapy is working
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. This means that the chemotherapy is working and the dead cells are being shed in circulation as a response to oxaliplatin and raltitrexed.
2. It is not an indicator of disease progression yet. The balance is still in favor of chemotherapy.
3. Chemotherapy is working for him.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Chemotherapy is working
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. This means that the chemotherapy is working and the dead cells are being shed in circulation as a response to oxaliplatin and raltitrexed.
2. It is not an indicator of disease progression yet. The balance is still in favor of chemotherapy.
3. Chemotherapy is working for him.
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
How we know if dead cells are being shed ?
But so far cea is rising n alkaline has increased too .
But so far cea is rising n alkaline has increased too .
Brief Answer:
Mild CEA and alkaline phosphatase rise likely signifies positive response
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The rise in CEA and alkaline phosphatase are as expected during the beginning o chemotherapy with oxaliplatin and raltitrexed.
2. It shows that there is a fight between the chemotherapy medicines and cancer cells and therefore there is destruction of cells in the liver. Now once the liver cancer cells get destroyed they have no where to go and will get shed in to the circulation. This causes a phase where there will be rise in CEA and alkaline phosphatase within the acceptable range.
3. It is confirmed that the chemotherapy is not causing any intolerance and toxicity. Therefore there is more chance of the chemotherapy to work and leading towards a positive response.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Mild CEA and alkaline phosphatase rise likely signifies positive response
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The rise in CEA and alkaline phosphatase are as expected during the beginning o chemotherapy with oxaliplatin and raltitrexed.
2. It shows that there is a fight between the chemotherapy medicines and cancer cells and therefore there is destruction of cells in the liver. Now once the liver cancer cells get destroyed they have no where to go and will get shed in to the circulation. This causes a phase where there will be rise in CEA and alkaline phosphatase within the acceptable range.
3. It is confirmed that the chemotherapy is not causing any intolerance and toxicity. Therefore there is more chance of the chemotherapy to work and leading towards a positive 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
I really really hope
So . Thanks so much for all your help in this hard time .
So the rise in alkaline is not progression then? Or could it be progression?
So . Thanks so much for all your help in this hard time .
So the rise in alkaline is not progression then? Or could it be progression?
Brief Answer:
Alkaline phosphatase presently in medium range means no disease progression
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. It is indeed a hard time for your family but we have to provide as much treatment possible and extend his survival.
2. I have worked in cancer hospitals for over 5 years and have seen patients from a close distance and am sharing my experience and knowledge to help you understand the situation and take required action.
3. I too hope that he makes a remarkable recovery from the recent weight loss and weakness with your care and support.
4. The rise in alkaline phosphatase is still in medium range and does not indicate disease progression at present.
5. You can always feel comfortable to discuss any questions coming to your mind and I will reply to the best of my knowledge and experience having worked intensively with cancer patients.
Hope your query is answered.
Do write back with your questions and doubts.
Regards,
Dr.Vivek
Alkaline phosphatase presently in medium range means no disease progression
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. It is indeed a hard time for your family but we have to provide as much treatment possible and extend his survival.
2. I have worked in cancer hospitals for over 5 years and have seen patients from a close distance and am sharing my experience and knowledge to help you understand the situation and take required action.
3. I too hope that he makes a remarkable recovery from the recent weight loss and weakness with your care and support.
4. The rise in alkaline phosphatase is still in medium range and does not indicate disease progression at present.
5. You can always feel comfortable to discuss any questions coming to your mind and I will reply to the best of my knowledge and experience having worked intensively with cancer patients.
Hope your query is answered.
Do write back with your questions and doubts.
Regards,
Dr.Vivek
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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