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Suggest Treatment For Difficulty Eating In A Person With Metastatic Colon Cancer
Question: Please advise needed . Had 3 chemo rounds for metastic colon cancer. In hospital on iv antibiotic as bowel thickening / inflammation seen. Also on fluids . Fever and pain gone now but unable to eat .
Not eaten 2 week and we are so worried. Why could he not be eating ?
Not eaten 2 week and we are so worried. Why could he not be eating ?
Brief Answer:
Bowels obstruction can be the reason.
Detailed Answer:
Hello!
Thank you for the query.
Can you please give some more information:
1. Where was the main tumor located and when was the surgery done?
2. Can you please paste a pathologist report from the removed tumor?
3. Where are the metastases located?
4. Do you have bloating, cramps and vomiting?
Most probable reason of such symptoms is bowels obstruction. It can be caused by intestine junction or tumor regrow/recur. Bloating, nausea, vomiting are typical signs of such obstruction as well as lack of stool and gas.
Hope this will help.
Regards.
Bowels obstruction can be the reason.
Detailed Answer:
Hello!
Thank you for the query.
Can you please give some more information:
1. Where was the main tumor located and when was the surgery done?
2. Can you please paste a pathologist report from the removed tumor?
3. Where are the metastases located?
4. Do you have bloating, cramps and vomiting?
Most probable reason of such symptoms is bowels obstruction. It can be caused by intestine junction or tumor regrow/recur. Bloating, nausea, vomiting are typical signs of such obstruction as well as lack of stool and gas.
Hope this will help.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok. I spke to you before . Bowel surgery march 2014 abs tumor removed successfully .
Then mets appeared . Irinotecan failed , liver mets and peritoneal mets . Started oxyplatin and raltitrexed . After 3 rounds :
Fever
Pain around tummy area
Admitted hospital . Ct scan shows whole bowel inflammed .2nd ct shows a slight blockage which they are suggesting a ng tube.
Now fever And pain gone . 2 weeks still cannot eAt, no appetite , feels gassy and like sick .
I attach the report re bowel finding .
Il then discuss the canxer issue .
Then mets appeared . Irinotecan failed , liver mets and peritoneal mets . Started oxyplatin and raltitrexed . After 3 rounds :
Fever
Pain around tummy area
Admitted hospital . Ct scan shows whole bowel inflammed .2nd ct shows a slight blockage which they are suggesting a ng tube.
Now fever And pain gone . 2 weeks still cannot eAt, no appetite , feels gassy and like sick .
I attach the report re bowel finding .
Il then discuss the canxer issue .
Brief Answer:
Try Megace.
Detailed Answer:
The point is to determine either there is an obstruction or you do not have an appetite due to chemo treatment.
Obstruction gives bloating, cramps, nausea and vomiting. If it was inflammation related (CT is not the best way to determine it, colonoscopy would be much better) could go away right now.
NG tube is only a temporal solution.
If you do not have symptoms right now apart from lack of appetite and being sickness, please start Megace treatment (this will stimulate the appetite for sure).
If you have no stool and no gas, go for colonoscopy to see what is going on inside the large intestine.
Try Megace.
Detailed Answer:
The point is to determine either there is an obstruction or you do not have an appetite due to chemo treatment.
Obstruction gives bloating, cramps, nausea and vomiting. If it was inflammation related (CT is not the best way to determine it, colonoscopy would be much better) could go away right now.
NG tube is only a temporal solution.
If you do not have symptoms right now apart from lack of appetite and being sickness, please start Megace treatment (this will stimulate the appetite for sure).
If you have no stool and no gas, go for colonoscopy to see what is going on inside the large intestine.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok thx . Ct scan showed severe inflammtion on whole colon .
2nd ct showed slight blockage only .
Fever and pain ok but a lot of has, nausea and no appetite . And weakness As not eaten 2 weeks .
Is it not dangerous for him having no food ?
I attach the report re bowel issue .
He's been on iv antibiotic 2 weeks now
2nd ct showed slight blockage only .
Fever and pain ok but a lot of has, nausea and no appetite . And weakness As not eaten 2 weeks .
Is it not dangerous for him having no food ?
I attach the report re bowel issue .
He's been on iv antibiotic 2 weeks now
Brief Answer:
Bowels obstruction may need surgery.
Detailed Answer:
Well, if he gets intravenous nutrition, he may not eat and it wont affect him. However if he does not eat and do not get anything through veins, this is dangerous.
Gas and nausea can be a sign of an obstruction. I would force the doctors to make a colonoscopy and determine the reason. He may need another surgery to bypass narrow area or to create a stoma.
Infection seems to not be the case.
Bowels obstruction may need surgery.
Detailed Answer:
Well, if he gets intravenous nutrition, he may not eat and it wont affect him. However if he does not eat and do not get anything through veins, this is dangerous.
Gas and nausea can be a sign of an obstruction. I would force the doctors to make a colonoscopy and determine the reason. He may need another surgery to bypass narrow area or to create a stoma.
Infection seems to not be the case.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
He has stoma from surgery last year
He only getting iv fluid via iv no food nutrition . U think he needs TPN?
Can this appetite issue and nausea and has be cancer related . Eg signs of cancer getting bad ? We keep thinking that ?
Does whole bowl inflammation mean colitis ? As that's what they are saying
He only getting iv fluid via iv no food nutrition . U think he needs TPN?
Can this appetite issue and nausea and has be cancer related . Eg signs of cancer getting bad ? We keep thinking that ?
Does whole bowl inflammation mean colitis ? As that's what they are saying
Brief Answer:
He needs TPN for sure.
Detailed Answer:
Yes, he needs TPN for sure. Without it, he has no strength to fight inflammation and infection. Otherwise he will have metabolic issues which can cause the worst.
His symptom can be caused by cancer recurrence or metastases indeed. You XXXXXXX answered my question about the tumor location and no pathologist result available so its hard to answer this question.
He didnt have colonoscopy. So we really do not know what exactly does he have. Inflammation is only a suspicion seen in the CT. Colitis is a synonymous of large intestine inflammation. But the reason of it remains unknown.
He needs TPN for sure.
Detailed Answer:
Yes, he needs TPN for sure. Without it, he has no strength to fight inflammation and infection. Otherwise he will have metabolic issues which can cause the worst.
His symptom can be caused by cancer recurrence or metastases indeed. You XXXXXXX answered my question about the tumor location and no pathologist result available so its hard to answer this question.
He didnt have colonoscopy. So we really do not know what exactly does he have. Inflammation is only a suspicion seen in the CT. Colitis is a synonymous of large intestine inflammation. But the reason of it remains unknown.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok had bowel
Tumor in 2014 and that was operated in march 2014 . Then developed mets . Has liver and peritoneal mets . No mets in colon .
After 3 rounds of another chemo . Cea was dropping as : 80, 55, 40.
Scan shows 4 small
Liver mets gone , only 3 larger liver ones there and 1 peritoneal
Nodule gone and now 3 left at 2 cm each .
So chemo
Showed improvement but this now is the issue .
Right so tpn is key here right ?
They wanted to do that this week and my dad said no . We should go with that yea ?
Cuz without food he has weakness .
They sais both large and small bowel
Inflammed . Can u please check report I sent re the vowel issue
Tumor in 2014 and that was operated in march 2014 . Then developed mets . Has liver and peritoneal mets . No mets in colon .
After 3 rounds of another chemo . Cea was dropping as : 80, 55, 40.
Scan shows 4 small
Liver mets gone , only 3 larger liver ones there and 1 peritoneal
Nodule gone and now 3 left at 2 cm each .
So chemo
Showed improvement but this now is the issue .
Right so tpn is key here right ?
They wanted to do that this week and my dad said no . We should go with that yea ?
Cuz without food he has weakness .
They sais both large and small bowel
Inflammed . Can u please check report I sent re the vowel issue
Brief Answer:
TPN is the key.
Detailed Answer:
Yes, he needs TPN for sure. Otherwise he will simply die from hunger. This is the most important right now.
Like I have mentioned before, bowels inflammation is only a suspicion seen in the CT. What is really happening can be checked via colonoscopy. Obstruction needs to be ruled out.
Either there is no obstruction or there is an obstruction and they decided not to do anything with it as his condition is not good right now.
TPN is the key.
Detailed Answer:
Yes, he needs TPN for sure. Otherwise he will simply die from hunger. This is the most important right now.
Like I have mentioned before, bowels inflammation is only a suspicion seen in the CT. What is really happening can be checked via colonoscopy. Obstruction needs to be ruled out.
Either there is no obstruction or there is an obstruction and they decided not to do anything with it as his condition is not good right now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi we spoke to dr today and there is a very very slight obstruction Apparantly and also they say his clinical signs how no obstruction.
Th have put a ng tube in today . Duno if that will
Help .
Main worry is the food. Will he be able
To eat again ?
The small
And large bowel is inflammed on the ct. So can all this cause not wanting to eat ?
What will the tpn do?
Th have put a ng tube in today . Duno if that will
Help .
Main worry is the food. Will he be able
To eat again ?
The small
And large bowel is inflammed on the ct. So can all this cause not wanting to eat ?
What will the tpn do?
Brief Answer:
Obstruction signs appear when a person eats.
Detailed Answer:
Well, he has no signs of obstruction because he does not eat and has a tube in the stomach. Obstruction appears when a patients eats.
I am not sure if he will be able to eat again. It is very probable that he may not eat again.
Bowels inflammation can be the reason of lack of appetite.
TPN is a full nutrition delivered without intestines. In simple words, patient can live on it without intestines.
Obstruction signs appear when a person eats.
Detailed Answer:
Well, he has no signs of obstruction because he does not eat and has a tube in the stomach. Obstruction appears when a patients eats.
I am not sure if he will be able to eat again. It is very probable that he may not eat again.
Bowels inflammation can be the reason of lack of appetite.
TPN is a full nutrition delivered without intestines. In simple words, patient can live on it without intestines.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What can be done for appetite , that our main worry now ?
The large and small bowel is inflammed so they called in entercolitis . Y would this cause lack of appetite ?
How long can tpn be given ?
The large and small bowel is inflammed so they called in entercolitis . Y would this cause lack of appetite ?
How long can tpn be given ?
Brief Answer:
Try Megace.
Detailed Answer:
Megace should be tried for appetite.
Yes, bowel inflammation can be the reason of appetite loss.
TPN can be given lifelong.
Try Megace.
Detailed Answer:
Megace should be tried for appetite.
Yes, bowel inflammation can be the reason of appetite loss.
TPN can be given lifelong.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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