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Suggest Treatment For Fever And Bowel Inflammation After Chemotherapy
Question: Met colon cancer. Admitted hosp with fever after chemo.
Iv antibiotic started as severe bowel inflammation .
Fever still up and down at times .
But unable to eat as feels sick / nausea . Therefore lost lot weight
Bilirubin increasing
Is this last cancer stage signs ?
Iv antibiotic started as severe bowel inflammation .
Fever still up and down at times .
But unable to eat as feels sick / nausea . Therefore lost lot weight
Bilirubin increasing
Is this last cancer stage signs ?
Brief Answer:
It is possible
Detailed Answer:
hello,
If the colon cancer is metastatic to the liver and bilirubin is increasing then it may be that this is the end stage liver disease.
It is also possible that the bilirubin is increasing due to a blockage or due to infection in which case it could be treated and it may not be end stage.
The symptoms of nausea, weight loss, loss of appetite and increasing bilirubin are ominous signs and may mean that the patient is entering the final stages of this cancer.
I am very sorry that this is happening
Please let me know if you have further questions
Dr. Robinson
It is possible
Detailed Answer:
hello,
If the colon cancer is metastatic to the liver and bilirubin is increasing then it may be that this is the end stage liver disease.
It is also possible that the bilirubin is increasing due to a blockage or due to infection in which case it could be treated and it may not be end stage.
The symptoms of nausea, weight loss, loss of appetite and increasing bilirubin are ominous signs and may mean that the patient is entering the final stages of this cancer.
I am very sorry that this is happening
Please let me know if you have further questions
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Full details . Was on chemo oxyplatin
And raltitrexed .after 3 cycles fever n chills . Admitted hosp with iv antibiotics .
In hosp on it for 2 weeks now . Fever in control but the odd rise happens . Then vomitting n nausea started and not ate for 2 weeks .
Ct scan done which showed bowel inflamation . Please see report attached on this issue.
After 2 weeks still appetite issues and decree fatigue .
Bilirubin on all
3 chemo rounds was fine . When admitted to hosp was also fine . This past week it has been going up .
These were readings
12,19,12,31,51,74
Whilst in hosp
And raltitrexed .after 3 cycles fever n chills . Admitted hosp with iv antibiotics .
In hosp on it for 2 weeks now . Fever in control but the odd rise happens . Then vomitting n nausea started and not ate for 2 weeks .
Ct scan done which showed bowel inflamation . Please see report attached on this issue.
After 2 weeks still appetite issues and decree fatigue .
Bilirubin on all
3 chemo rounds was fine . When admitted to hosp was also fine . This past week it has been going up .
These were readings
12,19,12,31,51,74
Whilst in hosp
Brief Answer:
bowel inflammation
Detailed Answer:
I have reviewed the CT report. Bowel inflammation could be cause of bilirubin elevations, especiallly if there is ongoing infection. It is still possible that the liver is failing. Do you know the results of other liver tests besides the bilirubin?
Dr. Robinson
bowel inflammation
Detailed Answer:
I have reviewed the CT report. Bowel inflammation could be cause of bilirubin elevations, especiallly if there is ongoing infection. It is still possible that the liver is failing. Do you know the results of other liver tests besides the bilirubin?
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ALT 50
ALP 130
They said bowel was inflammed a lot but surely 2 weeks on antibiotic would resolve infections as blood cultures have been negative
ALP 130
They said bowel was inflammed a lot but surely 2 weeks on antibiotic would resolve infections as blood cultures have been negative
Brief Answer:
yes, infection should be resolved
Detailed Answer:
It is true that the infection should be resolved. The elevation in ALT and ALP are not extremely high but could still be a sign of liver inflammation.
Dr. Robinson
yes, infection should be resolved
Detailed Answer:
It is true that the infection should be resolved. The elevation in ALT and ALP are not extremely high but could still be a sign of liver inflammation.
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
these are good results
Detailed Answer:
Hello, It is very good that the liver mets are stable and that the CEA is dropping. This means the chemo is working and that is excellent. The elevated bilirubin must be from some blockage in the release of bile from the liver or bile ducts.
Dr. Robinson
these are good results
Detailed Answer:
Hello, It is very good that the liver mets are stable and that the CEA is dropping. This means the chemo is working and that is excellent. The elevated bilirubin must be from some blockage in the release of bile from the liver or bile ducts.
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
There was a 4 week gap before starting chemo and the dr seems to think they have grown during that time obviously .
So from march scan to may scan the largest liver met shows a 9 mm increase . It's 8
Cm plus there are another 2.
So regardless of chemo response , can they still affect liver due to sizes etc or what ?
I'm
Just confussed now as cea was decreasing too and now bilirubin going up
So from march scan to may scan the largest liver met shows a 9 mm increase . It's 8
Cm plus there are another 2.
So regardless of chemo response , can they still affect liver due to sizes etc or what ?
I'm
Just confussed now as cea was decreasing too and now bilirubin going up
Brief Answer:
it is possible
Detailed Answer:
It is a confusing situation. Any time there are large liver mets whether they are stable or not they can cause an increase in the bilirubin. However, it is not clear to me why the bilirubin has gone up so high with the cea going down and the ALT and Alk. phos. just mildly elevated. It may be that the patient needs an ultrasound of the liver or HIDA scan to check the function of the gallbladder. A PET scan of the liver is also an option.
Regrds,
Dr. Robinson
it is possible
Detailed Answer:
It is a confusing situation. Any time there are large liver mets whether they are stable or not they can cause an increase in the bilirubin. However, it is not clear to me why the bilirubin has gone up so high with the cea going down and the ALT and Alk. phos. just mildly elevated. It may be that the patient needs an ultrasound of the liver or HIDA scan to check the function of the gallbladder. A PET scan of the liver is also an option.
Regrds,
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Yest he hosp ar doing ultrasound
With liver fIlure or damage alt n alp would b elevated too ?
Alp is 135 and alt 50 which is normal range right ?
What does a cea drop after each chemo round mean ? Unless cea drop was because of something else ?
With liver fIlure or damage alt n alp would b elevated too ?
Alp is 135 and alt 50 which is normal range right ?
What does a cea drop after each chemo round mean ? Unless cea drop was because of something else ?
Brief Answer:
both are slightly elevated
Detailed Answer:
Alkaline phos. is usually less than 130 and normal ALT is usually less than 40 but this is somewhat different from lab to lab so those levels may be normal in your lab. In any case they are only mildly elevated if at all. And yes you would expect all the liver tests to be elevated if the liver were failing. CEA drops after chemo mean that it is working to decrease the tumor burden.
Regards,
Dr. Robinson
both are slightly elevated
Detailed Answer:
Alkaline phos. is usually less than 130 and normal ALT is usually less than 40 but this is somewhat different from lab to lab so those levels may be normal in your lab. In any case they are only mildly elevated if at all. And yes you would expect all the liver tests to be elevated if the liver were failing. CEA drops after chemo mean that it is working to decrease the tumor burden.
Regards,
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
possible but not that common
Detailed Answer:
It would be unlikely for bilirubin alone to increase with liver mets unless one of the mets was blocking off a channel for the flow of bile out of the liver.
Dr. Robinson
possible but not that common
Detailed Answer:
It would be unlikely for bilirubin alone to increase with liver mets unless one of the mets was blocking off a channel for the flow of bile out of the liver.
Dr. Robinson
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ultrasound done and all was fine no blockage .
So this must be end stage liver disease right ?still alt a alp are normal range
He's been on codine and antibiotics and had a blood transfusison too
We have seen the bilirubin rise only since the transfusison
So this must be end stage liver disease right ?still alt a alp are normal range
He's been on codine and antibiotics and had a blood transfusison too
We have seen the bilirubin rise only since the transfusison
Brief Answer:
it is possible
Detailed Answer:
It is possible that this indicates liver failure, yet, it is not definitely. His doctors will have to watch what the bilirubin and other liver tests do over the next few weeks
Regards
Dr. Robinson
it is possible
Detailed Answer:
It is possible that this indicates liver failure, yet, it is not definitely. His doctors will have to watch what the bilirubin and other liver tests do over the next few weeks
Regards
Dr. Robinson
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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