Colon tumor with metastasis

A 66 y/o male was diagnosed with a colon tumor with metastases to other body parts. Patient undergone chemotherapy but started having general weakness, vomiting, nausea, loss of appetite. CEA serum levels was reduced to 3.5 μg/l in. No change in the size of the lung metastases was seen. But we had to pause the treatment. 6 months later the CEA-values increased to 5.7 μg/l. Now what should be done?

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I personally- feel a case of Ca colon with metastasis who had undergone chemotherapy- already - don't seem to have long life .Any further chemotherapy will not affect prognosis- but may further decrease appetite, may cause jaundice, gastric, nausea vomiting and remaining quality of life will remain poor. We should allow such patients to die peacefully and give only symptomatic treatment. I always feel - all - malignancies in stage 1 and 2 should be aggressively treated . Stage 3 - should also be treated. But Stage 4 disease- we should give any therapy but supportive treatment like In obstructive jaundice- a CBD stent In Ca oesophagus- a feeding gastrostomy

Go for PET SCAN repeat CEA ANOTHER ROUND 8F chemoradiotherapy So far weakness loss of appetite to be care routinely Nausea vomiting need to check KFTS and LFTS and sr electrolytes And supplement accordingly

Thanx dr A Dutta
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ADVISABLE..... TESTS. OF.. COLON. CANCER FOR SPECIFIC. UNIQUE.. GENOMIC. BIOMARKERS AND MANAGEMENT. ACCORDINGLY ..TARGETTED. PRECISION. CANCER. MEDICINES

Rise in CEA may indicate disease progression He may need evaluation for sane by PET CT Further chemotherapy can be planned based on report

even generalised symptoms can alleviate cea levels ,hence treat the cause with iv fluids,check for electrolyte imbalance and treat it repeat Cea levels after a month

I agree with Dr Shivraj Agarwal sir but I want to add one in my opinion that he should undergo PET -CT, CEA AND CBC,

Evaluate with PRT CT Plan for chemotherapy

PET CT should be done and Routine Ix accordingly. CEA for step up Chemotherapy. Tx must be in consideration of symptoms.

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