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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 47529
Experience:  Board Certified Physician
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Hi my dad has been noticing sum Bleeding from when he opens

Customer Question

Hi my dad has been noticing sum
Bleeding from when he opens his bowels . He does have a temp stoma but over the past week or so he can see blood when passing stools normally .
Does thise an tumor recurrence in the bowel ?
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Chip replied 3 years ago.
Hi--I need a little more information please. Are you saying he has had a partial colon removal for cancer and now has a temporary colostomy? And if so are you saying that he still has stools from his rectum?
Customer: replied 3 years ago.

as he has tumor in as ascending colon only part of right bowel

Was removed and yes has stoma for 6 months

Expert:  Dr. Chip replied 3 years ago.
And the blood is coming out of his stoma or out of his rectum Hina?
Customer: replied 3 years ago.

Rectum

Expert:  Dr. Chip replied 3 years ago.
OK Hina. No this isn't likely a sign that the tumor has come back. He could have what's called ischemic colitis--an inflammation of his descending colon--and his doctor needs to know about this and he needs a colonoscopy to look for that. There is treatment both with antibiotics and steroid enemas for this but it is a serious situation and his doctor needs to know about it right away
Expert:  Dr. David replied 3 years ago.
This is Dr. David

thank you for frequesting me.

his situation is quite complicated with his right colon surgery and his temporary ostomy

I know you were worried about his CEA levels going from 3 to 4 to 6

bleeding from his rectum could be due to many possible causes such as bleeding hemorrhoids, proctitis, colitis, bowel infection, prior surgery, anastamosis bleeding.

ischemic colitis is when the bowels are not getting enough blood flow and can cause the bowels to become inflamed and bleed. this can happen after surgery.

I don't think his bleeding is a sign of his cancer coming back.

he needs more testing like a CT scan of the abdomen and pelvis and a colonoscopy.

he still needs to undergo adjuvant chemotherapy to further reduce his risks for colon cancer coming back.

has he started 5FU or xeloda chemotherapy yet?
Customer: replied 3 years ago.

Thx

The bleeding from boweI is not daily it's only

at times n likhis the hosp was not worried .

He had completed 2 cycles of xeloda . But as he is finding the stoma very uncomfortable he's thinking stopping xeloda but of course we r trying to convince him to continue .

But as for the cea, what happens continue to rise each month?

Expert:  Dr. David replied 3 years ago.
don't worry about the cea level. they are still very low. his doctor is not worried about his CEA level either.

I hope he can continue the xeloda chemotherapy

xeloda sometimes can cause mucositis which is inflammation of the mucosa of the GI system and this could cause bleeding as well

I hope his bleeding stops.

let me know if you have other questions.

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Customer: replied 3 years ago.

Today he has been told he has bit hernia due to stoma being there .

What would you advIse? Will he need to stop xeloda or continue ?

Expert:  Dr. David replied 3 years ago.
a small hernia next to the stoma is ok if it is not trapping and encarcerating the bowel

he should be able to continue the xeloda chemotherapy .
Customer: replied 3 years ago.

Howwould we know if trapping the bowel and what symptoms would it cause ?

Expert:  Dr. David replied 3 years ago.
trapped or incarcerated bowel will cause severe amounts of pain and nausea and no bowel movements and no eating.
Customer: replied 3 years ago.

No he does

Not have any of that.

So would be best to finish xeloda off right ? When would he need a scan ?

Expert:  Dr. David replied 3 years ago.
it would be best then for him to continue the xeloda.

after he finishes the xeloda, he can get a scan

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

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Customer: replied 3 years ago.

Thx.

In your experience how long does it take for a cancer to

Spread?

Hes had surgery in march bt tumors elsewhere can form anytime right ?

Expert:  Dr. David replied 3 years ago.
yes, tumor scan form anytime

so it is very hard to predict.

he should continue on with his xeloda chemotherapy to give him his best chances for his cancer not to come back

best of luck to you and him.

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

here is my website if you need to reach me again:

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Thanks for using JustAnswers.com
Customer: replied 3 years ago.

Hi. My dad on his third cycle if xeloda today . Blood test indicated the haemaglobin levels dropped bit to before but the onco did not mention what to .

Why can this be?

Expert:  Dr. David replied 3 years ago.
most likely from the xeloda

have him eat more iron and B12 in his diet.

his blood counts should be fine.
Customer: replied 3 years ago.

Ok so not likely to be that tumor in bowel has formed agsin as initially when he was first diagnosed ,He had hidden blood in stool

Expert:  Dr. David replied 3 years ago.
no, most likely his cancer has not formed again

most likey the xeloda or is ostomy is bleeding and causing the blood

he can have more endoscopy to look at the anastamosis to check for recurrence, but it should be unlikely.
Customer: replied 3 years ago.

For mets the cea would be much higher right ? He is having a scan in 3 weeks time

Expert:  Dr. David replied 3 years ago.
yes, if he had mets, his CEA would be much higher.
Customer: replied 3 years ago.

Is cea a good measure for cancer in the lymph nodes? Would a steady ruse suggest cancer in the nodes?

Expert:  Dr. David replied 3 years ago.
you are still too focused and anxious about these CEA levels

you need to stop worrying about these CEA levels

they are very low and not worrisome.
Customer: replied 3 years ago.

Yes im just so worried . He has scan in 3 weeks so worried more .U can tell I'm worried I know . Hope scan is clear

Expert:  Dr. David replied 3 years ago.
I know you are worried

don't let your worries get out of control.
Customer: replied 3 years ago.

ThX for all ur help . I am very worried yes as I know that with dukes c the cancers spread alot.

If there was a recurrence, would cea levels still b high ?

How long would it usually take Since surgery ( which was in march ) for a recurrence or mets to occur ? Can it happen almost straight away ?

Expert:  Dr. David replied 3 years ago.
you have not accepted any of my responses so far

and so I have not received credit for helping you so far.

some colon cancers don't make CEA.

different patients have colon cancer recurrence at different times.

there are no set times
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 47529
Experience: Board Certified Physician
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Customer: replied 3 years ago.

Sorry i forgot but have done it now

Expert:  Dr. David replied 3 years ago.
thanks for the accept and bonus

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