This is Dr. David
I am an oncologist
what questions do you have?
Hi I wanted to ask ur advice . My dad us reallystruggling with the stoma bag. He has a rash near the surrounding area which is very painful, itchy and burns .Plus has hernia . They say if gets bigger it can b dangerous and then hard to operate . He's on third cycle of xeloda . Is there any way the reversal can be done n thereafterhere continue the xeloda ?
he could have a fungal infection around his stoma bag.
it sounds like his skin might be breaking down around his stoma bag as well.
his doctors and surgeons should be talking to each other about a plan to fix his stoma
and he might need a break from his xeloda chemotherapy.
Lots of ointments have been tried but still no good plus the hernia a
so hopefully he can get his ostomy reversed soon.
they did the ostomy as a temporary ostomy to allow his bowel anastamosis to heal.
usually that can take 3-6 months to heal depending on his healing abilities.
his doctors don't want his anastamosis to leak when his ostomy is reversed.
Yes exactly they only did it temporarily .
So can he have the reversal n then start the rest of chemo . Has 3 cycles to go
yes, the worry is if his anastamosis has had enough time to heal.
How can we know if it's healed? Surgery was in march ?
usually it takes 3-6 months to heal
his doctors can do a barium contrast study
like a barium enema study to see if they can see the anastamosis
and see if there is any leaking.
and if there is no leaking, it could be healed up by now.
Then could he continue chemo after ?
yes, then he could continue on with xeloda chemo after his ostomy is reversed.
let me know if you have other questions.
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It's just that the dr say he must stop chemo before reversal ? Why is that ?
so his immune system is not down and doesn't complicate the small surgery to reverse his ostomy.
do you have any other questions?
he has a scan in 2 weeks as we were worried Re his cea .is it notnsl
don't worry about his CEA.
his CEA of 6 is fine.
I am not worried.
I know I trust ur opinion alot but y from may to July Would it double from 3 to 6?
these levels are still very low.
any inflammation can cause that CEA level up to 6.
without cancer in you and me, we could get CEA blood level of 6 very easily.
CEA is not a very good blood test.
it has never been shown to be a good way to detect early cancer for screening.
Ok. I suppose the double increase got me frightened from 3-6 ESP as he had colon cancer surgery .so these figures would not suggest mets in the body. ?
no, I have told you before they are not a sign of metastasis in the body.
these levels are still too low.
I have told you this before.
Could xeloda cause it?
xeloda can cause some inflammation in the body as well.
With cea rise and blood in stool we r panicking ?
talk to his doctors
his doctor will also tell you not to panic.
As he had surgey In march I suppose it would b too soon for mets to show up on scan right ?
most likely his scan will not show mets.
his surgery did not show any spread to lymph nodes, correct?
It showed lymph nodes . 22 were removed and 10 bear the tumor site had cells in them but no other spread
I remember now.
What do you think of that ?
that is fine
he should be getting chemo.
hopefully he won't have mets on his next scan.
Yes he's on third cycle . Last q.Can inflammation on skin cause cea rise?
yes, inflammation on the skin, or a hernia or bowel inflammation can all cause CEA to rise.
let me know if you have other questions
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Thx so much .
Can blood in the stool mean hernia is causing obstruction. ?
Can hernia b serious ?
How can they find if trapping bowel ?
Im surprised the onco is not doing any tests to find this out.
Bur as he bleeding with stools could this mean re growth of tumor in bowel ?
With his hernia too is or better he gets this sorted and the reversal ?
Will him starting chemo after reversal put him at a disadvantage ?
And lastly how long does he have to stop chemo
For before the reversal ?
Thx. due to bleeding And steady cea rise could this suggest regrowth of the same tumor ?
Ok he has not had a cea done this month yet but say it rose again to 8/9 - would this mean something is not right as it keeps going up and up ?
With low cea levels can u still have mets?'
I get worried as when I read up it says smokers cea is up to 5 and non smokers 1-3. That's y I think why my dads rising from 3,4 and then 6.
The last scan done was in February which did not show .6 months has passed so next scan in 2 weeks .
Although on the net it says up to 5 for smokers , the fact he is above 5, does it indicate something abnornal going on in body ?
Ok . Thanks so much really appreciate it
Excellent service. We received a letter from the oncologist today following his meeting stating that cea is just above normal and a scan will be done to
Check for a relapse ? Does this mean
He's suspecting a recurrence ?
I wanted to ask that if there were mets in liver /lungs would any other blood tests be Abnormal?
Ok . I suppose even if cT in march was fine , things could have spread after right and may show this time ?
I had a look at the colom
Club forum whuch got me worried as ppl
With cea rises of 5,6 etc had liver mets.