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Ask Dr. Chip Your Own Question
Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 31218
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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What is the prognosis after a triple bypass heart surgery

Customer Question

What is the prognosis after a triple bypass heart surgery ?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Chip replied 2 years ago.
Hi. It somewhat depends on the circumstances that required the bypass and the medical condition of the patient and their age. If you can give me that information it would help greatly. And may I ask exactly what you mean by prognosis?
Customer: replied 2 years ago.

Survival

i mean.

all

arteties were clogged and half side of heart damaged

following a heart attacK.

aged 70 and also has copd

Expert:  Dr. Chip replied 2 years ago.
OK. It's still a little difficult to give you a precise answer here but I'd say there's about a 50& chance of a five year survival. Now that's just a statistic--based on probability--and you can't apply statistics precisely to just one patient. With good follow up, a healthy diet, sticking to proper medications, exercise, etc, that statistic might be raised to a ten year survival.
Dr. Chip and 3 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

What can be done for a single liver met and node in a person with colon cancer

Expert:  Dr. Chip replied 2 years ago.
That's a separate question that you've asked another expert about. I'd be glad to give you my thoughts but first I'd ask that you rate my service to you on this page
Customer: replied 2 years ago.

there's 1 liver met at 16 mm

and 1 aortocaval node which has a met. The surgery was done march to remove bowel tumor . Was stage 3.

but a recent pet scan shows the above z

Expert:  Dr. Chip replied 2 years ago.
OK but what can I add to what the other experts have told you?
Customer: replied 2 years ago.

Do u not want to answer my question ?

Expert:  Dr. Chip replied 2 years ago.
No I do but first I need to know if there's anything you don't understand about what other experts have told you. Also--you've asked about this for quite a long time so can I at least ask what his doctors have told you about what needs to be done?
Customer: replied 2 years ago.

Ok well he has 1 liver met and 1 node . His cea is 8. Blood works good . What kind of prognosis .? Some say good spme

say not

good . im confussed .

He he has started folfiri recently, can this stop further mets?

Expert:  Dr. Chip replied 2 years ago.
But what do his actual doctors say? We can give you our opinions here but since we can't have all the information his doctors are the best source for what you'd like to know.
Customer: replied 2 years ago.

That's the prob nothing . They said wel start chemo folfiri and that's it . According to them it's a small

met . But if a node is involve that's bad right ?

Expert:  Dr. Chip replied 2 years ago.
With the node involvement it is at a higher stage to be sure. I'd say that his chances for a five year survival with the chemotherapy would be about 50$ but again I don't have all the information
Customer: replied 2 years ago.

Can they not resect both node and liver met ?

Expert:  Dr. Chip replied 2 years ago.
Yes but the damage is already done in that the cancer has spread beyond his colon.
Customer: replied 2 years ago.

Yes I agree but can the chemo kill the 2 mets?

Expert:  Dr. Chip replied 2 years ago.
Possibly--the problem with any chemotherapy is that it has the ability to shrnk mets to the point where they are no longer detectable but at that point no one can say that the cancer has been cured--only time will tell that
Customer: replied 2 years ago.

Oh I see. The SUV uptake of the liver met was 5.2 on the pet scan : is that high ?

Expert:  Dr. Chip replied 2 years ago.
Actually, no. It's an indication that the cancer there isn't very aggressive and has a better chance of responding to chemotherapy
Customer: replied 2 years ago.

Oh that's good then . That explains why the oncologist said that the uptake is not very high but as it's a new finding we say it's a met .

Expert:  Dr. Chip replied 2 years ago.
Well it is a met for sure
Customer: replied 2 years ago.

Sorry I didn't get that what u meant. ?

Customer: replied 2 years ago.

What kind of SUV uptake is considered high on a pet ?

so is 5.2 not high ? Is it becsuse it's 16 mm- is that considered small?

Expert:  Dr. Chip replied 2 years ago.
Since there was uptake it is a met. Yes it's small and greater than 13 is a high value
Customer: replied 2 years ago.

So is it good it's 5.2 ?

Expert:  Dr. Chip replied 2 years ago.
Yes--just like I said it means it isn't aggressive and is likely to respond to chemotherapy
Customer: replied 2 years ago.

So higher the uptake the more aggressive right ? His cea is 8 When last checked .

Expert:  Dr. Chip replied 2 years ago.
That's high but it just means he still has cancer in his body. And, yes the higher the SUV the more aggressive the cancer
Customer: replied 2 years ago.

Now i

dont know if u can explain this but cea in sept was 9.8 but then they stopped xeloda as they neefed to do scans . So in oct his cea became 8 and this was whilst he was not on any chemo ?

Expert:  Dr. Chip replied 2 years ago.
The CEA is just a cancer marker and if it's at all high it's just an indication that the cancer is still present. If it ever drops to normal levels that can be an indication that's there's no more cancer but only an indication, it wouldn't mean for certain there was no more cancer. And, by the way you haven't yet rated my answer about you're arm lump
Customer: replied 2 years ago.

Il do now . With 1 met at present n 1 node how many years approx can a person survive ?

Expert:  Dr. Chip replied 2 years ago.
It isn't easy to apply statistics to just one person but I'd say he has about a 50% chance of living five years
Customer: replied 2 years ago.

I see. But we not looking at something worrying like 1-2 years right ?

Expert:  Dr. Chip replied 2 years ago.
No, I don't think just one or two years
Customer: replied 2 years ago.

You have been very helpful indeed .can I just ask would chemo be best option at present over surgically removing the met in liver and may be ablating the node ?

Expert:  Dr. Chip replied 2 years ago.
I think the Folfiri is best for his case
Customer: replied 2 years ago.

Can u get further spread still while on folfiri?

Expert:  Dr. Chip replied 2 years ago.
That can be the case--albeit rare--with any chemotherapy
Customer: replied 2 years ago.

U Mean it's rare? Is folfiri good chemo ?

Expert:  Dr. Chip replied 2 years ago.
Yes it's very good and yes it is rare for a cancer to spread while someone is on it but it can happen with any chemotherapeutic drug
Customer: replied 2 years ago.

Can the met go with folfiri and morw

othwr mets appear after ?

Expert:  Dr. Chip replied 2 years ago.
Yes the met could disappear and it isn't likely that other mets would appear
Customer: replied 2 years ago.

Well that means he cpuld

have a good prognosis if the chemo works right?

Expert:  Dr. Chip replied 2 years ago.
Yes--a very good prognosis if it works
Customer: replied 2 years ago.

for

stage 4 prohnosis is poor . But is that more if disease is widespread .?

Expert:  Dr. Chip replied 2 years ago.
Well, Stage 4 is in a since widespread disease but if the cancer also involve, say, the brain or other organs besides the liver that would be a very poor prognosis. I'll be happy to answer other questions you have, but we need to open a fresh page for that using this link
http://www.justanswer.com/medical/expert-doctorchip