Howard I am posting this to alt.support.cancer. John cannot get this group
on webtv.
Thank you for responding so quickly.
BetsyB

Thank you Mr. McCollister for answering me I am a stage 4 colon cancer
patient. I was diagnosed 12/22/05 with large mucosal mass on right
ascending colon with signet ring cell mets to omentum and peritoneum.
Debulking surgery to remove the mass as well as omentum and peritoneum
was done on 12/23/05 all visible cancer was removed with clean margins,
13 of 13 lymph nodes checked positive for cancer. I have gone through
one chemo protocal last year of folfox with avastin which helped but
disease still progressed. That ended in sept 06. I was sent to baltimore
to Dr Esquivel st agnes hospital in january this year for cytoreductive
surgery with HIPEC (heated interperitoeal chemo) this procedure was not
done because when he went in laproscopcaly to look, no cancer or
implants were seen in the peritoneal cavity. This new developement has
been a complete suprise as I was fine and walking 3 miles a day just a
few weeks ago and Prior CT examination 12/14/06 showed none of this.
My primary doctor at first suggested a stint via endocopic method to
open up the blockage but for some unknown reason my oncologist told her
no.

My CEA has however continued to climb I started a second chemo protocal
of irinitican or CPT-11 every 3 weeks roughly 8 weeks ago. Prior to
getting these first two doses of irinitican or CPT-11 at the strongest
dose I was fine except for a high CEA of 215. If I'm reading this CT
scan report right (scan report posted below), the bulky adenopathy in
the porta hepatis is blocking my lymph nodes from draining. So now I've
got swollen lymph nodes all over the place. 3 weeks ago my blood tests
showed normal bilirubin, ALT & AST, only alkaline phophotase was high at
300 but that's been running high for over 6 months and had actually come
down from 400. Now the CEA is 331, bilirubin is 2.2, ALT & AST are off
the chart at 551 & 422. I'm completely jaundice,itchy all over, pee is
ice tea color, liver, stomach and back are giving me lots of pain.
Taking diluadid but not helping much. My oncologist was nice enough to
tell my primary doctor but not me that my time was short, how short he
didn't say. Dec. 06 PET scan showed some retrocrural lymph nodes lightig
up but they appeared normal on CT scan
It seems the immediate problem is this liquid edema blocking the liver
drainage. I asked why we couldn't go in and drain, remove or put in a
stint it and he said no because no surgeon would touch me with liver
numbers that high but how else can we get rid of that blockage without
going in? I'm not getting much help here. I don't know how long my liver
will continue to function at these levels and if the swelling gets any
bigger it will block it off entirely.
My oncologist thinks the answer is to change the irinitican to a lower
dose every week instead of every 3 weeks and add erbitux. He thinks that
will shrink the swelling That doesn't sound right to me. Common sense
dictates if your liver has a partial blocking of the waste exit and you
have cirrosis issues from prior chemo then pouring more toxins in
doesn't seem like a good idea to me. I've had a hard time tolerating
this CPT-11 and judging from the disease progression it isn't working in
fact it seems like the cancer likes the stuff. I've been 15 months since
surgery with no visible tumors, now after two doses of this stuff they
are popping out all over. Any ideas? What can be done to deal with this
blockage so the liver and lymph nodes can drain properly? Is there
anything that can be done or should I call the priest? I mean up until I
started this CPT-11 a few weeks I felt fine despite rising CEA and was
walking 3 miles a day with no motor problems or pain, now it sounds like
they are just writing me off.

3/21/07 CT SCAN REPORT
Findings: There is marked interval worsening in the patient's disease
burden. Most notably, there is now bulky adenopathy at the root of the
mesentery extending up into the porta hepatis and posterior to the
pancreas. There is also some adenopathy extending down the aortic chain
and into the right retrocrural area. This is all concerning for metastic
disease.
The bulky adenopathy in the porta hepatis appears to be compromising the
lymphatic drainage as there is now periportal edema, predominantly in
the left hepatic lobe. I do not see evidence of actual metastasis to the
liver, however.
There also are at least two, punctate, subcentimeter nodules idenified
in the right lung base that were not clearly present previously. This
may represent very early metastatic desease to the right lung base as
well. There is stable diverticular desease to the sigmoid colon, without
diverticulitis.
***Impression:
1. Marked interval worsening in the appearance of the abdomen and pelvis
with extensive adenopathy at the root of the mesentery, extending to the
retroperitoneum and up into the porta hepatis.
2. The adenopathy appears to be compromising the lymphatic drainage from
the liver as there is now periportal edema.
3. Punctate, subcentimeter nodules in the right lung base. These were
not present previously and are also concerning for possible early
metastatic disease.