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How to manage colon cancer?

Q: My mother was diagnosed with colon cancer (grade III) two years ago. She was first given chemotherapy and then operated upon for removal of the cancer 1.5 years ago. Following this operation she had a persistent fever that did not go away. Two months later, tests revealed that there was infant recurrent growth and she was consequently operated upon for this growth removal 2 months later. This time she was fitted with a colostomy bag. After this she went through 7 cycles of chemotherapy. Eight months ago, an operation was conducted on her for the bag removal and hernia adjustment. She has had problem of frequent motions, mucus and blood in stools. Tests now revealed that there is infant recurrent growth yet again. There also seems to be cancer (secondaries apparently) in the lung. The measure this time is 5 cms in the colon and 41 mm in the lung. How long can the patient sustain with just chemo and radiotherapy? What is the prognosis? How long can the patient withstand all of this?

A:Your mother has colon cancer for which she has been operated thrice and she has had two rounds of chemotherapy. Now she has recurrence in the colon and lung again. It is evident that your mother has slowly progressive disease and that responds to chemotherapy and surgery. We have three main drugs for colon cancer - CPT 11, Oxaliplatin and 5FU/capecitabine. These are used in sequential fashion i.e., use them one after the other has failed. The drugs can be used as long as the patient is in good general condition with normal liver and kidney function tests. If the disease is localised and amenable to surgery, operation can be done. Even local radiation can be given if deemed fit by the doctor. There is no rule in the disease of cancer and if patients disease is responding, chemo drugs can be even repeated.

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