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Colon Cancer/Sigmoid colon cancer with uncontroled metastasis with urinary bladder invasion


QUESTION: My grandfather had surgery to remove mass from sigmoid colon in 8/2013. Biopsy report like this- moderately differentiated adenocarcinoma, TNM stage- pT3N1Mx, Separate lymph nodes- no metastasis seen. After that surgery he had blood in urine. Then urinary bladder invasion was diagnosed. Then chemotherapy was started with FOLFOX. But he is 72 years old and right kidney was removed 15 years ago because of damage by stone. His left kidney has slightly enlarged. In addition he has diabetes and moderated high blood pressure. Doctor giving chemotherapy with low dose of FOLFOX, like this, 1.5 mg 5-FU (D1+D2), 100 mg oxaliplatin (D1), 150 mg lucoverin (D1+D2). Two pulses of chemotherapy have already been completed. But his condition is not improving. Still blood is going through stool and urine. Excessive blood loss is being stopped with taxanemic acid. I think such a low dose of FOLFOX is not sufficient for him. What do you think? He had to take blood for several times in last six months because of blood loss. In addition, since last month he has burning sensation in the urinary tract for all the times with stub like pain in lower abdomen and fever. Antibiotics like cefuroxime, gemifloxacine, nitrofurantoin courses have already been completed but symptoms are not removing. Still nitrofurantoin is being continued. Do we stop nitrofurantoin? I think he might encounter with UTI. How could we stop burning sensation of UT? Because of vomiting and sore in mouth he is unable to take full meal and he is becoming weak day by day. Antiemetic drug is being administered. He has some black skin rash or spots in several body parts. Is this side effects? Is the doctor prescribing performing chemotherapy with the right medication with right dose? What should be the best treatment approach? How much possibility to stop his cancer progression? How many days he cold survive? Do we contact new physician for better treatment? Please help with your suggestions.

ANSWER: Since his cancer has invaded his urine bladder it must now be considered a stage 4 (the worst) colon cancer case. Such a case is at present incurable. The only thing chemotherapy can do at best here is to temporarily relieve symptoms and prolong survival. With chemotherapy you normally have to balance between trying to harm the cancer as much as possible and not harming the patient too much. Here that situation is made even more difficult by the fact that the medical condition of the patient is such that it does not allow any stronger chemotherapy. Since I am not in charge of the patient and very far away I can not comment or direct his treatment in detail. But since you have asked I have to inform you that the prognosis of this case is very bad indeed regardless of treatment and that his condition most probably will not permit any stronger treatment which anyway in a case like this would not be of much help. I am sorry I have nothing better to tell you!

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---------- FOLLOW-UP ----------

QUESTION: Thanks for your answer. Yesterday he had to defecate 5-6 times with huge amount of fresh blood and black blood clot in stool. The amount of blood is huge than previous time. Has fever of 101 degree Celsius. Now more blood is going through stool than urine. We are administering high does of taxanemic acid. He is now so much week. What can we do to stop blood in stool? Most probably his colon cancer is spreading so quickly. Please suggest.

Honestly this is something that his surgeon has to take care of. It may be necessary to do a colostomy and thereby shut down the normal exit of stools. But this must be decided by the surgeon. Good luck!

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Colon Cancer

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Claes-Gustaf Nordquist, M.D.


I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience with regards to this cancer.


I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: I have no restrictions on the number of questions there.

I also answer questions in these categories: Oncology (General Cancer), General History, Military History, Brain Tumors, Breast Cancer.

I'm a medical doctor and a specialist in medical oncology & radiation therapy.

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