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Oncology (General Cancer)/Post op Signet ring cell CA transverse colon with metastatic peritoneal deposits. In 19 year old


Discharge summary
Discharge summary  

Post op contrast ct
Post op contrast ct  
Dear Dr,
Shall appreciate if you would kindly give your expert opinion advice on further management and prognosis for this 19 year young man.
Brief Case History:
-          Diagnosed with Signet ring cell CA transverse colon with metastatic peritoneal deposits.
-          His colon resection has been performed on 18th October, 2015. He has 4/11 positive lymph nodes.
-          Post-op he was given 3 cycles of Chemo (Vectibix and Folfox).
-          After third cycle, he developed sub-acute intestinal obstruction on Dec 17, 2015.
-          Chemotherapy with Irenotacin 180mg injected on Jan 3, 2016. Doctor advised no further chemotherapy till obstruction is relieved.

I have also included detailed patient history along with the CT Scans and other reports with this mail.
I shall be very grateful if you could advise us as to what all options we have to get the right treatment and progress recovery.

Right now the patient is on conservative treatment with NG Tube and fluids.

Thanks and regards

I don't think much can be done for this patient, except try to keep him comfortable.  I don't think further chemotherapy under his current condition would be reasonable.  There is a slim chance that peritoneal surface therapy might be useful.  I don't know of any centers near you that do this.  This involves opening the abdomen, removing all the tumor (like ovarian cancer surgery) and then placing two tubes in the (closed) abdomen, and perfusing the abdomen with a solution of chemotherapy which has been heated to about 105 degrees farenheit).  There have been some very prolonged remissions with this approach, although it's hard to say whether any of these will translate into cures.  The place I refer patients for this treatment is Mass General, but they do it in several center in the US.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.


I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.


I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

American Society of Clinical Oncology

New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

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America's Best Physicians, last 14 years

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