Doctor insights on:
Hydro Colon Therapy
Is golytely (polyethylene glycol) fatal to pts with partial obstruction with colon perforation? (Stage 4 CRC with mets to lung)
No: Golytely (polyethylene glycol) is a bowel diuretic drawing fluid into the colon. If there is a patient with partial obstruction and with possible colonic performation, why would a bowel diuretic be employed that could cause a greater leak of GI fluid into the periotoneal cavaity, especially in the face of lung mets.? Laparoscopic evaluation of a possible leak may be necessary if not proven by radiologic evaluation ...Read more
Is surgery needed for spastic diverticulosis + severe narrowing of luminal + severe diverticulosis in a patiient with IBS. Colonostopy +Barium failed?
Surgery not for IBS: This may only be a partial answer to your question. Surgery is not indicated for IBS or "spastic colon". IBS is a functional disorder and cannot be cured by the knife. It must be managed in more conservative ways. Now if there is luminal narrowing of your colon, you must get seen to find out why and it is possible that surgical intervention may help depending on the etiology. ...Read more
Partially: Chemotherapy in all of its forms is only partially helpful in improving the survival of colon cancer. When there is an effective neoadjuvant response the remaining lesion can be successfully resected. complete surgical extirpation is the needed result. As immunochemo becomes more effective then the combination with surgery will even produce better results. ...Read more
Yes, absolutely: 5fu (fluorouracil) based chemotherapy is the standard chemotherapy in colon cancer. Combination of 5-FU and oxaliplatin is widely used and a standard regiment of chemotherapy in colorectal cancer. A big randoomized clinical trial in colon cancer ( mosaic study) has demonstrated the overall survival benefit of using combination of 5fu (fluorouracil)/oxaliplatin in stage iii colon cancer and limited case of stage ii disease. ...Read moreSee 1 more doctor answer
Redundant colon,candidate for elective colon resection. Linzess, miralax no help. Milk of mag or Sennokot 2-3x week helps.Use instead of surgery?
Chronic constipation: Most often, surgery is only considered as a last resort. For some people, having a bowel movement 2 to 3 times per week is normal. If you are able to achieve this using milk of magnesia, then I would not consider surgery at this time. It is always possible to have complications of surgery, and in your situation, it doesn't sound absolutely necessary. Fiber and hydration are key. Good luck. ...Read moreSee 1 more doctor answer
10cm ulcerative sigmoid bowel tumor found, disease also in s.4&5 liver plus other areas - what options pse? Aflibercept?Massive surgery, stent?
There is good chemot: There is good chemo available. It is often comined with targeted drugs like Avastin (bevacizumab) and erbitux(cetuximab)depnding on the kras mutation status of the tumor. The results of chemoa re quite good, so go for it. Aflibercept is not a particualry good drug...Certainly no better than avastin (bevacizumab). ...Read more
Can any targeted therapies or other drugs help with metastic colon cancer when Xeloda (capecitabine) n irinotecan has failed ?
Yes: Target agents that have activity either as single agent or as combination for recurrent or refractory metastatic colon cancer as a second line include: Avastin (bevacizumab) or Cetuximab/Panitumumab (if k-ras, n-ras, b-raf are wide type) or Regorafenib (inhibitor of angiogenic receptor) or aflibercept. FOLFOX may be effective too after irinotecan has failed. Clinical trials are aslo available. ...Read more
It is possible: Several factors regarding colon cancer liver metastasis predict long term survival. Where the mets present when the original tumor was discovered? How many mets are present? Is the CEA level over 200? How large are the liver mets? How many lymph nodes were positive from the colon specimen? Can all of the liver lesions be removed or ablated? Are there metastasis present elsewhere ie: the lungs. ...Read more
What would be best chemo / treatment after irinotecan n Xeloda (capecitabine) failed for colon cancer with mets?
Difficult to answer.: recommended chemotherapy regimens change regularly depending on the results of studies. Your oncologist should keep on top of those studies and will be able to recommend the next approved therapy or any experimental trials which may be available. I would talk further with your oncologist before making any plans. Good luck. ...Read more
Very good palliation: Y90 microspheres are very good at relieving pain or progression of liver metastasis from colon primaries. While this may improve survival chemotherapy addresses the disease in other parts of the body. Y90 is infused specifically into the liver and associated with good efficacy whith few side effects. ...Read moreSee 2 more doctor answers
Preparation H...: ...will neither fix rectal prolapse nor protect you against the injury caused by anti-inflammatory medications. There are several formulations of Prep H: a water-based gel, a petroleum jelly-based, or suppositories that use a base of cocoa butter. Active ingredients range from simple moisturizers with witch-hazel astringent to compounds containing phenylephrine, pramoxine, & hydrocortisone. ...Read more
Best treatment: All primary colon tumors must be resected. If localized, cure is very high. If mets already present it is still essential to remove primary since latter is polyclonal while mets to liver or lung are monoclonal and wont spread. If primary left to treat mets then new clones develop in primary and will continue spreading to new sites. Always resect the primary colon tumor with margins. ...Read more
Probably not: If these fistulas dont close on their own, they require surgery to repair. ...Read more
Some effect: Single drug chemotherapy has failed to produce significant improvement in colorectal Ca. Combination chemo as in FOLFIRI with irinotecan has added about 5 month prolongation in survival and with immunotherapy using Avastin (bevacizumab) or Erbitux an additional 2-3 months can be observed. Chemo-Immuno with a mAb targeting the immunogenic protein appears to be giving further enhancement. ...Read more
Fairly effective: Best used in the neoadjuvant setting to reduce the size of a rectosigmoid lesion to improve operability. In terms of long term survival this has not been achieved without the addition or RT. Better results can be anticipated when RT is combined with immunochemotherapy. It is also used palliatively if a large metastatic disease is present in the pelvis and the primary has already been resected. ...Read more
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Same drugs as other: Same chemotherapy drugs are used for treating both types of colon cancer. The only difference is lack of benefit from EGFR inhibitors(Cetuximab and Panitumumab). Avastin (bevacizumab) also works in both types. I trust that you know there are 3 chemo drugs that are widely used(5FU or Capecitabine, Irinotecan and Oxaliplatin) ...Read more
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