What Metastases Are There In Colon Cancer?

Posted on Thu, 28 May 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 28 May 2015 Answered on

Fri, 19 Jun 2015 Last reviewed on

Question : On ct reports
For metastic colon cancer , do radiologists mention each metastases?

Answered by Dr. Indranil Ghosh (15 minutes later)

Brief Answer:
depends

Detailed Answer:
If there are only a handful then yes, otherwise if there are numerous, they may not. Then they will say multiple metastases, XXXXXXX size ___

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (4 minutes later)

Please see reports I'm confused .

My dad had ct scan this week and it was compared to march and January scan . What can u make of this new scan ?
In march several
Liver mets were mentioned when this scan was done at another private hosp .

This time they mention only increase in size in 2 liber mets .

Please see all 3 reports

Answered by Dr. Indranil Ghosh (11 minutes later)

Brief Answer:
no new report uploaded

Detailed Answer:
I can see only one report, that of XXXXXXX uploaded 4 times. if you have problems in uploading, please send to YYYY@YYYY with ATTN: Dr Indranil Ghosh

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (11 minutes later)

In have attached again .
XXXXXXX report , march report and may report .

Answered by Dr. Indranil Ghosh (8 hours later)

Brief Answer:
current report not seen

Detailed Answer:
Now only march report seen uploaded 4 times. Please send to email.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

new report uploaded

Answered by Dr. Indranil Ghosh (25 minutes later)

Brief Answer:
disease progression

Detailed Answer:
Radiologist has not mentioned the size of all lesions but he must have taken the sum of sizes of all major lesions and has found that it has increased.

However it may be a good idea to have another radiologist look at it again and opine.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (2 hours later)

Thanks . Y mayb radiologist have said mixed response ?

Do U think there are any other options ?

Also march scan had several
Liver lesions but this new scan y does it only mention 2?

Answered by Dr. Indranil Ghosh (8 hours later)

Brief Answer:
yes mixed response

Detailed Answer:
But that is equivalent to progressive disease. He has mentioned that previous lesions increased. I don't think the other lesions have disappeared.

Other option is to try regorafenib.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (13 minutes later)

We have the next cea .

This is the pattern-
Before chemo-65
After round 1-80
After round 2-55
After round 3- 40

Why is cea reducing

But bilirubin seems to have gone up from 12 to 30

Answered by Dr. Indranil Ghosh (2 hours later)

Brief Answer:
seen sometimes

Detailed Answer:
Sometimes CEA reduces though disease progresses, exact reason unclear. Maybe cells lose the ability to produce CEA.

Bilirubin going up is a bad sign. I believe the units are umol/L, in that case upto 20 should be normal. He may look jaundiced when it is past 35.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indranil Ghosh (1 hour later)

Bilirubin was all fine but prob is he in hosp as had enteritis . What is this ? On antibiotic . He getting nausea , and can't eat well .

Bilirubin is fluctuating like .... 12,19,12,30all this week . What could it be ?

Answered by Dr. Indranil Ghosh (8 hours later)

Brief Answer:
infection of intestine

Detailed Answer:
This can also cause fluctuating bilirubin. Hopefully it will get controlled with antibiotics.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar