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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does The Prognosis Of Colon Cancer Need A Second Opinion?

MY FATHER IS 60 YEARS WITH ADVANCED COLON CANCER. HE HAS HAD THREE SURGERIES. THE FIRST TO REMOVE HIS APPENDIX, THE SECOND TO REMOVE PART OF HIS COLON AND THE THIRD WAS A RESECTION. THE CANCER WAS DISCOVERED WITH THE AFTER THE FIRST SURGERY BUT TREATMENT WAS WITHELD FOR FOUR MONTHS UNTIL HE WAS ABLE TO GET INSURANCE. AFTER THE SECOND SURGERY HE WAS PUT ON CHEMO FOR SEVEN OR EIGHT MONTHS. HE HAS BEEN WITH A NG TUBE FOR THREE MONTHS DUE TO THE TUMORS BEING THROUGHOUT HIS INTESTINE. HE IS UNABLE TO EAT BUT IS GETTING NORISHMENT THROUGH TPN. HE HAS HAD ONLY FOUR ROUND OF CHEMO BUT THE DOCTOR STATES THAT THERE IS NO CHANGE IN HIS CONDITION. HIS DOCTOR WILL NO LONGER GIVE HIM CHEMOTHERAPY. HE HAS A FEW BOWEL MOVEMENT AND A NURSE STATED THAT SHE COULD HEAR A FEW BOWEL SOUNDS. HE THINKS THE THE BOWEL MOVEMENTS WAS ONLY SPASMS.THE STOMACH CONTENTS THAT COMES FROM HIS NG TUBE HAS DECREASED GREATLY. THE DOCTOR SUGGESTS THAT WE PUT HIM IN HOSPICE AND JUST LET THE DISEASE TAKE ITS COURSE. WE SEE SMALL CHANGES. SHOULD MY FAMILY SEEK A SECOND OPINION? HE WAS DIAGNOSED IN OCTOBER OF 2009.
posted on Fri, 14 Mar 2014
Twitter Sat, 20 Dec 2014 Answered on
Twitter Fri, 18 Sep 2015 Last reviewed on
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Oncologist, Surgical,  's  Response
With the picture you have portrayed, it is obvious that your father has stage 4 colon cancer that has reached the end of its treatment algorithm. The delay between the 1st and 2nd surgeries should not have occurred and may have been the reason behind the progression of his disease. Anyways, whats done is over. For now, there is not much that you can do actively. The disease is not resectable and he has already received 2 lines of chemotherapy. The only possible alternative left is targeted + chemotherapy if that is possible based on his condition, his disease and your affordability (it is quite expensive). That you will have to discuss with your oncologist. A 2nd opinion is otherwise not required.
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Oncologist,  Dr. Deepak Sundriyal's  Response
Greetings. I appreciate your concern. Your father is suffering from terminal event of colon cancer and at this point of time his performance status is not good. Your doctor is right in advising hospice care for him as chemotherapy wont work for him. You should now opt for hospice care and provide him all supportive ,, spiritual, and homely care.
regards
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Does The Prognosis Of Colon Cancer Need A Second Opinion?

With the picture you have portrayed, it is obvious that your father has stage 4 colon cancer that has reached the end of its treatment algorithm. The delay between the 1st and 2nd surgeries should not have occurred and may have been the reason behind the progression of his disease. Anyways, whats done is over. For now, there is not much that you can do actively. The disease is not resectable and he has already received 2 lines of chemotherapy. The only possible alternative left is targeted + chemotherapy if that is possible based on his condition, his disease and your affordability (it is quite expensive). That you will have to discuss with your oncologist. A 2nd opinion is otherwise not required.