adhesions several months after surgey and chemo?

my 78 year old mom was diagnosed with stage 4 colon cancer a year ago. after radiation, which shrunk the tumor 50%, she had part of her colon removed and several small sections of her liver frozen in february. then she went on xeloda and camptosar for 4 to 5 months....she was very nauseous every time she took the xeloda.  she went into the hosptial emergency room after several days of severe diarrhea and was diagnosed with adhesions in her intestine and had to have surgery....she spent 3 weeks total in the hospital....it was a horrifying experience...she didnt eat for a week, as the doctors thought the adhesions might cure themselves, after that they operated. they found out the adhesions were NOT caused by a new tumor....so that was a relief.

my dad fired the oncologist, saying he thinks the xeloda is what caused this...the oncologist insisted that she was given a normal dose of xeloda and the adhseions are a normal byproduct of the colon surgery and not the chemo.
our new oncologist is going to prescribe 5FU with oxaliplatin, as she also says xeloda/camptosar is a very toxic mix. going to do that and see if it stops the tumor growth/spreading....and then switch to avastin if it continues to progress.

so what caused the adhesions?....at first i thought it was a screw-up from the original colon surgery, but now im thinking my dad was right and maybe it was the xeloda/camptosar....this is all very confusing. we dont want to go thru all this again now that shes starting chemo next week....we're afraid we might lose her if this whole trauma from adhesions happens again.

many thanks.

[Dennis MD]

Hi.
Adhesions are one of the late complications of intra abdominal surgery.  The risk of having intestinal obstruction secondary to post-operative adhesions is high within the first 10 years of surgery, and then tapers off.
Bowel rest can sometimes relieve the possible partial intestinal obstruction.  This means patient is admitted in the hospital, not allowed to eat, nutrition is delivered intravenously, and tube is inserted to decompress the intestine.  If these do not help, surgery and adhesiolysis is performed.
Diarrhea is a common complication of xeloda and camptosar.  Premedications are given before the start of each chemotherapy session to try preventing this complication.  Since your mother had severe side effects with her regimen (xeloda + camptosar), shifting to another regimen (5fu + oxaliplatin) is a reasonable option.  But bear in mind that these drugs can also produce side effects.
The treatment goal of stage 4 cancer is palliation, not cure.  This means that patient’s comfort is of utmost importance.  Chemotherapy is given to control the disease, relieve the patient of any pain, and improve the overall quality of life.      
Regards