continual vommiting

[John B.]

To give you a little background, My father is 79 was diagnosed with prostate cancer since 1990. He found this out on his own by doing the new urine test with a piece of paper. Unfotunatley, hsi doctor thoughtout the 1980's never did a digital rectal exam. The reason the doctor gave for not doing one was that since my father had treatmentin the late 1970's for benign prostate enlargemnet, the chances of getting prostate cancer was very small(this obviously is not true.) Sicne his cancer was the two stage level, the recomended treatment was nutrone beam radiation for about a five week period. this treament was somewath sucessful for the cancer, which temporarialy took care of the cancer and dropped his PSA back down. In about 1995 the PSA was going up again and the treament was shiftedt to hormaonal therapy.  The problem was that duing that radiation period his intestines suffered damaged. Due to continual digestion problems in the lower intestinal region,in the spring of 2001, my father had a colostomy and a urostomy(he wears a bag for the fecis and one for the urine). This helped a great deal and he could eat and was getting strong again, however in spring of 2002 he had to have an emergency endo-rectal-fistiotomy. Not sure what the surgen did, but he said that my father had a lot of scaring in the intesines and did what he what he could to keep everything were it should be. My father did well after the surgury and by the fall of 2002 was getting stong again(although only 125 pounds)and by inter was back to his old self. Then in the early summer he started to get nausea and vomitting but usually only for day or two and then he would be better. However in July and August it seemed that he was getting sicker more often and losing his appetite and strength.  The gastro doctor blamed it on the cancer coming back in his body, which to my dad was a virtual death sentence. Dad wertn to see a wll regarded  oncologist that specializes in prostate cancer and he said that the cancer was not causing his problems with the vomiting; that it was stomach/instestinal related problem. That was great news to my dad but that night he vomited then the next too. We took him back to the hospital and said it not the cance it somehting ewla try and find out what it is. They ran tests on him and nothing is conclusive except that his stomach looked clear. Now they are focused on the intestinal area for a blockage, a twisted or kinked intestine or a narrowing of some kind. They are reluctant to do surgeryt becasue they don't know what they would be looking for. They won't put him on a high calorie IV becaue they say it make a bigger hole in him and he could get an infection. He is slowly starving to death and there doesn't seem to be much we can do. Can you help us?

[Kevin Pho, MD]

Surgeon has kindly addressed this question in his comments below and I agree with his assessment.

If an upper endoscopy or gastric emptying scan hasn't been performed yet, this would be another test to consider.  However, I would consider these tests after the CT scan that was suggested below.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

It sounds like a very difficult situation. I assume he's had a CT scan of his abdomen with contrast in his intestine; if not, he should. It sounds like there may well be some sort of blockage in his intestine, either related to radiation or surgery. It can be hard to solve if that's the case, but it's most likely doable. If I were the surgeon involved, I'd like to see him on high-calorie feeding before operating. The risk of infection is present, but low for most people. It's impossible to diagnose a situation like this without being there. He certainly needs consultation with a surgeon. It may be that he needs to be transferred to a referral center such as a medical school hospital or major big city hospital, if he's not there already.

[marlow]

What is the urine test with a bit of paper?? & how is it carried out???