What to expect

[jakebair]

My father has colon cancer that has metastisized to his liver.  He has had his liver resected but the cancer has returned in his liver.  He started turning yellow including his eyes.  We finally talked him going to the doctor.  They put a drain in his liver because of an obtruction.  While in the hospital his kidney's started to fail, his temp dropped down to 95, his blood pressure was low and he started retaining fluid.  He was in the hosp for 2 weeks now he is home doing some better.  The next step is to talk with his doctor about what the next treatment options are.  My questions are, are these symptoms the beginning of his down hill slope?  What should we expect his symptoms to be to know when we should stop treating the cancer and only treat the symptoms?  Anything you can tell me would be great.  Thanks

[jakebair]

Thanks for the information.  2001 was when he was diagnosed with the colon cancer.  Since then he has had surgery on his colon, at least 3-4 rounds of chemo, radiofrequency ablation, another procedure that I can't remember the name where they put little things to block the blood flow to certain parts of his liver and in Jan 2007 the liver resection where they removed almost 2/3 of his liver.  The last round of treatment stopped in August of 2007 and then in January is when we saw the yellowing.  At this point they think the obtruction is from the cancer but I don't think they are 100% sure of that yet.  He has also had blood in his stool so I am pretty sure a colonoscopy is in the near future.  Any additional thoughts??  Thanks

[Fernando Roque, MD]

Hi.  From what you've recounted about your father's condition, I would say that he is indeed in a downhill course.  His cancer is progressive and has started affecting his liver and kidneys.  These are the two organs responsible for metabolizing and detoxifying chemotherapy drugs  (or any drug used for treatment, for that matter).  So if these two organs are not functioning properly, it means he may not be able to handle the usual doses of chemotherapy, which greatly limits his treatment options.  Given this scenario, probably the best thing that can be done is palliative care (treating the symptoms instead of the cancer).  Offhand, palliative care means controlling certain symptoms such as pain and infection, and keeping the patient as comfortable as possible. You should ask your father's oncologist about his treatment options since his doctor is in the best position to answer this.