Suggestion on course of action

bikash

My brother had cancer of colon/rectum of stage II around two and half years back. He did radiotherapy, chemotherapy and surgery. The final diagnosis after the surgery was Ca Rectum, mod. diff. Adenocarcinoma with T3N1M0.

Then he did several doses of follow up chemotherapy. After that he has been carrying out regular tests - CEA, Ct scan as advised by doctors looking after him. Recently, he discovered some blood in his stool and did blood tests, pathological tests, CEA, CT Scan and colonoscopy (with biopsy and polypectomy). The report are as follows:

CEA: 4.1

CT Scan:
Eccentric thickening of rectum with gross obliteration of lumen. Dilation of proximal segment with feacal filed lumen.

Impressions:
CT findings consistent with recurrence of rectal mass. known case of CA. rectum.

Colonoscopy impressions:
small polyp and erythematous lesion at anastomotic site with fissure in ano

Histopathological Report

Gross findings :

The specimen consists of 2 small pieces of grey white colored tissue measuring 0.2*0.2 cm. a/e

Impression and diagnosis:
The section shows moderate degree of acture and chronic inflammatory cell infiltration. malgnant cells are not seen

Impresion: non-specific proctitis
no evidence of malignancy.

Lately, he has been complaining about tiredness without much physical exertion which he complained before his initial diagnosis. The doctors have said that there is nothing to worry about but I am a bit worried. Can anyone suggest if there is a need to carry out any further tests or suggest future course of action.

PS: we are from Nepal, Asia.

PGLGreg

I think blood in stool is
I think blood in stool is something which needs to be explained. Perhaps his doctors believe they understand this --- have they told you about it? If there continues to be blood and his doctors don't know why, there might be a need for further tests. (Please bear in mind that this comment comes from a layman with no medical expertise.)

--Greg

Lifeisajourney

One of my symptoms
in hindsight was breathlessness, it turned out I was severely anemic, has he had bloodwork checked. Just a thought. Pat

Kathryn_in_MN

Fissure
You said the colonoscopy confirmed fissures. They can cause enough blood loss to become anemic. It happened to my stepdad. He should be checked for anemia - that would explain the fatigue.

If his blood counts are ok since he already had CEA checked, CT and colonoscopy, I don't know what else they could do right now, other than wait to see if he gets better or worse, and address it all again then.

karguy

I think
I think he should see another doctor,blood in the stool is not normal,and when I read the medical definition for the CEA test,it stated that normal healthy people do not have CEA.That it starts in the fetus,but goes away before you are born.His CEA is just within "normal"limits.I think he should get more tests done,and if he has to,see another doctor,Because it is his life your talking about.

John23

karguy said:

I think
I think he should see another doctor,blood in the stool is not normal,and when I read the medical definition for the CEA test,it stated that normal healthy people do not have CEA.That it starts in the fetus,but goes away before you are born.His CEA is just within "normal"limits.I think he should get more tests done,and if he has to,see another doctor,Because it is his life your talking about.

CEA


Everyone has CEA.


"What is the normal range for CEA blood levels?

The normal range for CEA in an adult non-smoker is <2.5 ng/ml and for a smoker <5.0 ng/ml."</i>

From:MedicineNet.com

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