question about persistent bleeding

badoix

Hi,

I am hoping to get some information/experiences regarding my uncle's current condition. He lives in India and is undergoing treatment there; so please keep in mind that many medical procedures are somewhat different there, but still, I am hoping to get a sense of what he may be facing. I also don't know the full details of his current treatment plan but I can fill in essential details.

He was diagnosed with Stage 3/4 rectal cancer (adenocarcinoma of the rectum) in Feb '10. Surgery was attempted but aborted due to some complications regarding metastases in the para-aortic lymph nodes. He underwent a full round of radiation therapy and has been on chemotherapy since. His treatment plan consists of IV chemo every 3 weeks - oxaliplatin and 5-Fu/Leucovorin under the oncologist's administration.

The problem is that, for the last month or two, he has persistent bleeding from the rectum. The initial thought was that this may be due to ulcers/inflammation associated with tissue damage due to radiation/chemo. But colonoscopies have been performed twice and it has been determined (once it was done when he was actually bleeding) that the source is the cancerous growth and diseased tissue itself.

When the bleeding gets severe, it is treated with tranexamic acid ('trapic') either ingested or IV, and in very severe cases with hemocoagulase, which helps control it. However these are clearly only addressing the symptoms and not the problem.

My question is: what does this mean regarding the treatment of his cancer? Have other people experienced similar bleeding, that is persistent and does not seem to improve with chemo/other treatment? Does it mean that the cancer is continuously spreading?

I am aware that I may not get a medically correct opinion from this forum, but I am still hoping to see if others have faced this problem, and if so, how it was addressed.
Thanks!
Best wishes to all,
Badri

Sundanceh

Badri
Hi Badri

From what you are describing, it sounds like the bleeding is coming from the acutal tumor itself. This could stem from the tumor attaching itself to the wall of the intestinal lining and growing enough to cause this issue.

Chemo and radiation by themselves will not eliminate this problem, as you say, they will address the symptoms but not the fix. Radiation would bust up the tumor DNA and cause growth damamge - chemo is good at shrinking cancer cells. Hopefully, he would put himself in good position to be able to do the surgery. Really need to cut this out when the opportunity presents itself, just gives you so much better of a prognosis.

Before I had rectal surgery (even w/chemo and radiation) I would bleed at different intervals, it would stop, then it would repeat. Even after resection, bleeding issues continued from complications associated with surgery and all the treatments.

I remain hopeful that surgery will be an option for him...until then, continue the treatments and do follow-ups and see where he is at at that time.


Best Regards,
Craig

Lovekitties

Hi Badri
I had to go do a little reading in order to find out just where those lymph nodes were...apparently abdominal close to the spine.

If they abandoned the surgery, it may be that they thought radical surgery for the original condition would delay treatment of the lymph node issue. From everything I have seen you must be almost completely healed before chemo or radiation therapies can begin. If that is the case it could delay 6 weeks or more.

I didn't have either chemo or rads (my choice) but it almost sounds like they are hoping that the treatment he is getting will treat the original problem as well.

Since he has begun treatment has he had any CT or PET scans? Seems that would be the way to tell if there is spread beyond what they knew at start.

In any case, yes the situation is serious but that does not mean hopeless.

Sorry I can't be more helpful, but I am sure others here will chime in with more information.

Take care and let us know how things go for your uncle.

Marie who loves kitties

badoix

Lovekitties said:

Hi Badri
I had to go do a little reading in order to find out just where those lymph nodes were...apparently abdominal close to the spine.

If they abandoned the surgery, it may be that they thought radical surgery for the original condition would delay treatment of the lymph node issue. From everything I have seen you must be almost completely healed before chemo or radiation therapies can begin. If that is the case it could delay 6 weeks or more.

I didn't have either chemo or rads (my choice) but it almost sounds like they are hoping that the treatment he is getting will treat the original problem as well.

Since he has begun treatment has he had any CT or PET scans? Seems that would be the way to tell if there is spread beyond what they knew at start.

In any case, yes the situation is serious but that does not mean hopeless.

Sorry I can't be more helpful, but I am sure others here will chime in with more information.

Take care and let us know how things go for your uncle.

Marie who loves kitties

Thanks Craig and Marie for
Thanks Craig and Marie for your replies! It is great to hear other people's experiences.

I don't know if my uncle has had any recent CT scans.. during the recent colonoscopy, the doctor mentioned that the original tumor has shrunk significantly due to the therapy (radition + chemo). He mentioned that earlier there was severe obstruction of the rectal space but that it was now easier to insert the scope. I suppose a full CT scan will reveal more about the current extent and spread of the disease.

I don't know exactly why the previous surgery was aborted, but maybe surgery is possible now if the primary tumor is still significantly large. At any rate it sounds like a full CT scan at this stage might be a good idea to refine the further treatment.

Thanks again for your suggestions, I will pass them along and see if he gets any relief.
Best wishes
Badri