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Does Minimal Ascites means metastasis?

Posts: 25
Joined: Aug 2011

My mom, was diagonosed with stage 3c (10/26 lymph nodes +ve) rectal cancer May'11 and underwent durgey, radiation and chemo (folfox) which ended in dec'11.
Onc has advised for ultrasound scan, CEA every 3 months. Her last scan in Mar23rd, said Mild hepatamegaly with fatty changes with liver measuring 158mm
Doc said its nothing to worry about majorly. Today again she went for 6th month scan. Her liver size is measured to be 150mm and the scan report says below as the impression -
1. Mild hepatomegaly with fatty changes (As in previous scan)
2.Minimal ascites (Minimal free fluid seen in pelvis)

The report also says no mass/bowel thickening/significant lymphadenopathy seen in abdomen.

Am scared if this ascites is because of tumour somewere though this scan doesnt show.
Could it be because of chemo drugs she had? Is this normal?

What tests we further need to do to confirm?
We will be meeting onc. on monday.

ALso her CEA today was 3.05, last time it was 2.65, before that it was 3.6 and before surgery it was 23.9
with the standards saying 0-4.6 is normal for women.

Will CEA be elevated if ascites is cancerous?

Thanks a lot for your help on any info about this.

WhatsA_Mom2Do's picture
Posts: 46
Joined: Sep 2010

Hi, minimal ascities does not necessarily mean that this is cancerous. My son has had this on his scan several times as well. The enlarged liver (hepatomegaly) can be caused by many things (especially given that many chemo druges are processed via the liver), and ascites can be the result of a malfunctioning liver. In rare cases, it can be a sign of a pertoneal carcinomatosis, but again RARE and the data shows it depends on the volume of ascites.

In terms of her CEA...has the CEA been a reliable cancer marker for your mom? It is not a reliable cancer marker for everyone. Does her Onc also do a CA-19-9?

One thing that has helped me is to not think ahead of myself and take each thing as it comes....it saved me a LOT of gray hairs. :)

God speed to you and your Mom!


Posts: 25
Joined: Aug 2011

Thanks Dee for your reply..
I think we can rely on CEA to certain extent since it was high pre-surgery(23.9) and post surgery there was full response(4.3).
NO, our onc has never asked for CA-19-9.

In your sons case did it go by itself or anything medication had to be taken for that?

Wish you and your family, a wonderful weekend!

WhatsA_Mom2Do's picture
Posts: 46
Joined: Sep 2010

Hi Bala...no medications for my son. It's just a finding on the scan. Also, to be clear, any response from me in never intended to interpret results...I'm not a radiologist or an Onc. My intent was to simply ease your fears so that you were aware that OTHER VARIABLES could contribute to the findings. As others have so graciously posted, it's best to discuss your questions with your mum's Onc.

I pray your weekend was well! Dee

PhillieG's picture
Posts: 4912
Joined: May 2005

is to write all of your questions down and ask them to her oncologist. I'm sure many on here have their interpretations of the scan but in my years of dealing with this, the best source that I've found is to ask the Onc. They should be the expert. I would also ask for a better answer than "Doc said it's nothing to worry about majorly".
Why isn't it anything to worry about?
What would be a reason to worry?

There are a lot of "what if's" in your post Bala. I know how we all like to have answers but the people who are taking care of your Mom would be the best source of those answers (in my opinion).

As far as CEA goes, it's not always the most reliable tool for measuring how a person is doing. CEA can be elevated for any number of reasons and many of them have absolutely nothing to do with cancer.

I'm sorry your Mom is dealing with cancer, it sucks. At least Monday is tomorrow and hopefully you can get those questions answered. I have always found it helpful to have a list with me. That way you can just go through it and hopefully the questions will be answered as best as possible.

Posts: 835
Joined: Apr 2004

One thing I do worry on this site about is very complex medical questions where we don't have all the info and the questions are beyond our knowledge. Even as a doctor I would hesitate to give you much of a reply except to say put your questions to the team. Write them before you go, make sure you understand the answers and are happy with them and make sure your mum is included in all of it.

Mild ascites is a bit of fluid in the abdomen with a thousand potential causes. yes, cancer is one of these but you oncs will be able to interpret if it is one they need to progress with investigating in your mum's case and if so with what tests- scans, bloods, getting some of the fluid out to test it.

It is more a matter of finding ways to cope with the uncertain periods along this path and living through them. They happen to all of us and the times of tests and scans are always the worst. Dont let your head run away with the 'could it be cancer', 'if it is what next', 'then what' thinking. You know the results, you don't know totally what it means but you will know more Monday.

It isn't easy but this journey is going to be filled with these challenges and finding ways of getting through them is vital for you so you can best support your mum.


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