Mental status changes

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pantufla
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Mental status changes

Postby pantufla » Fri Dec 08, 2017 12:18 pm

Does anyone have experience with mental status changes? At diagnosis DH was acting very strange, paranoid and not making sense. That leveled off. He is now 1-1/2 years since chemo and he is very forgetful and not making sense again. Its almost like a dementia or something. Liver was clear on CT. No rise in CEA. Any thoughts?
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT

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susie0915
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Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Mental status changes

Postby susie0915 » Fri Dec 08, 2017 8:49 pm

I don't know what could be going on. Might be related to something other than the cancer. He may need a brain scan. Maybe there is some fluid or something else. I would start with your GP maybe can refer you to a neurologist
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoidoscopy/only scar tissue left
8/15 PET scan NED
9/15 LAR
0/24 nodes
10/15 blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 C 4mm lung nod
10/17 pel/abd CT NED
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, CT pel/abd/lung NED
11/18 CEA .6
5/19 CT NED, CEA <.5
10/19 Clear colonscopy
11/19 CEA <.5

pantufla
Posts: 148
Joined: Thu Dec 03, 2015 12:44 pm
Facebook Username: kelleykulina

Re: Mental status changes

Postby pantufla » Fri Dec 08, 2017 11:57 pm

I did a search and found that I posted the same thing 2 years ago, when he was diagnosed.

He was totally normal tonight. Very strange. It remains a mystery.
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT

Ampes
Posts: 13
Joined: Wed Sep 20, 2017 6:14 am

Re: Mental status changes

Postby Ampes » Sat Dec 09, 2017 8:09 am

Could be a mini stroke or TIA . He should probably be evaluated by a physician
DH diagnosed 9/17 57 yrs
CRC ascending 7x3 cm tumor
T3N0M0 stage 2A well differentiated MSS
LAR right hemicolectomy 10/11/17 clear margins

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mypinkheaven
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Facebook Username: Sally Cunningham
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Re: Mental status changes

Postby mypinkheaven » Sat Dec 09, 2017 1:38 pm

10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm."


Is it possible that he is worried about the CT scan from 11/10 since his scan a year ago was clear? Stress can cause forgetfulness, etc. Has he talked about how he feels about this last scan? What did the oncologist say?
MSS, KRAS Wild NRAS Mutated
9/2012 CRC IIB Lft Colectomy 0 lymph nodes 0 Chemo
10/2013 CT clear
11/15 CEA 2.7 to 4.6
11/15 Spread to uterus. Hysterectomy
2/16 Pelvic radiation 25, brachytherapy 3
4/16 - 6/16 Xeloda
6/16 CT Several lung nodules 5 mm
8/16 CT Nodules still present. Most stable. Some growth
11/16 Transfer to UCSD Moores
12/16 Folfox + Avastin failed
2/17 Folfiri + Erbitux
8/17 5FU+Erbitux No 5FU bolus
7/18 Spread to vagina
6/18 Folfiri + Avastin + Trametinib
6/18 CEA dropping

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ocstacy
Posts: 264
Joined: Mon Jun 19, 2017 11:29 pm
Facebook Username: stacy

Re: Mental status changes

Postby ocstacy » Mon Dec 11, 2017 9:35 pm

He is now 1-1/2 years since chemo and he is very forgetful and not making sense again. Its almost like a dementia or something. Liver was clear on CT. No rise in CEA. Any thoughts?


It's called "Chemo Brain" as my mother's dr. says.
My mom will be 78 this Wed, and yes she has been very forgetful and more cloudy minded ever since her DX last May. She gets mad at me every time I say "You don't remember?" Or if I just explained something to her and she forgets she gets upset. The dr. says it's from the anesthesia, chemo meds, radiation, and surgery all mixed into 6 months. We always seem to get into a fight regarding when she forgets things. One in particular is her finances. My father is 83 so he cannot help her with the bills cause they fight all the time. Her credit card bills are a mess, she gets confused with which meds she takes, or what type of diet to take, and I have to remind her how to text message or go on Facebook from iphone. She always gets that part confused.. then she gets frustrated. She didn't understand the whole neoadjuvant and than lars surgery, pouch thing. She failed her driver's test twice and finally passed after 3rd time. I was starting to worry about her. She still sends checks to places where she can pay online cause she is always late. What else? She forgets that Turmeric is a vitamin and not a medicine. I get real exhausted as her caregiver cause she is a real big hard head, rarely listens and she was told to get a colonoscopy many years ago and didn't get one and she is where she is now. I think I get mad thinking about why she never had her procedure done 4 years ago, if things would be different today. I am happy that she is alive and present and things could have been a lot worst. I think my mom def. has early stages of dementia. How old is your DH? Talk to your Dr. about it. I remember telling my mom that Xeloda will give her hand and foot rash, and she still thinks that it was flea bites according to the derm, that it could of been both. Anyhow, best of luck. I am dealing with that now too :shock: :(
Caregiver/daughter to dear mother age 78, dx 5/09/17 because of me!! :wink:
Rectal CA Stage 3 low-grade adenocarcinoma- 6 cm
Neoadjuvant start 7/10/17 ended 08/16/17
3D Lap. surgery @ Keck USC, Dr. Sang Lee 10/17/17 temp ileostomy
11/1 hospitalized abscess/hernia - home 11/06/17 antibiotics
NO LYMPHS INVOLVED! NEAR PATHOLOGICAL RESPONSE! YAY! :shock:
Took her last chemo med 05/10/18! Ileo reversal 07/24/18
1st BM after reversal 07/25/18 Anal Fissure 8/15/18
Me:1st Colonoscopy age 38. 08/17 Benign polp.

turtle
Posts: 30
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Location: Encinitas, CA
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Re: Mental status changes

Postby turtle » Wed Dec 13, 2017 4:23 pm

He may want to get a "liver panel" or CMP (Comprehensive metabolic panel) to make sure his liver is working well and removing toxins.
Feb. 2015 at age 39: Dx stage IIIb cecal cancer extending into appendix
March 2015 at age 40: Began FOLFOX, discontinuing early after 10 cycles due to suicidal ideation and difficulty moving
Oct. 2016 at age 41: Dx stage IV with 3 metastases to lungs (one 3.7 cm x 2.2 cm) and 1 to liver
KRAS-mutation positive

MissMolly
Posts: 645
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: Mental status changes

Postby MissMolly » Wed Dec 13, 2017 6:31 pm

turtle wrote:He may want to get a "liver panel" or CMP (Comprehensive metabolic panel) to make sure his liver is working well and removing toxins.


I agree with Turtle that laboratory blood work is in order - liver enzymes and complete metabolic panel.

A liver may look A-OK on a CT imaging scan (anatomy and structure of the liver is normal) but faltering in how it is functioning and working (physiology is off-kilter). An ailing liver can lead to an increase of ammonia in the bloodstream. High levels of ammonia are associated with mental/cognitive changes.
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

pantufla
Posts: 148
Joined: Thu Dec 03, 2015 12:44 pm
Facebook Username: kelleykulina

Re: Mental status changes

Postby pantufla » Thu Dec 14, 2017 5:33 pm

His blood work is all within normal range???? He is much better than he was. Thanks everyone.
DH T2 N1b M0. 3/15 positive nodes.
Stage IIIA moderately differentiated adenocarcinoma.
Tumor size 6 cm.
Left hemicolectomy 10/26/15.
FOLFOX 11/30/15 to 5/2/16, full 12 cycles.
10/3/16 CT scan clear.
11/10/17 CT: "Focal opacity along the left lower lung, 7 mm. Two small peripheral opacities along the right lower lobe, 2 to 3 mm. A few small to mildly prominent left-sided central mesenteric nodes, up to 13 mm.
June 2019: NED.
2020: NED 5 years. 4 mm lung nodule on CT

ilovemyfrenchie
Posts: 23
Joined: Fri Nov 03, 2017 9:20 pm

Re: Mental status changes

Postby ilovemyfrenchie » Thu Jan 04, 2018 1:01 pm

Did they check his ammonia level or urine sample for a bladder infection? When your ammonia level is high you can get encephalopathy and confusion.
Daughter to 59 yo w/ Stage 4 Mets to liver & peritoneal
10/1/17 ER trip for GI bleed found rectal tumor (CEA 71)
10/2/17 emergency colostomy (no resection, told tumor inoperable due to Mets found)
10/17 started Folfiri with Avastin (CEA 171)
8/18 CT = liver Mets continue to shrink (CEA 4)

“Chemo for life” hoping for surgery soon


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