CT Scan and Updates

Please feel free to read, share your thoughts, your stories and connect with others!
Rikimaroo
Posts: 362
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

CT Scan and Updates

Postby Rikimaroo » Wed Sep 29, 2021 1:46 pm

Hello My Friends,

CT Scan seems to be stable with Cancer, but I have major issues with my small bowel. It's got worse and now I am distended almost everyday, even if I barely eat, have Small Bowel Obstruction (Partial) they are going to meet next week to discuss next steps, like surgery most likely. Oncologist postponed Chemo today because of possible surgical procedure and plus with the SBO issues I barely eat and lost about 15 LBS so far over 3 weeks. I am drinking Ensure and eating yogurt, once a day and maybe something heavier, but very small portions, still have partial blockage so I get swollen belly like I am pregnant(LOL) and it kind of sucks cause then I throw up what I might of ate day before because its just not moving into the intestines'.

I think once this is fix which I have been dealing with for 2 years since last open surgery I am going to be much better. They are not 100% sure yet if its adhesions, peritoneal carcinomatosis or something else, but I am leaning toward adhesions cause I never had this issue before. The Abdominal pain can be super painful almost excruciating, it doesn't happen everyday, but I am distended most days.

I tell you if its not one thing its something else. Ugh!!! PS Cea is now 53 from 23 3 weeks ago and I think its all have to do with the abdominal issue because cancer is stable.

Riki
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

Claudine
Posts: 562
Joined: Tue Mar 12, 2019 2:41 pm
Location: Montana

Re: CT Scan and Updates

Postby Claudine » Wed Sep 29, 2021 3:55 pm

Gosh you're going through the wringer! I hope whatever comes next (surgery?) provides a good solution for your small bowel issues. At least it's good news that your scan is stable re. cancer. Keep us posted XXXXX
Wife of Dx 04/18 (51 yo). MSS, KRAS G12A
No primary (involuted?)
Lytic tumor L4 vertebrae, EBRT 04/18, SBRT 02/19
Resect small intestine 05/18 (no cancer - Crohn's)
Failed adjuvant Xelox
Folfiri + Avastin 03/19 to 01/20
6.7 cm left adrenal mass 03/19, successful resection 02/20
CEA since 03/19: high 81.1, low 3.2, now 66.1
Scan 03/19: Multiple small lung nodules, now gone/calcified
PET 04/20 uptake by L4
L3-L4-L5 fusion surgery and partial corpectomy 05/20
Scan 09/17/2021: stable

User avatar
beach sunrise
Posts: 539
Joined: Thu Mar 05, 2020 7:14 pm

Re: CT Scan and Updates

Postby beach sunrise » Wed Sep 29, 2021 9:23 pm

Happy to hear scan is stable.
Hate to hear sm bowel is acting up. Sounds just awful.
I'm telling ya, a good probiotic for gut flora does a body good.
Keep us updated, OK.
8/19 RC CEA 82.6 T3N0M0
Neoadj 5FU/rad 6 wk
High dose IVC 1 1/2 wks before surgery. Continue still twice a week
Surg 1/20 APR - margins T4bN1a IIIC G2 MSI- 1/20 LN+ LVI+ PNI-
pre cea 24/post 5.9
FOLFOX
7 rds 6-10 CEA 11.4 No more
7/20 CEA 11.1, 8.8
8/20 CEA 7.8
9/20 CEA 8.8, 9, 8.6
10/20 CEA 8.1
11/20 CEA 8's
12/20 CEA 8's & 9's
ADAPT+++ TM drug
MHL1+
PMS2+
MSH2+
MSH6+
POLD1 , KRAS Q61H
Chem-sens test NCI "Test failed, neo adj CR worked. Not enough ca cells to test"

JMRWife
Posts: 94
Joined: Mon Oct 05, 2015 9:41 pm

Re: CT Scan and Updates

Postby JMRWife » Thu Sep 30, 2021 5:37 am

I'm so sorry you have to deal with this. It sounds awful. I hope your discomfort ends sooner than later. ❤
Age 58.
4/27/2021 - Dx obstructing "apple core" sigmoid tumor at 30cm. MMR proficient. 4/28: Diverting colostomy.
Neoadjuvant Folfox 5/18; CEA 107.
9/8: 9 rounds Folfox completed. CEA 2.1.
Pathology: COLON, SIGMOID: -- INVASIVE ADENOCARCINOMA, MOD DIFFERENTIATED Clinical stage IIA.

9/28/21 CAT scan: Tumor was 6.4 x 3.8 cm, now 2.6 x 4.5 cm.

10/4/21: Sigmoid colectomy. 36 lymph nodes removed, 0 cancerous. Stage T2N0M0.

DarknessEmbraced
Posts: 3649
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: CT Scan and Updates

Postby DarknessEmbraced » Sat Oct 02, 2021 9:28 am

I'm glad your scans are stable but I'm sorry you're having such a hard time with your small bowel. I hope things will improve for you soon.*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Sat Oct 02, 2021 12:56 pm

My husband had an SBO this past summer, about a year after his surgery. Not fun. They did not do surgery and it resolved on its own after two long, long weeks most of which was spent on a nasogastric tube. So the conclusion was it was due to adhesions and not cancer (he did have CTs but sometimes peritoneal mets don't show up well, as we are all too aware). The surgeon offered to snip scar tissue while she's in there if he is able to have his reversal eventually. I guess she'd just hunt around for something that looked snagged. He's still having problems but lower down and C. diff is a strong contender right now.

The biggest issue is nobody has a good idea why this happens (other than scar tissue is stiff, but why does it seize up and then release?) so there was no coherent advice on avoiding it recurring. We have decided he should avoid most raw vegetables but even that may not be necessary.

I hope that surgery can resolve this for you. They do have to be careful because surgery causes *more* scar tissue, but often it's the only option.

Bowel obstruction is certainly capable of raising CEA since it causes inflammation. Hoping that's the case here.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Rikimaroo
Posts: 362
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: CT Scan and Updates

Postby Rikimaroo » Mon Oct 04, 2021 12:09 pm

Thanks CatStaff for the info. It seems that when I got my open surgery 2 years ago, overtime it got worse and now I am getting partial bowel obstructions all the time and I am mostly on a liquid diet, with some small small solid food. The reason I know this is recurrent and persistent is because all my poop is watery no solid poops, even if I eat some solid I would expect solid sometimes. Even before it got this bad the poop was more watery and this is a colostomy.

Laparascopic surgery would be the best case scenario since less risk of scar tissue. But given I had prior surgery in pelvic region twice not sure what they will decide. They called me today and told me surgery would most likely be the best route. I am past the NG tube stage this is recurrent, so that won't resolve unfortunately. I am going to meet with the surgeon hopefully next week to go over details of what we can do. I know open surgery can cause more or recur scar tissue but there is a wax paper they can put over your internal organs to prevent some of this from what I read.

This is The Cleveland Clinic so I am expecting top notch thought process and my Surgeon is very well known and experienced.

I will keep you all posted.

Best Regards,
Rikimaroo
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Mon Oct 04, 2021 2:38 pm

I assume they have seen this obstruction on CT? My DH also had an open surgery so presumably a lot of scar tissue, and turns out he is currently dealing with a recurrence (partial this time). Right now he's on "bowel rest" since it resolved previously. However, since yours has been persistent that's presumably why they need to try surgery. Laparoscopic surgery still causes some scar tissue though the benefits presumably outweigh the risks in your case.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Rikimaroo
Posts: 362
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: CT Scan and Updates

Postby Rikimaroo » Mon Oct 04, 2021 6:35 pm

Yes, here is the CT of Abdomen:

GI tract: Postsurgical changes of proctectomy with stable soft tissue
density within the prostatectomy bed/presacral region, corresponding to
areas of heterogeneous enhancement on most recent MRI and focal FDG
uptake along most recent PET. End colostomy in the left lower abdomen.
There are multiple significantly dilated distal small bowel loops
measuring up to 6.3 cm in caliber with transition point in the deep
pelvis at area of tethering of the distal ileum to lower scarring in the
presacral soft tissues. The terminal ileum is decompressed.

Is your husband able to eat normal? I can't eat normal like I use to because of this and I get loss of appetite even though I am not taken chemo right now. It really sucks. I love to eat. LOL....Mine hasn't resolved the right side of my abdomen is pretty hard and I can feel like ripples and I don't know if that's intestine stuck to my abdomen wall. The partial blockage has been there for about 2 months now.

Rikimaroo
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Mon Oct 04, 2021 7:23 pm

He can't eat now. He will be transitioned to liquid diet tomorrow. We don't know how things will go after that. It resolved on its own last summer but I don't see how that's a permanent fix. We have talked to multiple surgeons and resident surgeons and oncologists and though they all say it's a fairly common complication of extensive surgeries, none knows of any well-established way to predict who will experience it or how to prevent it.

Interestingly, he had a recurrence right about in the same area you describe for yours. Folfiri seems to have knocked it down since it seems to have disappeared into the scar tissue remaining from radiation. I doubt it's related to the bowel obstructions, however.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

DarknessEmbraced
Posts: 3649
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: CT Scan and Updates

Postby DarknessEmbraced » Sat Oct 09, 2021 11:22 am

I'm sorry you're having such a hard time. *hugs* I hope that what they decide to do will help you.
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17
NED 12/21/18
Clear colonoscopy 09/23/19
Clear 5 year scans 11/21/19- Considered cured! :)

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Sat Oct 09, 2021 6:13 pm

Riki, we may be in your boat since he was in the hospital and was released, but is still having problems with anything solid getting through (liquids and very soft things may be OK). Same thing, history of major surgery, no sign of a mass on the CT. Radiologists here haven't speculated about scarring since they can't see that directly, they just assume it's present. Another oncologist checked the CT and agrees with that diagnosis (adhesions). He is naturally thin and is even more so now so losing weight would be pretty bad.

The "ripples" you mentioned are probably peristaltic waves where it's trying to push the intestinal contents through and is meeting resistance. That can be very painful if the blockage is complete or nearly so.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Sun Oct 10, 2021 6:10 pm

Update: looks like they will decide on surgery but I won't know specifics for a few days. I hope this will resolve the issue once and for all.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

catstaff
Posts: 165
Joined: Wed Mar 03, 2021 11:37 am

Re: CT Scan and Updates

Postby catstaff » Fri Oct 15, 2021 12:16 pm

Riki, have they scheduled surgery for you yet? DH's was yesterday and it was more extensive than they'd expected. He had significant scarring and had to have a bowel bypass. Obviously it was never going to resolve long-term on its own. No sign of new or unknown cancer, it was all scar tissue consistent with the CT findings.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis
FOLFIRI+bev 3/21-

Rikimaroo
Posts: 362
Joined: Tue Dec 20, 2016 8:48 pm
Location: Florida

Re: CT Scan and Updates

Postby Rikimaroo » Tue Oct 26, 2021 2:10 pm

Hi Catstaff - Yes I have updates. I met with Surgeon and he wants to go with a pharmacological therapies which is Reglan and Protonix which honestly I been doing for 2 weeks now and it has not help. I know this is a surgical issue. They said they see the problem its small bowel kink in the deep pelvis. I guess because I had 2 surgeries in Deep Pelvis already with radiation it's a more difficult surgery. Bypass was mentioned and I would do that 100%, but that discussion was made with the fellow dr, when my surgeon came into the room he mentioned that not sure how much small bowel would be ignored. The bottom line my main surgeon didn't seem to be very understanding of the situation I feel like he just comes in like a hurricane doesn't read my chart, review scans, etc...prior to talking to me.

He is a great surgeon but somehow I think he let's the residents/fellows review then have them fill him in, but then he brushes them off LOL....I am still having the pain, and just suffering through it. I have a call out to my surgeon in Ohio Cleveland Clinic who did the surgery that caused this problem, not on purpose of course. He wants to talk to me and go over my symptoms and scans. There both Cleveland Clinic so he has all the records.

I am so frustrated with this. I am at my wit's end. I have lost over 30 LBs within 1 month, which is not good. I am on a total liquid diet, but sometimes I will slip in some solids when I feel better only to go through the motions of pain, throw up and just uncomfortable. Can't sleep most nights because of the peristalsis movements causes slight pain, sometimes severe. I am kind of shocked my world renowned surgeon was so hesitant to say let's do surgery. I am not rushing to surgery, trust me prefer to not have the knife, but I think that is the only solution. If they can bypass I would do that. I miss eating :(

How did you husband surgery work out? How is he feeling? Did it help? Does he feel relief? Was it deep pelvis, that is where my issue is?

Riki
RC T3N1M0 12/16
MSS - NRAS Mutation
Chemo Rad, CCR - W&W 5/2017
Recurrence 11/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
LAR/Liver Resect 4/2018
Reversal 10/18
CEA highest 500, lowest .8 throughout process, waiting for latest
Recurrence left vesical/pelvic sidewall - 10/7/2019 resect perm bag,
CEA rise Feb/May 3.7, 8.8, 30, Recurrence in Pelvic
CEA 40 right now, but was 57, so folfiri to beat it back down.
Lots of chemo for the past 4 years.


Return to “Colon Talk - Colon cancer (colorectal cancer) support forum”



Who is online

Users browsing this forum: boxhill and 41 guests