This question was answered on Thu 17, Dec 2009 10:16pm by Dr.Kokil Mathur

midsection ct scan spots

    
Asked by jdvorak (Female; 94; Hi there! Writing to ask a question on behalf of my dear 94 year old grandmother. Recently she has been experiencing pressure on what feels like her colon, swollen ankles, shortness of breath and abdominal discomfort. When she visited a doctor, ct scan of mid region showed sprinkling of spots. Her doctor is saying the spots are cancerous and producing the excess liquid and causing fluid filled stomach and associated abdominal pressure. No biopsy has been done as the doctor feels this would be too invasive, given her age. They are using this same justification for not attempting to drain excess fluid. She has a history of colon cancer which was a minor event later in life , nearly ten yrs ago. Otherwise remarkably healthy for a woman her age, living independently , cooking, taking care of my grandfather. Somewhat surprised when the doctor told her she may only have a week to live as the discomfort was not that bad. Any information you think might be helpful would be much appreciated, in terms of what could be done to alleviate discomfort, I.e. Draining fluid., and potential diagnosis or certainty of cancer without the biopsy.as an additional note, no smoking, no drinking, healthy diet and exercise even to this day, highly mobile! Thank you! ) on Tue 08, Dec 2009 05:51pm

Any information you think might be helpful would be much appreciated, in terms of what could be done to alleviate discomfort,

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Answer by Dr.Kokil Mathur  on Thu 17, Dec 2009 10:16pm:

Hi Welcome to the AMD forum! I am so sorry to hear your grandmother going through so much at such an old age of 94 years. It is sad that the metastasis was discovered so late. At times during surgery evidence of distant metastasis is not caught. Your doctors are right that it will be too dangerous to drain the fluid or do biopsy as both can irritate the cancer tissue and increase the growth. What can be tried are drugs to step up the immune system. Chemotherapy and radiation can help but at her age she may not be able to take the brunt of it. Also if there are cancer spots in liver too, then she will not be able to tolerate chemotherapy at all. In such cases cryotherapy or delivering chemotherapy directly to liver can tried. What your grandmother has is probably malignant ascites. That is the fluid contains cancer cells. Though the fluid can be drained for symptomatic relief it is often known to trigger a worse reaction. Hence probably an attempt should be made to step up her immunity. Also since the situation is so serious, please take another opinion regarding the best course of treatment from an oncologist who can examine her and see her reports first hand. A peritoneal catheter can be placed for symptomatic relief if the treating oncologists agree to it. Hope this helps. It is difficult to comment beyond this at this stage. Please let me know if there is any thing else and do keep me posted. Take care!

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Comment by Dr Bhupinder K, MD on Fri 18, Dec 2009 01:16am:

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