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Bilirubin of 74. Metastic colon cancer

Category: Oncologist

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Category: Hematologist
 31 Doctors Online

Thank you for your query at
I am one of the InHouse Physicians and before I can assign this consult to our oncologist, can you kindly give us more information on the condition of the patient as of now?
What are the symptoms he/she is having? When was it diagnosed?
Feel free to discuss further,

Patient replied :

Hi diagnosed nov 2013. Surgery march 2014 for bowel tumor removal. All was fine and mets appeared June 2014 . Liver .
irinotecan failed . Mets size increased . Started oxyplatin and raltitrexed . Had 3 rounds but then in hosp as was having fever and chills . Bowel
inflammation seen on ct . In antibiotics iv 2 weeks and fluids .
Stable response seen from this chemo but liver mets grew by 9mm.suddenly bilirubin in shooting up in the last week. Other liver tests are normal .
experieving fatigue as not eaten much 2 weeks in hosp , appetite loss .
ultrasound done - no bile duct blockage . Bilirubin jumping as

Will you be able to mail the CT SCAN report and the LFT report?
You can mail them to [email protected]
That will give me a better idea.

Dr. Prasad

Patient replied :

I don't have report of bloods but bilirubin jumping as stated above and alt and alp normal .
i attach ct report and his cea was dropping too on chemo
.from 80 it wNt to 40. From seeing the ct images the liver met has only grown 9 mm in 3 months , 3 small liver mets have gone an in liver 3 in total.
ct shows inflammed bowel they said he had colitis as both bowels
were severe inflammed but since in hosp
his bilirubin rising . He was on antibiotic as codine .

I am not sure if chemo will be beneficial with high bilirubin levels but you can try with cetuximab or bevacizumab initially (although with risk).
Kindly consult with your oncologists regarding the fact if they can really help you, as we are suggesting therapy only based on reports and your doctors physically see you and take a decision based on your clinical condition.

Patient replied :

Ok . What is causing the high bilirubin ?will this fail the liver or ?

The liver mets as well as the inflamed bowel can cause disturbance in the bile excretion leading to high bilirubin levels.
It definitely needs to come down soon.

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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