Patient: April 6, blood in the stool. In mid-April, he underwent radical surgery for colon cancer at Jejun General Hospital, and the surgery was quite successful. However, on June 17, the third chemotherapy treatment revealed liver metastasis. Dr. Zhang, how can my father’s disease be treated and can he still undergo surgery? Zhang Xiaoqiao, General Surgery Department, Jinan Military General Hospital
Zhang Xiaoqiao, General Surgery Department, Jinan Military General Hospital: The specific treatment method depends on the location and size of the liver metastases. Is your father still hospitalized in the ward?
Patient: Back to Director Zhang, my father is still hospitalized in Hospital 90, and is estimated to be doing chemotherapy today. The ultrasound and CT have been done, and the site of liver metastases is in the middle of the liver, there are three of them, the largest one is 18*14 in size. My father has worked hard all his life at work, and he just got this disease when he was about to retire, and my son is out of town, so I am really unfilial.
Patient: Director Zhang, two days ago, the results are as follows: ultrasound results, the liver is 57mm thick in the left slice, the right lobe oblique diameter of 127mm, parenchymal echogenicity is not homogeneous, and the liver deep and two slightly strong echogenic clusters, the size of 18 * 14mm, *mm, the border is clear intrahepatic vascular literature is still clear, the gallbladder size of about 58 * 24mm, the wall is not smooth, 2.0mm thick, the internal transmission is homogeneous, the body is thick The parenchymal echogenicity was about 30 mm, the size and shape of both kidneys were normal, the deep boundary of the body medulla was clear, and no separation of the collecting system was seen. Ultrasound suggests: a solid intrahepatic occupying vascular flow? Further examination is recommended. The second biliopancreatic and spleen renal sonograms did not show significant abnormalities. CT findings Impressions: liver parenchyma, scattered multiple nodular shadows of He type with still clear margins, diameter of about 0.5~1.0 CM, uneven density within the foci, some of the foci can be seen in small pieces, high density, enhancement scan foci are mildly enhanced, peripheral not known, gallbladder tension is not high, the scanned spleen, organs, pancreas and both kidneys did not see significant abnormalities. Summary: Multiple intrahepatic occupancies, combined with clinical observation of metastasis. Please give a suggestion from Director Zhang.
Zhang Xiaoqiao, General Hospital of Jinan Military Region, Department of General Surgery: Hello! I just came back from a business trip, so I’m very sorry for not being able to reply in time. I will look at the results of the examination and reply to you tomorrow after work.
Dr. Sun said to wait for the next chemotherapy and then do another CT to determine which treatment plan to use. Can I ask Dr. Zhang to take a look at my dad for the next chemotherapy? I would like to thank you again, Director Zhang. Can you tell me your phone number so that we can contact you in advance before we go? I wish you good work and good health.
Zhang Xiaoqiao, General Surgery Department, Jinan Military Hospital: Hello! I wanted to talk to your father about his condition on Tuesday of this week, but it turned out that the surgery was too late that day, and your father was already discharged from the hospital after getting off the stage. I am very sorry! I have a basic understanding of his condition and the possibility of liver metastasis is high. In that case, we can review the CEA before the next chemotherapy and then consider whether to change the chemotherapy regimen. On the other hand, targeted therapy is a better treatment for liver metastasis of colon cancer than chemotherapy, so we can test the relevant indexes and consider applying this method in combination if appropriate, but it is more expensive. However, since the test is now free of charge, you may try it. Please contact if you have anything.
Patient: Director Zhang, thank you for your prompt reply. You are the most responsible and enthusiastic doctor I’ve ever met. Thank you again, and I wish you good health and good work.
Zhang Xiaoqiao, General Surgery Department, Jinan Military Hospital: Thank you for your kind words. If you are willing, I can arrange to test the indicators of the applicability of targeted therapy as mentioned last time, so that we can have a good idea before the next chemotherapy. I don’t know what you think.
Patient: Yes, let’s listen to Director Zhang’s arrangement. In addition, I would like to know how many courses of targeted therapy are needed and what is the cost? I don’t have a good family, can I use my medical insurance? Thank you, Director Zhang.
Zhang Xiaoqiao, General Surgery Department, Jinan Military Hospital: Hello, we have contacted you in the afternoon, you can call if you have anything.