If someone has been referred to a specialist in regard to a liver secondary, how long should he wait?

Question

to be seen?
He had bowel cancer- operated successfully but then they discovered liver secondary. severe complications set in due to mrsa and c-diff, severely weakened him and he had to have a colostomy! he had one dose of chemo( the idea was to chemo, then operate on the liver tumours), however he reacted badly to chemo and nearly died. Dr will not do more chemo, as he says it will kill him. He was referred before xmas but still no appointment- is this acceptable? the cancer will still be growing! An mri early in January showed that the liver growth had grown slightly, but he is now complaining of pains in the lower chest region- could it be related? what should be done?

its obviously not always 2 weeks in the uk then as that is where he lives!

Answer 1

The 2 week wait scheme is for GP referral and not consultant to consultant referral. It is likely that his case will have been discussed both at the colorectal MDT and then the hepatobiliary MDT. An MDT is a multi disciplinary meeting, where by the physicians, surgeons, oncologists, histopathologists, radiologists and specialist nurses attend to make team decisions on the patients care.

It is difficult to make any comment on the MRI showing progressing liver lesions, as the timescale is important. When was the primary resected, where from in the colon, or rectum, and when was the last MRI?

I would contact the secretary of the oncologist in charge of his care, and find out who he was referred to in the liver team. Either ask the secretary or speak to the secretary of the liver surgeon, who will be able to ensure that he hasn't fallen into a black hole and is being planned to be seen. Failing that, the specialist colorectal nurse he presumably saw for his primary should be able to track the referral to ensure it has reached the team.

In my opinion, standard procedure here is that we would discuss the patient at the MDT prior to seeing him in clinic to discuss the options. It would likely be them who have ordered the MRI as it is a better medium to see if there are any other liver lesions not picked up on CT scanning. With the results of that then discussed at the MDT again, he would then certainly be overdue an appointment with either the liver team or oncologist to explain the results from that meeting.

Answer 2

If the liver is affected by metastasis of the colon cancer, then he has reached Stage IV: (Cancer that has spread to other organs).
Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Cancer cells usually spread through the bloodstream or the lymph system. However, once the cancer has spread beyond the bowel, chemotherapy is used.
Consult your doctor.
Please note that I am not a medical professional.
Please see the web pages for more details on Colon cancer, Metastases and Liver metastases

Answer 3

I trust Grizzler yet would upload that maximum cancers that has metastisised from yet another organ to the liver isn't liver maximum cancers yet keeps the call of the accepted web site (eg colon). That being the case, it is extremely no longer likely which you would be extensive-unfold for resection till the accepted maximum cancers has been dealt with. consequently it would be an quite foolhardy difficulty to proceed to drink once you're receiving treatment. in case your liver is broken via fact of alcohol, case in point, having mentioned that that's quite no longer likely which you would be extensive-unfold for resection. if so, assuming the accepted web site has been dealt with, you would be finding at a transplant. of course it does no longer do your case any sturdy in case you may no longer show your willingness to provide up ingesting. I truthfully have in no way come throughout the time of a medical web site that debates using alcohol via liver maximum cancers sufferers. i think of the shortcoming of such debate speaks volumes of the probable conclusions.

Answer 4

Ring the oncologists secretary asap to make sure you will be getting an appointment soon.
patients have been known to be forgotten and/or not contacted. Remind them of the 2 week rule as well.

Answer 5

Liver disease is very severe, life threating, he needs to see a doctor, quick

Answer 6

Contact your oncologist immediately and discuss all with him/her.
Report the new symptoms I am sure the appointment will be made asap...

Answer 7

if he lives in uk it would be within two weeks,yes the pain is probbly pressure pain from an enlarged liver