Seeking Innovative Treatments for Rectal Cancer: A Family's Plea for Help

Save the health of family members, save the whole family... Inform about the medical authorities in the relevant field and the most effective or innovative treatment methods (forwarded from the President's mailbox to the Director's mailbox)?

In June 2009, my spouse experienced abdominal discomfort and was diagnosed with rectal cancer after examinations revealed a CEA level of 112.3.
On June 24, 2009, surgery was performed at Linkou Chang Gung Memorial Hospital, where 13.3 cm of the rectum and 1/8 of the liver were removed.
She was hospitalized until July 8, 2009, and then rested for a month.
On August 7, 2009, she began the first round of chemotherapy, receiving a total of 12 sessions until around February 2010.
During this time, her CEA level decreased from 43.3 to 1.43/1.86 (normal range).
However, PET and CT scans indicated metastasis to the liver and lungs, leading to a second round of chemotherapy consisting of 18 sessions over six months, which concluded on October 29, 2010.
Unfortunately, her CEA levels did not return to normal.
Consultations with Hsinchu Hospital and National Taiwan University Hospital yielded no innovative or advanced treatment options, leaving me feeling fearful and helpless.
On January 21, 2011, her CEA level rose from 117 to 238.
In desperation, I reached out to the presidential mailbox, pleading for help for my spouse (born June 3, 1967) and for the health of our family.
I earnestly request information on the most effective or innovative treatment methods from medical authorities in the field, and I am deeply grateful for any assistance provided.

Qiu Xiansheng, 30~39 year old female. Ask Date: 2011/02/09

Dr. Lai Yicheng reply Oncology

Dear Mr.
Chiu,
Regarding the condition of your esteemed wife mentioned in your letter, we are very concerned.
You referred to the "most effective or innovative treatment methods" currently available, and our team has had preliminary discussions on this matter.
In order to provide the most appropriate treatment recommendations, could you please provide a summary of your wife's medical history (including pathological staging, surgical records, chemotherapy process, and examination reports)? If you need any assistance, please feel free to contact us at (04) 829-8686 ext.
1051.

The medical team at the Changhua Hospital, Department of Health, is here to support you.

Reply Date: 2011/02/09

More Info

I'm truly sorry to hear about your family's struggle with rectal cancer. It’s understandable to feel overwhelmed and desperate when facing such a challenging situation. Your inquiry about innovative treatments for rectal cancer is both timely and crucial, especially given the complex history of your loved one's condition.

Rectal cancer, particularly when diagnosed at an advanced stage, can be challenging to treat. The treatment typically involves a combination of surgery, chemotherapy, and sometimes radiation therapy. In your case, it appears that your loved one has undergone significant surgical intervention and multiple rounds of chemotherapy, but the rising CEA levels and the detection of metastases indicate that the cancer may not be responding adequately to the current treatment regimen.

Innovative Treatment Options:
1. Targeted Therapy: Depending on the specific characteristics of the tumor, targeted therapies may be an option. For instance, if the cancer cells express certain genetic mutations, drugs that specifically target those mutations can be effective. For rectal cancer, drugs like cetuximab or panitumumab may be considered if the tumor is KRAS wild-type.

2. Immunotherapy: This is a rapidly evolving field in oncology. Drugs that enhance the body's immune response against cancer cells, such as PD-1 inhibitors (like pembrolizumab or nivolumab), have shown promise in various cancers, including colorectal cancer. If your loved one’s cancer has specific genetic markers, immunotherapy could be a viable option.

3. Clinical Trials: Given the complexity of your loved one’s case, participating in clinical trials may provide access to cutting-edge therapies that are not yet widely available. Many hospitals and cancer centers conduct trials for new drugs or combinations of therapies. It would be beneficial to consult with oncologists who specialize in clinical trials for colorectal cancer.

4. Multidisciplinary Approach: Engaging a team of specialists, including medical oncologists, surgical oncologists, radiation oncologists, and palliative care experts, can provide a comprehensive treatment plan tailored to your loved one's needs. This approach ensures that all potential treatment avenues are explored.

5. Supportive Care: While pursuing aggressive treatment options, it’s also essential to focus on quality of life. Palliative care can help manage symptoms and side effects, providing support for both the patient and the family.

6. Genetic Testing: If not already done, genetic testing of the tumor can provide insights into specific mutations that may be targeted with newer therapies. This can also help in understanding the prognosis and potential treatment pathways.

7. Nutritional Support and Lifestyle Changes: Complementary approaches, such as nutritional support and lifestyle modifications, can play a role in overall well-being during treatment. Consulting with a nutritionist who specializes in oncology can be beneficial.

Next Steps:
- Consult with Oncologists: It’s crucial to have open discussions with your loved one’s oncologist about the current treatment plan and the possibility of integrating innovative therapies. Ask about the feasibility of genetic testing and the potential for clinical trials.

- Seek Second Opinions: If you feel uncertain about the current treatment plan, seeking a second opinion from a different cancer center can provide new insights and options.

- Emotional Support: The emotional toll of cancer treatment is significant. Consider seeking support from counseling services or support groups for both the patient and family members.

In conclusion, while the journey through cancer treatment can be daunting, there are innovative options available that may provide hope. It’s essential to remain proactive in seeking the best possible care and to utilize the resources available to you. Your family's plea for help is a testament to the love and support that surrounds your loved one, and that is a powerful ally in this fight against cancer.

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