True on the part where final staging is done on the operating theater as there is limited vision in endoscopy and ultrasound.

Just curious. Since biopsy is also taken from the esophagus. Where is the report about that? If normal then fine.

Latest Update (15th July 2015, 10.00pm) :



Now, I can only surrender to the doctors and nurses.

1. Your dad has H.pylori
    There will be a regimen and concoctions of anti-biotics he might be asked to gulp down. ( I see the doctor note a triple therapy given).
    The cause is probably due to the H.pylori presence, causing Peptic ulcer in recent years.  The "white" findings are suspect of erosion,  due to bleeding-healing.

The antibiotics are very strong, so there are bound to have side effects in most cases.

Choice is your if the doctor wants your dad to start to start this 10-14 days course.
Alot of pills.  IF the treatment fails, another dose of stronger antibiotics would be given.

IF you want to.... start observing stools colors.  Tar-black stools shows bleeding.
(unless you are eating dragon fruit, or certain red pigment food )
2. Piles or hemmerroids. Mild, and no bleeding. So that is safe to say less complication there, but he has stricture on the rectum end....
HE needs to walk/stand more often than sit down.

You might want to be selective about diet from now on for him. Avoid making hard stools....( note, some people think fiber is good...but not necessary...those Oat Beta GLucen...are NOT entire good. Processed food again there ).

3. Internal organs looks OK except fatty liver. This renders difficult to detoxify the body...so, more water, less salt, sugar, fried diet... steam food and less processed food.
Less processed food would mean...getting it from  A to your mouth with less processing between.

4. If you wish to go to Penang and meet with Chris Teo.  CA Care org.
http://cacare.org
You need to personally go there and meet him, not make calls.
This are traditional meds options.

5. The overall focal is the stomach; atrum near the duodenum.  That is the usual place H.pylori bacteria resides.
It can be many reasons....50%+ world population has it...
Older people are said to be more , due to the perception of low acid suppression at older age.
Chinese world population has one of the highest gastro related cancer due to our diet.
I suggest he stop eating..."dried, salty, perserved" chinese food....like dried duck/chicken, dried meat, and anything related to sour, salty and sweetness.

Reduce sweet intakes...

Because of his fatty liver, he must be a person that likes to eat all those "kuah" that comes with food...
Lastly, I am not a doctor. Please have your research done as well. Finally, please give your dad some strong emotional support. I wish you all the best and speed recovery for your dad.

If you meekly ''surrender'' to the doctors and nurses, you will restrict
your dad to, as the other poster said, just ''cut, burn and poison''.

That's all the medical centers here know what to do, no matter how
classy, expensive and ''up to date'' they are, such as Princecourt.

The oncologist - your dad has colon cancer ?  All he knows is the
standard chemotherapy protocol.

Which would likely be oxaliplatin and 5-FU for colon cancer.

Unless he uses the more advanced tyrosine kinase or EFGR inhibitors,
that is, which is going to cost you a bomb.

5-FU has been around since the 1950s. It's still in use.

Your dad should get ready for the side effects.

https://en.wikipedia.org/wiki/Fluorouracil#History
They may also give him Tegafur, a prodrug of 5-FU.
The Japanese have been using a more advanced prodrug of 5-FU
called S-1, which have far lesser side effects and more effective,
but I don't think the backward hospitals here have it.

You could ask Sunway or Mahkota.
I would prefer S-1 plus irinotecan.
Phase I/II study of a 3-week cycle of irinotecan and S-1
in patients with advanced colorectal cancer.

http://onlinelibrary.wiley.com/doi/10.1111...010.01728.x/pdf
Why Not Use Oral S-1 in Colon Cancer ?

http://www.medscape.com/viewarticle/834019
Efficacy of S-1 in colorectal cancer.

http://www.ncbi.nlm.nih.gov/pubmed/25032886
S-1 as adjuvant chemotherapy for stage III colon cancer:
a randomized phase III study (ACTS-CC trial).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143094/
Oral Chemotherapeutic Agents for Colorectal Cancer.

http://theoncologist.alphamedpress.org/content/5/2/99.full
Systemic chemotherapy for metastatic colorectal cancer:
Completed clinical trials.

http://www.uptodate.com/contents/systemic-...clinical-trials

Need you to decipher the CT scan report as well if you don't mind.

the CT Scan report:

Wish your father speedy recovery. Thank god the operation went okay. How is he now? How is the blood culture going on?

He is still in HDU right now, the latest chest X ray shows sign of lung infection.
Blood culture of 48 hours shows no sign of in-growth.

We are waiting for the biopsy of the lymph nodes to see whether chemo is necessary.

Thanks =)

Fever post operation is actually quite common and normal. But abnormal if come together with low blood pressure and cough.

Could there be some upper respiratory tract infection goon on not picked up previously or is this some hospital acquired infection that I don't know.

Hospital acquired stuff can be very nasty.
If not already on please ask him to do deep breathing exercise and buy the device for incentive spirometer.

After surgery due to pain and reduced mobility infection can further reduce the function of lungs and things can go very bad from there on.

Use often the incentive spirometry , learn how to do chest physiotherapy and encourage him to move in bed, sit up or even walk if allowed by the surgeon

Be mentally prepared for te worst if there is a need to use medication to rise the blood pressure or there is reduced consciousness.

Run over to your friendly pharmacy, and ask for the very old (it's been
around since 1958), very common drug for diabetes - metformin.

It costs just 10 cents a tablet.

Get your dad to take a couple a day. It will boost his chances.

Metformin is quite a safe drug.
You won't be surprised if any oncologist which you are going
to consult for your dad shows you a dumbfounded face if you
ask him about this.

Neither will the pharmacist - he did not learn this in university.

Dr Samuel Tay is a good surgeon, but he is unlikely to know this either.
Metformin fights cancer at three levels :
metabolic, cellular and molecular.
Metformin: a potential therapeutic agent for recurrent colon cancer.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896365/
Metformin: An Emerging New Therapeutic Option for
Targeting Cancer Stem Cells and Metastasis.

http://www.hindawi.com/journals/jo/2012/928127/
Metformin selectively targets cancer stem cells, and acts together
with chemotherapy to block tumor growth and prolong remission.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756324/
Cancer stem cells and novel targets for antitumor strategies.

'' Several drugs have been identified by screening or other observations
(salinomycin, metformin, tesmilifene, sulforaphane, curcumin, piperine
and others). ''

http://www.ncbi.nlm.nih.gov/m/pubmed/22390767
Cancer therapy targeting cancer stem cell.

'' Therefore, major clinical challenges towards the complete
eradication of minimal residual cancer are likely to target CSCs.

Several drugs (salinomycin, metformin) have been also
identified by chemical screening.''

http://www.ncbi.nlm.nih.gov/m/pubmed/24597346
One of the molecular targets of the new generation
of cancer drugs is mTOR.

Metformin blocks mTOR.

Inhibiting mTOR is also one of the main aims of people who
attempt to live longer with supplements and drugs.

That is why many life extensionists take metformin daily (like me).
Understanding the benefit of metformin use in cancer treatment.

'' Moreover, metformin may exhibit direct inhibitory effects on cancer
cells by inhibiting mammalian target of rapamycin (mTOR) signaling
and protein synthesis.''

http://www.biomedcentral.com/1741-7015/9/33
Glioblastomas are the most aggressive of brain cancers.

Metformin Inhibits Growth of Human Glioblastoma Cells
and Enhances Therapeutic Response.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4395104/
Metformin prevents aggressive ovarian cancer growth driven
by high-energy diet: similarity with calorie restriction.


http://www.impactjournals.com/oncotarget/i...434&path[]=9066
Metformin Makes Headline News.

'' The problem is that it is illegal for metformin manufacturers to
promote this drug to cancer patients or oncologists. It's also illegal
to promote metformin to healthy people who want to reduce their
risk of cancer, diabetes, vascular occlusion, and obesity. ''
'' It turned out that only patients with severe kidney, liver, pulmonary,
or cardiac impairment had to avoid metformin because of lactic acidosis
concerns, and even these worries were overblown. ''

" If this study showing lactic acidosis is not a risk for metformin users is true,
then the multi-decade oversight that caused doctors to fear metformin
represents one of the great blunders in medical history. ''

http://www.lef.org/magazine/2012/11/Metfor...ne-News/Page-01
Diabetes Drug Metformin Safe for Patients With Kidney Disease: Review.

http://news.health.com/2014/12/23/diabetes...disease-review/
The study referred to above.

Metformin in Patients With Type 2 Diabetes and Kidney Disease.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427053/
The Phantom of Lactic Acidosis due to Metformin in Patients With Diabetes.

'' Metformin rarely, if ever, causes lactic acidosis when it is used as labeled. ''

http://care.diabetesjournals.org/content/27/7/1791.full

Tham,

You seems like a doctor 

Most doctors don't know that metformin is a cancer fighter.

Hi, it seems like many are against chemo treatment. And is chemo really has little affect to curing the cancer? My relative is third month onto his chemo after his surgery to remove part of the colon. He's in chemo because the cancer cell had spread into the lymph.
However in our recent chemo session, we had asked the doctor (unfortunately she's a junior doctor, not the senior oncologist. It's very hard to see the senior oncologist in govt hospital) and she said that the cancer cells were already removed and the chemo is just precaution to make sure no relapse of the cancer.

Hi, it seems like many are against chemo treatment. And is chemo really has little affect to curing the cancer? My relative is third month onto his chemo after his surgery to remove part of the colon. He's in chemo because the cancer cell had spread into the lymph.
However in our recent chemo session, we had asked the doctor (unfortunately she's a junior doctor, not the senior oncologist. It's very hard to see the senior oncologist in govt hospital) and she said that the cancer cells were already removed and the chemo is just precaution to make sure no relapse of the cancer.

Of course, we are happy to think like that, but I am not so sure whether to believe that. How do the cancer that spread to lymph disappear when all the surgery did was to remove part of colon?

Is keto diet works better? Right now, he has no appetite cause everything taste the same to him. He survives on plain & grain breads, which I am opposed of. But it's hard to make him believe that eating more other food is better than carbs and grains.

I've lost confidence in the hype of grains cause I always have health issues when I eat grains for a few days - swollen throat (to the point that doctor thought I have goiter), gassy stomach, bloated stomach.

All his life, he eats what he called healthy grains - brown rice, grain bread, grain drinks and steam fish, hardly touch any red meat and fried food, yet he still gets colon cancer.

Is keto diet suitable for colon cancer patient? How about Paleo? But it's hard to convince him and family, cause his sister is a nurse and like any health workers in our country, believes everything the text books generally told them - grains are good, meats are bad.

When the surgeon do the tumor removal operation, it's a usual practice to remove the lymph nodes surrounding the tumor.
You would want to enquire the surgeon or the oncologist on the staging of cancer they did for your relative, since this determines what treatments come after. But yea, having adjuvant therapy will lower the chances of cancer coming back.

Cancer has wide causes, which is sometimes hereditary, diet is only one of the many causes.
Well, I think staying alive happy is quite important too, I hardly force my father to follow a strict diet, since he is unlikely to change his way of life.
So, doing your best is good enough