A Unique Treatment Stratergy in a Case of Syncronous Multiple Primary Colorectal Cancer with Grave Comorbidities

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A Unique Treatment Stratergy in a Case of Syncronous Multiple Primary Colorectal Cancer with Grave Comorbidities

Journal Title: Scholars Journal of Medical Case Reports - Year 2018, Vol 6, Issue 11

Abstract

This citation is about an interesting synchronous multiple primary colorectal cancer with severe co-morbidities like severe restrictive airway disease which led to pulmonologists and anesthetists declaring him as very high anesthetic risk case. Pulmonologists had even professed that he will require lifelong noninvasive ventilatory support such as C-PAP or Bi PAP. In addition, patient had extensive cerebral infarct in the right high frontal region with extension along the cortico-spinal tract with Wallarian degeneration. He also had a 3 cm lobulated cystic mass in the right thalamus either due to? Inflammatory? infective? Neoplastic etiology. To add on to the woo, patient vehemently refused to have colostomy. Considering his poor respiratory function and the absolute necessity to perform total colectomy, a very major surgical ordeal, oncologists gave a dismal prognosis not because of the malignancy but because of the severe co-morbidities. Also they declared that he must accept permanent ileostomy, for there is no other alternative according to protocols. Given a bleak prognosis and a stern compulsion for permanent ileostomy, patient walked out of the corporate hospitals in Bangalore, saying in disgust that he preferred dying than having colostomy/Ileostomy. Such a complex problematic case was given an excellent clinical recovery, of course without colostomy, wiping out both the cancers in the colon and relieving him of his respiratory distress with a combination of conventional Right Hemi colectomy for his ascending colon cancer and an innovative unique first of its kind treatment strategy with CRYOFREEZING as the main tool to deal with the anorectal growth and his restrictive airway disease decisively. Actually his restrictive airway disease was in fact primarily due to allergy induced hypertrophic nasal mucosa(which the medical fraternity rarely recognizes) and it can be easily tackled by yet another first of its kind cryofreezing procedure which I have successfully used in more than 3000 cases. With these procedures diligently accomplished, patient did not have the necessity to live with permanent ileostomy/colostomy and long term non – invasive ventilator support. There wasn’t the need for a Major abdominal perineal resection/Total colectomy etc. I have been consistently using cryotherapy in all my oncosurgeries, of course as an additional tool. This is one occasion where only cryotherapy was utilized to deal with one of the notorious cancer, the Ano Rectal cancer. This amply illustrates the extreme utility and dependability of cryofreezing. It made things so easy. Of course as a part and parcel of multimodality approach, this patient also had 6 cycle of combination chemotherapy with Carboplatin + Docetaxel and Interferon injections for immunopotentiation, along with nutritional care.

Authors and Affiliations

Dr. RS. Ravi Chandra

Keywords

Keywords: multiple primary colorectal carcinoma Ano Rectal carcinoma and cryofreezing Obstructive airway disease comorbidities with colo-rectal carcinoma Allergic nasal disorders Hypertrophic nasal mucosa chronic obstructive nasal disease (COND).

EP ID EP488845
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