James P. Stevenson, MD
Last Modified: November 1, 2001
Dear OncoLink "Ask the Experts,"
What can be done for a 60-year-old male with stage IV colon cancer with metastases to the liver and extra-hepatic disease? Multiple regimens of chemotherapy have failed. The patient currently has an elevated bilirubin and is receiving 5-FU via portable IV pump.
James P. Stevenson, MD, Assistant Professor of Medicine in the Hematology/Oncology Division of the University of Pennsylvania School of Medicine, responds:
This is a difficult situation. Given an elevated bilirubin level, it may be advisable to continue with the 5-FU in a circumstance such as this for as long as is possible. Also, consultation with the treating oncologist to determine if the obstructed areas in the bile ducts can be drained in any way may be helpful as well. Many times this is done by interventional radiologists. If the 5-FU stops working then it may be advisable to explore available phase I clinical trials.