CASE 1: Metastatic Colorectal Cancer (CRC)
Neil H. is a 62-year-old construction manager from Houston, Texas.
The patient was diagnosed with colon cancer in February 2011, after reporting to his PCP with symptoms of intermittent nausea, vomiting, and blood in his stool
In January of 2013, he presented to his oncologist for evaluation after his CEA had increased to 85 ng/mL.
The patient was asymptomatic at the time of recurrence
CT scan showed multiple unresectable metastatic lesions to the liver and lung; the patient’s ECOG performance status was 0
He received initial therapy with FOLFOX and bevacizumab for metastatic disease
After 6 cycles the patient experienced a good response but developed grade 3 neuropathy and oxaliplatin was discontinued
The patient was continued on 5FU with bevacizumab with eventual improvement of his neuropathy symptoms; his disease continued to be stable
In February of 2015, the patient presents with fatigue, nonexertional dyspnea, and cough, and his CEA had increased to 110 ng/mL.