(5) 17.00 18.00 bob steele

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Information about (5) 17.00 18.00 bob steele

Published on May 8, 2014

Author: ACPGBIADMIN2011

Source: slideshare.net

Cancer Disaster Prof. Bob Steele Ninewells Hospital, University of Dundee

Invermark Estate, Head of Glenesk

FT – 63 years • 1st Sept 2011 – positive FOBt • Three month history of LIF pain and loose stool. Slight weight loss • 15th Sept- Colonoscopy – Stricturing tumour in upper rectum – Unable to negotiate – Moderately differentiated adenoca.

Screening history • 2001, Age 53 – Negative • 2003, Age 55 – Negative • 2005, Age 57 – Negative • 2007, Age 59 – Negative • 2009, Age 61 – Weak positive, negative • 2011, Age 63 – Strong positive

CT Colography 6th October

CT Colography 6th October

CT Thorax 11th October

Plan 18th October • Anterior resection with RFA – First available date – November 10th • Symptoms now very severe – Incipient obstruction

Tumour stented – 21st October

Surgery 10th November • Anterior Resection and RFA – No stoma • Urinary retention • Discharged 20th November – Indwelling catheter – On tamulosin • Pathology – CRM +ve – 8/27 lymph nodes involved

Oncology • Oxaliplatin de Gramont • Local radiotherapy to pelvis

2nd June 2012 • Referred to ophthalmology for double vision • Loss of sensation over ophthalmic division of trigeminal nerve • Left superior oblique palsy

6th July 2012 • CT and MRI of head – normal • CT of chest and abdomen – Deterioration of lung field with multiple nodules – New foci of reduced attenuation in liver

PET FDG Whole Body 16th August 2012 L temporal lobe

MRI Head 23rd August 2012 L Meckel’s cave and cavernous sinus

Oncology • 5 fractions of radiotherapy to base of skull • Still keen for further treatment

Oncology • Admitted 19th September for IV irinotecan • Vision better, but numbness in face and throat. Significant weight loss • Discharged home 21st September

Invermark • Died at home 20th October • Had never been out on the hill since surgery

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