A 53 year-old gentleman came to me the other day to review his blood results. He was surprised that his cholesterol was significantly elevated, especially the LDL, exceeding 6.0 mmol/L. It was normal a year back. His ALT, AST, GGT and alkaline phosphatase were markedly raised too. When I flipped to the next page of the blood results, his CEA was sky-rocketing high. Obviously something is not right here.
Examining his abdomen, it was distended. The patient told me it has been distended all these while, so it didn’t occur to him that it was abnormal. Ascites was present. Deep palpation revealed a mass over the epigastrium-umbilical region. It was mobile and I could literally grab hold of it.
So, I did a quick scan of the abdomen and here’s the results.
Multiple lesions were seen over the liver, most likely a hepatoma. And if I guess correctly, the source is from the transverse colon.
Informed him that the likelihood of him having cancer is high, and he should have it checked thoroughly. He was stunned. He needed time to think about it. He asked, “How long do I have?”. “I don’t know”, I replied.
Then it occurred to me, that being a doctor doesn’t really necessary mean you will be able to save lives. The only help I could offer was to guide him to what he needs to do next. We all very know the end result. Colonoscopies. resections, colostomies, chemotherapy, multiple CT scans, long hospital stay and the yadda yadda stuff. Would it actually do more harm than good? Sometimes, I really just wonder.