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Preoperative radiation as part of a multidisciplinary strategy for a medically inoperable patient with a bleeding colon cancer
  1. June S Peng1,
  2. Neha L Lad1,
  3. Edward J Spangenthal2,
  4. David M Mattson3 and
  5. Steven J Nurkin1
  1. 1 Department of Surgical Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
  2. 2 Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
  3. 3 Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
  1. Correspondence to Dr Steven J Nurkin, steven.nurkin{at}


An 84-year-old man with a history of deep vein thrombosis on warfarin and coronary artery disease presented with haematochezia and was diagnosed with an ascending colon cancer. He was short of breath with lower extremity oedema at the initial surgical consultation. Evaluation revealed an acute exacerbation of congestive heart failure, and further workup and treatment were recommended by the cardiology team. After multidisciplinary discussion, he underwent radiation for the control of bleeding, followed by cardiac catheterisation and placement of a bare metal stent. The patient subsequently underwent robotic-assisted right hemicolectomy. Pathology demonstrated a complete response, and the patient recovered uneventfully. He is alive swith no evidence of disease recurrence 12 months after surgery and 18 months after initial diagnosis.

  • heart failure
  • cancer intervention
  • colon cancer
  • gastrointestinal surgery
  • radiotherapy
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  • Contributors JSP, EJS, DMM and SJN provided clinical care of the patient, and conception and design of the report. JSP and NLL drafted the article. JSP, NLL, EJS, DMM and SJN provided critical revisions and final approval for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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