Reference no: EM133241832

Case Scenario

A 58 years old female was diagnosed with colon cancer 3 years. Previous medical history in relation to this includes colon resection followed by 6 cycles of combined chemotherapy completed around 18 months ago. History also revealed that she has smoked for 50 pack years (2 packs/day in 25 years). Current diagnosis of MT is recurrent colon cancer with bone metastasis. She was advised to have Pembrolizumab. However, she is skeptical to take this and was wondering why she can't receive her old chemotherapy cycles. She has shown significant weight loss (height: 5'3" with current weight of 98lbs.). She is found to be nutritionally depleted. The surgeon noted that they need to do an exploratory laparotomy for lysis of adhesions, small bowel resection, colectomy, and colostomy with Hartman's pouch just so she could defecate properly and improve her nutritional status. 

Surgery was performed and MT is transferred to Surgical Ward where you are on duty. She has a large abdominal dressing and she was ordered to be placed on total parenteral nutrition (TPN). The medical and surgical oncologist now wants to prepare her for administration of the advised Pembrolizumab and Bevacizumab given that her advanced stage colorectal cancer and you have been advised to take care of her nutritional and immunologic status for this. While caring for her, a day after admission to the ward, you noticed that when you rolled MT side to side to remove the soiled surgical linen, the dressing became saturated with large amount of serosanguineous drainage. 

1. With the concept of cancer survivorship, what could have been a factor that lead to recurrence and failure to detect at an earlier stage in the patient's case?