### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My husband is suffering from colorectal cancer which has become metastised to the liver.I understand that his cancer is at stage IV. He was told this in October 2010 after having a colonscopy and was given one year to live if he did not have chemotherapy.He started in Nov. 2010 his chemotherapy (Oxiplatin) with a 9months treatment and was also put on Capecitabine tablets with one week rest. The chemo treatment being every 3 weeks.In Sept 2011, he has a liver resection followed 6 days later by a portal vein embosilation . Two months later, they discovered that the section of the liver which had been operated open still had lesions and he had to have a RFA .one still remained as it was on the periphery of the liver and too close to the heart.He carried on with Oxiplatin treatment combined with Avastin as previously. Since the operation, he has lost 7 stones but he was very much overweight previously.However, they realised this year in July 2021 that the Oxiplatin treatment did not work any longer and they put him another chemo Irinotecan.At first, the results were not good but he had since better results, and the tumor markers have gone down.He has been complaining however of pain in the stomach, has an enlarged liver , severe constipation. Had diarrhea this time after this chemo for a couple of days, severe digestion problems for a few months now, cannot eat meat now apart from chicken and cannot consume food in the evening as it takes him a really long time to digest his food.I know that the chemo used for colorectal cancer is not really good for the liver but he has been given liver functions tests.What is his liver so enlarged then and why he is in pain? are serious is his condition now.He has to have his chemo treatment every two weeks for 3 days, and I have noted that once we went in holiday and he did not have chemo for 3 weeks that he lost then more than a stone.Please let me know how serious it is.Thank you.R. Bellis

### output:

Hi, Thanks for writing in. Sorry to hear about the progress of colon cancer in your husband and metastasis to the liver. In about half the patients being treated for colon cancer, even after surgery, there is chance of spread to the liver. Explain and Capacitative work in such cases and are recommended for treatment. At that time he has been diagnosed to have stage 4 cancer colon and this means 6 months to 2 years on chemotherapy and supportive treatment.  Portal vein embolization is a well known complication after liver resection. Irinotecan is a medication that is given as a second choice Chat Doctor.  Most chemotherapy medicines have side effects and liver enzymes have to be regularly monitored. The cause for his liver enlargement can be the disease itself causing appearance of new lesions or that can be due to the chemotherapeutic toxicity of 