Conversation: The conversation between human and AI assistant.
[|Human|] In a cancer patient with stage IV ovarian cancer that has recurred in the colon and has matasticized in the pelvic lymph nodes and liver. She has recently begun radiation, which is the last procedure that the doctors plans to try. Today she found feces in the vagina.  What might this indicate? How urgent would it be to contact her doctor?
[|AI|]  Hi, Thanks for writing in. Cancer in ovary that has spread to liver is stage 4 disease; it has limited treatment options and if chemotherapy does not show response then radiation therapy is used to reduce the symptoms. Feces in the vagina might be due to adverse effect of cancer causing a recto vaginal fistula. This is an abnormal connection between the colon wall and vagina and leads to feces matter coming out of vagina. Patient might be considered for surgical repair if general condition permits. Please consult her doctor within a day. Please do not worry.