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How Can Deteriorating Health Due To Side Effects Of Chemotherapy For Lung Cancer Be Managed?
Question: Dear Dr. XXXXXXX
Myself, XXXX, elder son of a lung-cancer patient, Mr. XXXX, writing to you to get your valuable advise.
Mr. XXXX has been diagnosed with Lung-Cancer during August-2017. As per the advise of Dr. XXXX, Professor, Department of Medical Oncology, XXXX Hospital, XXXXXXX XXXXXXX treatment is going on for last 7 months. I am attaching the referrals (1st cycle and 2nd cycle) by the doctor and clinical reports.
However, the health condition of my father is getting deteriorated day by day. He is having several side effects of the chemo-therapy, e.g. nose bleeding, fever, etc. More importantly his pain is not getting reduced.
It will be very kind of you if you please review the case and kindly inform me if there is any further possible treatment for my father.
Looking forward to your kind advice.
Regards,
XXXX
Myself, XXXX, elder son of a lung-cancer patient, Mr. XXXX, writing to you to get your valuable advise.
Mr. XXXX has been diagnosed with Lung-Cancer during August-2017. As per the advise of Dr. XXXX, Professor, Department of Medical Oncology, XXXX Hospital, XXXXXXX XXXXXXX treatment is going on for last 7 months. I am attaching the referrals (1st cycle and 2nd cycle) by the doctor and clinical reports.
However, the health condition of my father is getting deteriorated day by day. He is having several side effects of the chemo-therapy, e.g. nose bleeding, fever, etc. More importantly his pain is not getting reduced.
It will be very kind of you if you please review the case and kindly inform me if there is any further possible treatment for my father.
Looking forward to your kind advice.
Regards,
XXXX
Brief Answer:
It seems disease is not responding
Detailed Answer:
Hi,
Unfortunately, he has a disease with bad biological behavior and it seems that treatment is having no effect on it. He is just getting the side effects.
As he has already completed 3 cycles of resent regime, I would suggest getting the PET-CT now, and if it is progressive disease, then stop it. Palliative RT to D9-10 lesion for pain relief can be considered.
As documented, immunotherapy is not affordable, so I am not recommending it. A trial of oral medicine Afatinib/Erlotinib can be undertaken, as I can see that there is squamous component also.
Rest is all palliative care, to keep him comfortable as much as possible.
Hope this helps. Let me know if I can assist you further.
Regards,
Dr. Indranil Ghosh
Oncologist
It seems disease is not responding
Detailed Answer:
Hi,
Unfortunately, he has a disease with bad biological behavior and it seems that treatment is having no effect on it. He is just getting the side effects.
As he has already completed 3 cycles of resent regime, I would suggest getting the PET-CT now, and if it is progressive disease, then stop it. Palliative RT to D9-10 lesion for pain relief can be considered.
As documented, immunotherapy is not affordable, so I am not recommending it. A trial of oral medicine Afatinib/Erlotinib can be undertaken, as I can see that there is squamous component also.
Rest is all palliative care, to keep him comfortable as much as possible.
Hope this helps. Let me know if I can assist you further.
Regards,
Dr. Indranil Ghosh
Oncologist
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Dear Dr. XXXXXXX
Thank you very much for your reply.
I understand the situation. We will try to get the PET-CT done asap.
Regarding the oral medicine, afatinib/erlotinib, do they also have huge side effects? I found they are very costly. However, if there is a hope to get the pain reduced by them, we will consider. Please advise.
Do you suggest any other pain-killer in combination with morphin?
Thanking you,
Sincerely,
XXXX
==========
Thank you very much for your reply.
I understand the situation. We will try to get the PET-CT done asap.
Regarding the oral medicine, afatinib/erlotinib, do they also have huge side effects? I found they are very costly. However, if there is a hope to get the pain reduced by them, we will consider. Please advise.
Do you suggest any other pain-killer in combination with morphin?
Thanking you,
Sincerely,
XXXX
==========
Brief Answer:
Oral medicine side effects are also there
Detailed Answer:
Hi,
Usually they are well manageable. If Afatinib is costly for you, you can try Erlotinib, it is available at 5000/month. However, I would not place great hopes on any of these. Kind of desperate attempt.
We use following drugs in varying combinations with Morphine - paracetamol, Aceclofenac, Dexamethasone, Amitryptilline. You can discuss these with his doctor.
Hope I have answered your query.
Regards,
Dr. Indranil Ghosh
Oncologist
Oral medicine side effects are also there
Detailed Answer:
Hi,
Usually they are well manageable. If Afatinib is costly for you, you can try Erlotinib, it is available at 5000/month. However, I would not place great hopes on any of these. Kind of desperate attempt.
We use following drugs in varying combinations with Morphine - paracetamol, Aceclofenac, Dexamethasone, Amitryptilline. You can discuss these with his doctor.
Hope I have answered your query.
Regards,
Dr. Indranil Ghosh
Oncologist
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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