HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Severe Pain In The Abdomen While Treating Stage-4 Esophageal Cancer

default
Posted on Mon, 8 May 2017
Question: Hi, my wife has stage 4 esophageal/gastric cancer and we have been getting chemo treatment for about 15 months now. Primarily with 5fu and irronoclan combined with cyramza every other week. She had an infection in her med-port that resulted in a 3 week ordeal in the hospital to remove it, get rid of the infection and manage the pain that spiked out of control, we are now home on hospice. I guess the blood numbers went down and treatment is not now a viable option anymore so we were sent home with the pain managed via morphine and methadone. My questions are this, what should I do to check on other treatment options rather than wait to die? She is still eating, still fighting but the pain in her abdomen and back area where the lymph glands are enlarged, is going to get harder to control. The cancer seems to reside in the glands primarily in a belt around her lower torso. Is there any oral pill form she can take to fight this type of cancer? My insurance company was willing to carve out a payment to the oncologist to continue treatment while still going on hospice as a form of pain control. It seems the oncologists office declined to submit for authorization because they had not been paid in a similar instance and treatment and hospice are mutually exclusive occurrences. Also stated they did not believe the treatments to be effective anymore. I have no clue about any of that other than the insurance was willing to give it a go.Any advice? Are there any other type of pain blocking treatments to seek besides morphine, like a nerve blocker or something? The main problem seems to be the cancer growing inside the lymph glands and causing pressure (thereby pain) on the surrounding area. Is that approximately the right way to think about it? Thank you for any direction you can point in or advice on how to proceed. We knew the treatment was palliative not curative. but prior to the infection we were coasting along with a pretty decent quality of life and then bam, we're done. XXXX XXXXXXX
doctor
Answered by Dr. Deepak Sundriyal (53 minutes later)
Brief Answer:
Hello. Oral chemo drugs are an option

Detailed Answer:
Hello dear. I have gone through the details. I understand your concern for your wife.

Since injectable chemotherapy has been tried and the patient is still upright, we can have certain options for her. First of all, you must know that pain is due to cancer itself and anything which kills cancer cells will help to relieve pain.

Another injectable drug in small doses which will help to maintain the quality of life can be tried and one such drug is NAB-paclitaxel. It can be given in small weekly doses. Another option is Tegafur-uracil drug which is an oral drug.

Pain can be controlled by either increasing the dose of morphine by patient controlled analgesia or by adding nonsteroidal anti-inflammatory drugs. Once chemo starts working, the pain will decrease.

Moreover, pain can be decreased by alternative methods of medicine like Ayurveda, yoga, physiotherapy etc.

Please discuss these options with your primary care provider.
Thanks and regards

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1655 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Severe Pain In The Abdomen While Treating Stage-4 Esophageal Cancer

Brief Answer: Hello. Oral chemo drugs are an option Detailed Answer: Hello dear. I have gone through the details. I understand your concern for your wife. Since injectable chemotherapy has been tried and the patient is still upright, we can have certain options for her. First of all, you must know that pain is due to cancer itself and anything which kills cancer cells will help to relieve pain. Another injectable drug in small doses which will help to maintain the quality of life can be tried and one such drug is NAB-paclitaxel. It can be given in small weekly doses. Another option is Tegafur-uracil drug which is an oral drug. Pain can be controlled by either increasing the dose of morphine by patient controlled analgesia or by adding nonsteroidal anti-inflammatory drugs. Once chemo starts working, the pain will decrease. Moreover, pain can be decreased by alternative methods of medicine like Ayurveda, yoga, physiotherapy etc. Please discuss these options with your primary care provider. Thanks and regards