Question: Hi Doctor,

We just received the report which is now uploaded here. I had the following questions based on the report:
- this seems to be a rare form of cancer, how rare is it ?
- how aggressive is this form of cancer ?
- what are our next steps and are there any recommendations ?
- I know it is not exact science, but based on experience what would you like to comment on patient leading a painless life moving forward ?

I have uploaded the Report for your reference.


Below is the pervious discussion which we had with health care magic


my Grand mother is having a big tumor in the stomach, doctor are suspecting its a ovarian cancer, but she is still fine and no symptoms of any cancer, or she is not suffering form any infection.
Report say,
Impression PETCT
a.19.3*11.6*30 cm solid cystic mass lesion in the right anterior peritoneal cavity, extending the sub hepatic region to the pelvis with metabolically active enhancing solid component and septations and mass effect as described
Above- likely representing right ovarian neoplasm

b. Mild ascites with nodular thickening of the omentum - likely representing peritoneal metastasis
c. Discrete few right anterior supradiaphragmatic lymph nodes- likely metastatic

d. no evidence of hepatic, pulmonary or skeletal metastases .I

I think there is no option to upload the reports hear, let me know if you need any details

my grand mother is a heart patient and she has undergone angioplasty and taking medicine for BP (Telma 40MG), blood thinner, and cholesterol(ecosprine Gold 75/20) and nebicard 2.5mg
she doesn't have Sugar problem

Please let me now the feature plan of action what doctors may prefer to do and will she recover from this.

Please let me know if you need more details


Regards,
XXXX










Asked by Me , Fri, 29 Apr 2016
Doctor's reply to your question above... Brief Answer:
Reports needed

Detailed Answer:
Hello sir, thanks for trusting health care magic.
You have a feature to upload the reports by yourself on the right side of this query page. Please utilize it. Alternatively, mail it to YYYY@YYYY subject line as 'attention to Dr. XXXXXXX Jain'.
I just need the MRI report and doctor's prescription so that I can advise you best.
Take care
Regards
Dr XXXXXXX XXXXXXX

Replied by Dr. XXXXXXX XXXXXXX , Fri, 29 Apr 2016

Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also. Hi Doctor

Thanks for the update, currently I have uploaded the PET Scan Report, blood test will upload it ASAP as I do not have it handy.

we have not done MRI Scan.


Regards,
XXXXX



Asked by Me , Fri, 29 Apr 2016
Doctor's reply to your question above... Brief Answer:
Surgery is a must

Detailed Answer:
Hellk sir I have seen the attached reports and this is quite serious and thus surgery is a must.
Surgery and removal of as much tumor burden as possible and then she might need chemotherapy and radiotherapy after the surgery for complete palliation.
Though quality of life is a little poor of course after chemotherapy but usually patient tolerates it well.
Replied by Dr. XXXXXXX XXXXXXX , Fri, 29 Apr 2016

Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also. Hi Doctor, Thanks for the answer, do you suspect its a confirmed cancer, she dose not have any symptoms of infection, fever etc... may I know why and for what all reasons chemotherapy is provided. why dose she need chemotherapy after removing the tumor.

sorry I have lots of question in mind and please explain in details treating this disease.


XXXX
Asked by Me , Mon, 2 May 2016
Doctor's reply to your question above... Brief Answer:
Chemotherapy is very important

Detailed Answer:
I completely understand your concerns.
Yes in my opinion this is a confirmed case of cancer and thus needs proper surgery and additional chemotherapy.
Chemotherapy is given to eradicate the microscopic implants of cancer in the body which need to be eradicated for complete remission from disease.
The cancer cells have involved many vital areas which cannot be removed totally with surgery alone.
Replied by Dr. XXXXXXX XXXXXXX , Mon, 2 May 2016

Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also. Thanks for the information doctor, post surgery what are the symptoms may occur. i.e. which respect to cancer and how many months or years she may leave,
Asked by Me , Tue, 3 May 2016
Doctor's reply to your question above... Brief Answer:
Can be predicted after surgery only

Detailed Answer:
Post surgery she will recover in around 2 weeks and then according get reports and surgical status she will be subjected to chemotherapy.
Chances of survival can only be predicted after surgery as during surgery only you will get to know the involvement of various vital organs and thus the need and dose of chemotherapy.
So we will discuss this question once again after the surgery and till then in my opinion you should get her operated as soon as possible.
Wish her the best of health.
Regards
Dr XXXXXXX XXXXXXX

Replied by Dr. XXXXXXX XXXXXXX , Tue, 3 May 2016

Disclaimer: The Expert's advice is provided for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, as a complete assessment of an individual has not taken place. Please consult your nearest physician before acting on it. The advice is not valid for medico-legal purposes also. Thanks for the Answer doctor, the surgery was successful.
The surgery happened on 4th, as suspected the tumor was not from the ovary it was from the intestine, as per the update from doctor, there was 4 liters of waste watery substance and tumor chunks (like a pockets) in the intestine, they removed all the tumor chunk with some part of small and large intestine and left some part of intestine out connected to bag to pass the waste out for 6 weeks.

as small tissue was sent for testing, Frozen test and microscopy exam report said its from squamous cell, and also they have removed the uterus, and ovary's because they are not sure from where this is getting generated,

Please let me know what will be the next best procedure to treat this.


Regards,
XXXX



Asked by Me , Thu, 5 May 2016
Doctor's reply to your question above... Brief Answer:
After histopathology report

Detailed Answer:
In my opinion you have to wait till histopathology report and then only further treatment can be decided.
She will need additional chemotherapy most likely.
Your surgeon is right as it is very difficult to find the source of tumor at times, especially between ovary and bowel.
Get the histopathology report and then we will discuss further management
Replied by Dr. XXXXXXX XXXXXXX , Thu, 5 May 2016


I have uploaded the discharge summary and Histopathology Reports

Waiting for you Answers.