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Advanced stage of lung cancer, left lung gets very little oxygen, right lung fine, breathing difficulty, loss of appetite. Treatment for lung cancer?

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Hi1 My Aunt is suffering from advance stage of lung cancer. The back side of left lung is completely gone and the front side of left lung gets 1/4th Oxygen. The right lubg is completely fine. Please suggest further course of action as she has breathing problem and is not eating for the last 3 days.
Posted Sat, 5 May 2012 in Cancer
Answered by Dr. Indranil Ghosh 2 hours later

Thanks for your query.

I have gone through all the reports. It appears that your aunt is suffering from Stage IV lung cancer with a pleural effusion (fluid within the chest). Based on the records which you have sent, I see that she completed 4 cycles of chemo till August. Post 3 cycles CT scan showed stable disease (no change), hence planned for 3 more cycles. I could not find how many cycles she has received till date. From the prescription of Dr XXXXXXX XXXXXXX it appears that she probably had an increase in fluid in the chest for which a tube insertion was planned.

I also see from the last prescription that her general condition was not good and now you have also mentioned that she has breathing problem and not eating. All these suggest that her disease is growing out of control and no further chemotherapy can be planned at present.

Current plan of action should include the following
1. Taking out the fluid by needle or prefarably a tube. We can later instill some substances through the tube to stop the fluid production.

2. Relief of pain and respiratory distress by opioid group of drugs (like morphine)

3. Females and non-smokers sometimes show very good response to a class of oral drugs called tyrosine kinase inhibitors (gefitinib or erlotinib). I think one of those should be started if not already tried.

Unfortunately the expected survival is not very good. Most patients in this stage will die of their disease in 3-5 months. We should try to minimise her suffering as far as possible.

Hope I answered your query completely.
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Follow-up: Advanced stage of lung cancer, left lung gets very little oxygen, right lung fine, breathing difficulty, loss of appetite. Treatment for lung cancer? 1 hour later
Thanks you doctor for the reply.

Her face has swollen today ans she is bleeding blood and the doctor has given some medicine which has to be taken every 2 hours. Doctors are saying the face has swollen as the left nerves below her left ears have stopped functioning.

Based on you analysis and prescription above and the current condition thatI am referring, will the same medicines prescribed above to be taken? Or there will be additional medicines added?

How many days for survival? She is breathless, not able to talk as she is bleeding blood.

Your prompt reply will be of some help. Am too helpless because she is in Kolkata and me in Bangalore
Her bleeding has stopped and weakness has come down a bit after taking the homeopathic medicine (Acalytho Liquid, iudica) every two ours from yesterday night. She has taken a bit of milk too.

Please let me know on the above information requested and the exact prescription and dosage of medicines which needs to be taken.

Also wanted to know if you are available in Kolkata; so that I can tell my cousin and my aunt to consult you. Pleas let me know your contact details.

If you are out of country, could you prescribe some good oncologist in Kolkata where you can send the patient as your recommendation.


Answered by Dr. Indranil Ghosh 9 hours later
Hello again XXXXXXX

I think the tumor is obstructing the venous flow, that's why the face is swollen. Bleeding is also because of the tumor itself.

At this point she may get some benefit from palliative radiotherapy, if her condition permits. Exact prescription and dosage of medicines can be prescribed only by the treating physician. I am sorry on this.

Overall, I feel she is terminally ill now.

As she is quite sick and they are probably located at Howrah, I would not suggest bringing her to our center. Rather they may contact Dr J XXXXXXX (radiotherapy department) at Westbank hospital, Howrah.

In any case, I am available at Tata Medical center, Rajarhat, Kolkata. Tel 033-6605-7000.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

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