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Patient of Carcinoma cervix with lung secondary. Lungs showed pleural effusions. Reports indicate lesion in posterior segment. Help?

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Hello sir
My mother is a patient of Carcinoma cervix with lung secondary. The primary is currently silent but the CECT if the lungs showed a pleural effusions of (4.5*3.5*4cm; AP*TR*CC) in the posterior and apical segment of right upper lobe and (4.7*3.1*7cm) in the posterior basal segment of the right lower lobe. After inducing 6 cycles of Unicarb(450mg) and Oncotaxel (260mg) at an interval of 21 days each the current current reports, dated 18/07/2013, indicate a lesion ONLY in the peripheral part of posterior segment of Rt upper lobe (2.8*3.5*3cm). Can u pls elaborate on what should be the next step in this case.
p.s. Also she reports numbness in her fingertips and toe tips.
Posted Tue, 13 Aug 2013 in Cancer
 
 
Answered by Dr. Jawahar Ticku 2 hours later
Dear XXXXXXX
I am very sorry to convey you that your mother is in advanced stage of cancer. By virtue of lung metastasis and pleural effusion ( fluid in the chest cavity) it is stage 4. At the same time you are lucky that she has responded to chemotherapy very well. it is advisable to continue chemotherapy as per the advice of the oncologist. After your Oncologist feels that she is unresponsive he might opt for the second regimen of chemotherapy. If patients general condition is good and tolerance to chemotherapy is good your oncologist will suggest continuation of chemotherapy same or altered regimen till the disease is completely wiped out. May be Conformal radiotherapy may be advised to you for the residual metastatic deposit in the lung.
I wish your mom best of luck.
Truly,
Dr. J. Ticku
Above answer was peer-reviewed by
 
Follow-up: Patient of Carcinoma cervix with lung secondary. Lungs showed pleural effusions. Reports indicate lesion in posterior segment. Help? 2 hours later
Hello sir

Is it too early for radiotherapy? Can CyberKnife be of any help at this stage. Secondly what is the apparent life span keeping in mind the way she is currently responding. Are there any chances (even negligible) of the disease being completely cured. Moreover I would like to email you the current reports along with the blood investigations. Please respond so that I can send them at the earliest. She is aged 58 and is perhaps showing signs of neuropathy owing to the numbing symptom I had mentioned previously.
Thanks a lot
Maryam
 
 
Answered by Dr. Jawahar Ticku 1 hour later
Dear XXXXX,
Cyber knife therapy is meant for lesions which are less than 1 cm size. Conformal Radiotherapy or IMRT will include the tumor along with a good margin. Your Oncologist will decide what will be suitable for her. Radiotherapy is indicated once there is residual disease after it is found that chemotherapy is not helpful.

Platinum analogue of drugs do cause nervous system problems like neuropathy you are describing. Stopage of drugs or alternation of drugs is indicated at such time.

Your mother has fared well after treatment and should give her reasonable survival. Your Doctor is doing a good job.
Truly,
Dr. J. Ticku
Above answer was peer-reviewed by
 
Follow-up: Patient of Carcinoma cervix with lung secondary. Lungs showed pleural effusions. Reports indicate lesion in posterior segment. Help? 2 days later
Hello sir
An you please elaborate on the use of geffitinib and pazopanib as an oral chemotherapy drug. Is gefitinib an advisable option or is it better to wait and watch without any oral or I.V. Medicine.
 
 
Answered by Dr. Jawahar Ticku 6 minutes later
Dear XXXXX,

There is no harm to use these drugs if your budget allows. They come under the group of targeted therapy and will definitely improve the survival.

Hope this helps. Let me know know if you need clarifications.

Regards
Dr. J. Ticku
Above answer was peer-reviewed by
 
Follow-up: Patient of Carcinoma cervix with lung secondary. Lungs showed pleural effusions. Reports indicate lesion in posterior segment. Help? 19 minutes later
The doctor has advised either to wait n watch or to take gefitinib/pazopanib/avastin
Also since mama was diagnosed with tb (after her treatment for cervical cancer) the doctor suspects chances of tb too due to cavity formation. Is it possible for the two (cancer+tb) simultaneously, as the lesion has already responded well to chemotheraputic drugs.
And we at home are unable to decide our plan of action. He has also advised duloxetine (20mg) to minimise peripheral neuropathy.
 
 
Answered by Dr. Jawahar Ticku 29 minutes later
Dear XXXXX,
It is very much possible that two diseases like cancer and tuberculosis can coexist.
because of the immuno suppression of the chemotherapu the old preexisting tubercular lesion may get acctivated.
As I told you earlier starting geftanib will have no adverse effect but will be helpful as the disease has not completely gone out.

Dr. J. tICKU
Above answer was peer-reviewed by
 
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