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Suggest Treatment For Severe Back Ache, Constipation And Weight Loss

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Posted on Thu, 18 Jun 2015
Question: Hi , My Dad was misdiagnosed with diabetes for the last couple of years . From january he had big weight loss and kidney pains - again put down to diabetes. This week he had backache, constipation ,kidney pains went to emergent hospital last Sunday - had a scan it was fuzzy but showed something on pancreas. Next day confirmed tumour - pancreatic cancer. tuesday they said it has spread to liver. Waiting for the big meeting next week to have proper prognosis . However Im 12hours flight away and trying to debate wetehr to rush home now or wait for a bit - mum says he's deteriorated but we don't know if its the pain meds doing it or not - he has some patches the first were too strong - for pain this is so he has weaker ones now the first mad whim feel very funny. He also has some top up medicine which has morphine. Mum says of he sits down he falls asleep , is dopey and confused , was wet with perspiration through the night , repeats the same questions. Im trying to gauge could this just be the medicine or should I be flying home - can I afford to wait until wednesday to find out what they say. Mum said it was warmer but are night sweats a sign of something ?
doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
Appears to be advanced pancreatic cancer

Detailed Answer:
Hi
Thanks for your query.

I am sorry to hear about your dad. Unfortunately he has got stage 4 pancreatic cancer and going by his age and general health, prognosis is not at all good. Chemotherapy will most likely be avoided in him. Probably only supportive and palliative care will be considered for him by his oncologist.

Now, coming to the last few symptoms you have mentioned, they all go very well with morphine side effects. However, it will be difficult for us to say whether you can wait till wednesday. I would suggest you to be at your dad's side as soon as possible.

Hope this helps. I will be available for followup.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (20 minutes later)
Thank you - i suggested my mum contact out if hiurs doctor and yes it turns out the pain patches and medication are he cause he was given too storng doses and notnadvised how to take morphine . I dont understand why surgery not posisble - you can live without a great chink of your ljver why wont they cut it out ? Am shocked about je chemo i assumed this would be what helps hom
And i thought that was pallayive care . Please elaborate for me - is it because he wouldnt survive chemo or money reasons for nhs ? Would it be just pain reduction then ? My dad hopes to make ot to
My wedidng in july . Why do some people get chemo amd others not . In your honest opinion without knowiing full facts ( he ha sneevr had diabetes by the way thatvwas wrong diagnosis over last couple of years ) are we talking weeks only ? I have feared this as been bad since january and jow has pain , constipation etc . After this question i will save my follow ups until we get the bug meeting on wednesday which we fear may well be dreadful but i think I may need advice
doctor
Answered by Dr. Indranil Ghosh (39 minutes later)
Brief Answer:
surgery not done in stage 4 pancreatic

Detailed Answer:
Surgery does not improve survival in these patients. Chemotherapy can add a few months, but that is only in very fit patients. From the description you have provided I don't feel that he is this category. But this is without assessing the patient first-hand and may be wrong as well.

By palliative care I mean reducing the symptoms without trying to control the disease (with morphine, etc). If chemotherapy is given that would be palliative chemo.

Please keep me posted.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (18 hours later)
Thank you . I realise i have to ask anothwr question before the wednesday news or I will be out of time so I will save my last until then . What concerns me right now is the loss of appetite and poor eating i know is common . Its just got very bad in last week ive been reading - i know little and often but conflicting advice about what - some suggest building up with creams , sugars etc . But i thought those things are bad - he only wants desserts but again sugar ? Im sure this will be addressed but i worry about it being too little for too long . Im guessing he will get nutrient milkshakes but until then - can he get anything like that form health food shop , can he buy digestive enzymes , would juicing fruit and vegetables be a good or bad idea ? What is good for him to eat , can he take multi vit - i think we have to make him eat at least a little please can you advise ?? Thanks
doctor
Answered by Dr. Indranil Ghosh (51 minutes later)
Brief Answer:
Nutritional supplements required

Detailed Answer:
Yes, supplements required. Only dessert will not provide all nutrients. He can take products specifically meant for diabetics, like Glucerna-SR (Abott) or Resource Diabetic (Nestle Nutrition). You can follow the instructions given on the pack for preparation.

He can take pancreatic enzyme supplements to help in digestion. Fruit and vegetable juices are fine. Multivitamins are also ok.

You can keep this query open for as long as you want by recharging as and when required.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (3 days later)
Hi , so latest is my dad realky didbt get on with the morphine medicine and so it was changed to um tamaform or simething like that . He was then in agony , ambulance calked they gave him the mirohine again . He stayed home overnight but was in pain . They went ti the meeting next day very little infirmation guven exceot its terminal 3-6 months . Yhey saud they had to get the pain under control as he coukdnt have treayment until it was chemo implied and mentioned . They gave him an injection and adnmitted him , he perked up a but and ate a bit but was in pain again overnight and the dictor had to come and up the meds . He now has enzymes , mum thinks uts when he eats he has the trioubke and they said it was the liver causing pain . My question is we feel very much in dark so far only be sooken to fir ten minutes - i think we have the right to reasonably exoect details of diet , supplements , whats going on now . Mum saud stay in china for a bit longer . R they right with the time frame and managing pain is just what hapiens till they find the balance at first ie dont panic at the pain they have to find the balance . I also wAnted him moved to the care of iyr nearest specialist pancreatic cancer hospital can i insist on it ? Should i ignore the time frame given ? Still trying yo decude wether to stay or go . Thanks
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
yes unless he is fit chemo can't be given

Detailed Answer:
What they are trying to do is try and make him bit fit with nutrition, pain killers, etc so that he can take chemo. Because chemo has no benefit is unfit patients. The disease indeed appears terminal. However, the bedside doctor is the best judge.

You can surely insist on transfer to a center specializing in pancreatic cancer. You also have every right to know what is happening. Please approach your doc again and he should be happy to help.

Please let me know if you have any further queries.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1712 Questions

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Suggest Treatment For Severe Back Ache, Constipation And Weight Loss

Brief Answer: Appears to be advanced pancreatic cancer Detailed Answer: Hi Thanks for your query. I am sorry to hear about your dad. Unfortunately he has got stage 4 pancreatic cancer and going by his age and general health, prognosis is not at all good. Chemotherapy will most likely be avoided in him. Probably only supportive and palliative care will be considered for him by his oncologist. Now, coming to the last few symptoms you have mentioned, they all go very well with morphine side effects. However, it will be difficult for us to say whether you can wait till wednesday. I would suggest you to be at your dad's side as soon as possible. Hope this helps. I will be available for followup. Regards