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Advanced pancreatic cancer - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2009
Answered : 681 Questions
Doctor :   Hi
Doctor :   How can I help you?
User :   good day to you dr.
User :   can you kindly give me an idea of what to expect in pancreatic cancer ppatient in its advance stage
Doctor :   The outcome of any cancer depend on multiple factors and not just the the stage of the cancer.
User :   yes but i just would like to know what can possibly come
Doctor :   Various other parameters that includes the age of the patient, the general condition, nutrition, the extent of metastasis and presence of other comorbidities - all play a role in deciding the eventuality of the condition.
Doctor :   Let me put across in simple terms.
Doctor :   Any cancer in advanced stage is treated palliatively.
User :   the doctor doesnt anymore want him to undergo surgery or chemo
Doctor :   That means treatment is given to improve the quality of life, prevent the spread of tumour to as much as possible.
User :   bloating and feeling his stomach very heavy started 3 days ago then today he has fever
Doctor :   Care is also given to prevent infections and to keep up the nutrition and general health in good terms.
Doctor :   If this can be achieved along with pain free life, this will improve the standard of living as well as the life expectancy.
User :   his oncologist told us the if he would undergo chemo it will just waste his remaining reserve
Doctor :   The positive effects as well as negative effects of chemo are considered before opting chemotherapy.
User :   what may be causing the fever?
Doctor :   If doctor decides against chemo, if the tumour is has widely spread across, in which case chemotherapy medications are not much use.
Doctor :   The tumour cells can be the cause of fever.
Doctor :   Alternatively, infection could have set in due to reduced immune status that could be causing the fever too.
User :   and what other things should I expect so we could already be ready to deal with it
Doctor :   Let me clear this point to you.
Doctor :   My opinion is purely based on presumption, as I do not have access to the reports of the patient and nor am able to physically examine the patient.
Doctor :   If doctor's decision to avoid chemotherapy was because of the advance stage of the cancer,
Doctor :   then the life expectancy is a short one.
User :   ok sorry, I am just very scared and worried, his oncologist told us that he may just live 3 weeks to 3 months
Doctor :   Palliative care in the form of pain reduction, infection control, better nutrition are the goals of treatment.
User :   and he let us already go home so that to let my father enjoy the remaining time that he has but in just 4 days new symtoms and complaints he has
User :   so i have literally have no idea what might come next
Doctor :   I am really sorry to hear and discuss about these with you.
Doctor :   But consult a palliative care specialist, who will guide you through the palliative care in improving the standards and quality of life which your father has from now on.
User :   this is the reason that i thought of asking a doctor to atleast give me some of the things that can happen very soon
User :   we do not have here something
Doctor :   May I know the symptoms that he has presently?
User :   no support group or someone that can guide and support the patient and their families in a situation like this
User :   bloating
Doctor :   Ok
User :   he said that he feels his stomach that it became very heavy
User :   then justb 30 mins ago he has fever, last night he feels so cold
Doctor :   Ok
User :   but because of the stent that was placed the jaundice is almost gone
Doctor :   Ok
Doctor :   Have you contacted your primary doctor?
User :   not yet because we leave very far, we live in the province and his doctor is from the capital of the country
User :   thats why i ask online
Doctor :   Ok
Doctor :   Fever as mentioned earlier could be due to factors secreted by the cancer cells or may have occured due to infection.
User :   ok
Doctor :   While the formed can be treated with antipyretic medications such as paracetamol,
Doctor :   but infections need antibiotics.
User :   even he is already taking medicine for the bloating he said that its desame and sometimes even worst
Doctor :   It is hard to differentiate the cause of fever without a physical examination.
Doctor :   I would suggest you to consult a doctor at your locality, who after physical examination can differentiate among these 2 condition and treat it accordingly.
User :   of course, dr. what other thing can he be feeling in the next few days?
Doctor :   The other symptoms that can occur are bed sores, pain, liver condition worsening, reduction in the urine output,
Doctor :   increase in the fever,
Doctor :   drowsiness and so on.
User :   oh he also said that this past few nights he kept on urinating frequently
Doctor :   These are the worst situtations that I can occur and such symptoms need to not occur.
Doctor :   There can be changes in his general condition, pulse and BP fluctuations can also occur.
Doctor :   Apart from this body water and electrolyte fluctuations can also occur.
User :   i observe that he became always sleepy this past few days
Doctor :, WWW.WWWW.WW
Doctor :   The above 2 links have details of palliative care programmes
Doctor :   You can contact them and they will be able to suggest you a few centres near your locality.
User :   doctor what should i need to do now with regards of his fever?
Doctor :   Some of these centres do have home visits
User :   should i need to let him have laboratory test?
User :   wow that would be very helpful
Doctor :   where doctors and support staff can come over to your home/fathers home
Doctor :   and may provide the needful at home itself.
Doctor :   As I am not from Philippines, I am not aware such centres available at your locality.
User :   wow thank youvery much for that i will be contacting him after this conversation
Doctor :   Hence I suggest you to contact one of them, and they will be able to provide you with much more information with regards to palliative
User :   here none only in the main capital
Doctor :   They will be able to suggest you a few such centres near your location
Doctor :   as palliative centres are widely available at most reputed multi specialty hospitals.
User :   yes hopefully we have here
Doctor :   I do wish that you find one close to your place.
User :   i hope so too
User :   but for the mean time should i let him have some laboratory test?
Doctor :   They will be the best person to help you through at this circumstances.
Doctor :   He may need a urine and blood test to look for the possible source of infection.
User :   ok what kind of blood test?
Doctor :   A urine routine and complete blood counts are the initial investigation that may be necessary now.
Doctor :   But as you suggest he is suffering from illness, I do not recommend you to take him out for the test.
Doctor :   A doctor coming home and visiting him and may be a lab technician coming home and taking the samples will be the best
Doctor :   if that is possible.
Doctor :   The palliative care staff will be able to do this through their home visits.
Doctor :   Hence I suggest that you contact them first.
User :   oh ok i will look for someone that came have home service
Doctor :   If it isn't possible, then alternatively one of your doctor at your locality can help you.
Doctor :   In the mean time while you look for the doctors,
User :   doctor is it safe to give him 1st paracetamol for his fever?
Doctor :   If he doesn't have nausea/vomiting a small dose of paracetamol is fine.
Doctor :   use tipid sponging (wipe his arm pits, chest, forehead with luke warm water) to reduce the temperature.
Doctor :   These are the few measure that you can use to bring the fever down, while you look for the doctor.
Doctor :   Have you followed what I have suggested?
User :   that is one of my main proble he doesnt tell me all of what he is already feeling, he doesnt want me to get worried
Doctor :   I do understand that.
Doctor :   Most individual's do suffer from depression, so it is necessary that you give your best care and affection
User :   yes writing all you instructed down
Doctor :   to keep them elevated and in good spirits.
User :   i will
Doctor :   and the doctors and palliative care staff will take care of the medical care.
Doctor :   I hope I have helped you if not solving atleast in partly sharing your burden.
User :   is it ok for him to take multi vitamins?
Doctor :   Our prayers with your dad.
Doctor :   A better and quality nutrition are better that multivitamins.
User :   thank you very much you were such a help
Doctor :   Vitamin pills and other medical pills have effects on liver.
Doctor :   Do you have any other query?
Doctor :   Are you there?
Doctor :   Are you there?
Doctor :   Are you there?
Doctor :   I have to close the window as you are not responding. Please chat with our doctors 24/7 for medical queries.
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