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Prognosis of a patient diagnosed with secondary liver cancer and bone cancer from the breast - Online Doctor Chats

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

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   Secondary liver cancer and bone cancer from the breast
Doctor :   Hi
Doctor :   How can I help you?
User :   Dear Doctor, my Nan was diagnosed with secondary liver cancer and bone cancer from the breast a month ago. Stage 4. She is now in hospital with severe pain and vomiting - she is also on dia-morphine (a syringe driver I think) - could you tell me what this sounds like please?
Doctor :   May I know her age?
User :   She is 72
Doctor :   Ok
Doctor :   Let me brief you.
User :   Thank you
Doctor :   Since she is in an advanced stage, the treatment requires a combined effects of the gastroenterologist(hepatologist), oncologist, palliative care specialist and others.
Doctor :   The treatment is mainly based on giving her a pain free, supportive treatment in the form of nutrition, and in the mean time restricting the spread of the cancer.
User :   Are you able to give me any kind of life expectancy or does this depend on a patient by patient basis?
Doctor :   Hence pain relief measures (both opioid and non opioid) drugs, nutritition (orally or through fluids) along with chemotherapy and radiotherapy measuress.
Doctor :   Life expectancy can be better determined by physical examination, I mean
Doctor :   It depends on the present state of the individual.
Doctor :   Various parameters such as the stage of the cancer, the physical build and nutritional state of the patient,
Doctor :   presence of other comorbid conditions are all considered.
User :   She is not able to eat anything at the present time as she is vomitting bile constantly. This is after only sips of water and when she was on oral medication.
Doctor :   Since these details are better known by her treating doctor, the approximated expectation can be better suggested by her doctors.
Doctor :   I can understand that, she will need medications to support her along with the anticancer measures, along with giving her pain free life.
Doctor :   Hence it requires a multispeciality approach.
User :   I completely understand everything you have said and it makes complete sense. Thank you. Based on the information given, are you able to give an indication of a maximum life expectancy should she continue the way she is? Of course, we will not expect this, but just so we can prepare for what may be on its way.
User :   Also, for the cancer to be at stage 4, do you have any idea of how long she may have had the cancer?
Doctor :   If her liver functions are not severely hampered and her nutritional state are fine, 20% of advanced breast cancer can survive upto 5 years.
Doctor :   However, a deterioration of the conditions can hamper this.
Doctor :   If her liver functions and physical condition has been impaired severily, the expectancy can be as low as few months.
Doctor :   My suggestions on this are not totally valid as I do not know her present condition.
Doctor :   Hence I suggest that you discuss these issues with her treating doctors.
Doctor :   They would be able to give you a better expectations.
Doctor :   Have you followed what I have suggested?
User :   I completely understand and thank you so much for telling us this but its just something for us to bear in mind as we have not really been told much by the cancer specialists and we felt we needed to know what could be expected.
Doctor :   Do you have any other query?
User :   We will be speaking to the cancer specialist later today...I will ask them if they can give us an indication.
Doctor :   They will be able to give you a much clear picture than me.
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
User :   Thank you for your help, goodbye.
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