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Had hysterectomy. Follow up scan and tests revealed cancer cells in lungs. Suggested provera. What should be done now?

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Oncologist, Radiation
Practicing since : 2007
Answered : 526 Questions
My wife has recently had a hysterectomy. Follow up scans and blood tests revealed the presence of cancer cells in her lungs. As she is very frail the oncologist has suggested provera as a treatment ... it is hoped that this will slow down cancer cells (fingers crossed). She is taking 250mg once per day ... started treatment Thursday 1st Aug. Today, Sunday she has been vomiting all day and I am concerned for her wellbeing. What should I do? I am her husband and carer.
Posted Sat, 24 Aug 2013 in Cancer
Answered by Dr. Dipanjan Majumder 41 minutes later
Thanks for posting your query.
The exact disease you have not mentioned. From the treatment history it seems to be endometrial cancer treated with curative intent but after operation lung metastasis identified.

Scan showed lung deposit , then whether it is a primary lung cancer or a metastatic disease from previous disease (? endometrium) should be identified.

As your oncologist suggested provera ( hormonal treatment ) he / she tries to treat in a metastatic endometrial cancer line.
Now provera in high dose can be used in such condition.
Response rate depends on ER/PR positivity.

Response rates as high as 37% have been reported in patients with PR positive
disease (measured by immunohistochemistry) compared with a response rate of 8% in women with PR-negative disease.
So follow your oncologists' advise. In case of vomiting antiemetics should be tried first. But you should be cautious. If projectile vomiting with altered consciousness develops better to get examined by a physician. Serum electrolytes and brain imaging may have to be done.
Take care of your wife. I will be available for follow up.
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