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Having Jaundice. Patient Of Diabetes And Blood Pressure. Diagnosed With Cancer. What Can Be Done?

Posted on Fri, 21 Jun 2013

Question: My brother in law aged 60 years was having jaundice since last one month. He is also a patient of Diabetes and High Blood Pressure. The colour of white portion of his eyes as well as the whole body has become yellow. Though he is not having any pain etc., but minor itching is there. He is taking meals as a normal person would have taken. The Doctors have diagnosed that he is having Cancer. But their first priority is to reduce Jaundice and then only they will consider treating Cancer (If possible). His Triple Phase CT of Whole Abdoment as well as the Doctor's Findings and Path Reports are enclosed.

Please advise what to do in the circumstance?

Answered by Dr. dr. Jawahar Ticku (1 hour later)

Dear XXXXXX,

Your brother in law is possibly suffering from carcinoma of head of pancreas or liver cancer giving rise to obstructive variety of jaundice. In this condition liver functions are deranged and if the drugs are started right now they will do more harm than good because all the drug go to the liver to get metabolized there.

Therefore, before starting the treatment liver functions have to be improved by reducing the jaundice. For this a stent may be needed to drain all the toxins and bile products. Once optimal liver functions are achieved, the treatment can be started.

I am not able to see the pathological report but I am sure that some benefits will definitely achieved after starting chemotherapy.

Truly,
Dr. J. Ticku

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. dr. Jawahar Ticku (20 hours later)

Thanks for your reply. To add further, the Ultra Sound was done yesterday to explore the possibilities of Stnentig but as per the attending Doctor, the possibility of doing metal stenting is very thin (hardly 1%).

I am also attaching herewith the Pathological Reports including the Ascitic Fluid for Cytology Report for your reference and consideration.

Please advise what should be done for reducing Jaundice and what should be our further action in the matter? If Jaundice is reduced, should we go for chemotherapy?

Answered by Dr. dr. Jawahar Ticku (59 minutes later)

Dear XXXXXX,

Thanks for your further interest. Ultrasound will not decide the possibility of stent but ERCP at the hands of expert gastroenterologist might solve the problem. Starting C.T at this stage will be harmful. The other possibility is the external drainage of the bile through a good gen. surgeon. If this is done and jaundice subsides, you can start chemotherapy as will be advised by the Oncologist. These measures will give a good palliation and benefit of longer survival.

Truly,
dr. j. ticku

Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E