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Is lump in throat, brown mucous and weigh loss symptoms of cancer?

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77 year old female stroke victim. Has had husky voice for over 6 months. Lower left lobe pneumonia with half a litre of fluid in pleural layer. Still has pneumonia like symptoms including difficulty breathing, shortness of breath, crackling in both lungs, 5 courses of antibiotics have not cured it. Feeling of a lump in throat, and possible lymph node swelling on external examination. Nasoendoscopy showed healthy vocal cords but thick brown mucus plug. Has previously had a goitre removed via full thyroidectomy which turned out to be malignant but had been removed in it's entirety, so no need for additional treatment. Has lost weight and sleeps a lot. Referred to head and neck cancer unit. What are your thoughts? Staging? Possible treatments, prognosis?
Posted Fri, 13 Apr 2012 in Cancer
Answered by Dr. Robert Galamaga 49 minutes later
Hello and thanks for the query.
It sounds like there are quite a few things going on in your case. First of all a history of stroke can increase the risk of swallowing difficulty as well as aspiration of secretions. This can subsequently leave her prone to developing pneumonia.

With these respiratory symptoms I think you need to see a pulmonary specialist for a thorough consultation and possibly a bronchoscopy to look inside the airways. An infectious disease specialist may also be able to recommend appropriate antibiotics in this setting.

Now the weight loss and possible neck mass is concerning but the workup seems incomplete. She will need imaging including a CT scan and possibly a PET scan to look at the soft tissue in the neck. In addition she will need some kind of biopsy if there is a true mass there to determine what is going on. This could be a lymphoma or a carcinoma. Until a sample is analyzed it is not possible to assign a stage or prognosis.

Hopefully she will see a physician in the head and neck unit who can coordinate the continuation of her workup and devise an appropriate treatment plan.

Again I thank you for your query. I hope you hbe found my answer to be both helpful and informative. Should you have additional concerns I would be happy to address them.


Dr. Galamaga
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