Suggest treatment for stomach cancer
My father had reported weight loss of 8+Kg over last two months and his weight is still going down, He has difficulty digesting food and get burps even if he drink water. Loss of appetite, Nausea are the other symptoms. He has gone very lean and has lot of weakness. his ALP & GGT are high, HB is 13.4 and Iron and calcium are low. We went to a local doctor and he suggested Ultrasound and then CT. As per CT, it looks like my father probably has Stomach cancer with Liver metastasis. His biopsy report for stomach tumour was done yesterday and is awaited however doctors here are very certain that he has it. The tumour in the stomach is of size 7.3* 6.8* 6 cm. Liver has multiple lesions mainly in right lobe of liver and CT report also says portal vein thrombus. When we consulted the GI surgeon , he suggested that chemotherapy is the only option and we should consult a medical oncology. We have done the PET CT whole body today as well . I know I should wait for biopsy but just wanted to check whether radiation therapy like cyber knife or surgery is any option? Should I consult radiation oncologist and a different surgeon? Please help. Many thianks
chemotherapy is only option
I am sorry to know about your dad. This indeed appears to be advanced stomach cancer with spread to liver. This is unfortunately incurable.
Only option is to proceed with chemo. After the biopsy report obviously. Biopsy report can be expedited if doctor speaks to pathologist.
Radiation or cyberknife has got no role here. Same for surgery, unless there is a block in stomach outlet which needs to be bypassed.
So I think consulting a medical oncologist is appropriate.
Hope this helps. I will be available for follow up.
Could you please advise:
1) How much life expectancy can we guess?
2) How can we make his last days better. Is there any digestive enzyme, Ayurveda medicine or anything we should give him that can help him digest food better?
3) How do we know if he can withstand Chemo?
difficult to predict life expectancy
Without seeing a patient personally, it is very difficult to predict life expectancy. Even after seeing it is hardly accurate. But overall, metastatic stomach cancer patients survive around a year on average.
some medicines can definitely be given to improve his quality of life. This is called palliative medicine. The medical oncologist can prescribe those himself or else he can send him to a palliative care specialist.
Whether he can tolerate chemo is entirely dependant upon his general health and blood parameters. Only the medical oncologist who is treating him can make this judgement.
lung nodule too small
The lung nodules and neck lymph nodes are too small to characterize but possibility of spread is there. Liver spread is definite. PET CT is more accurate so we will go by that only. Liver size is of no importance at this point. The liver spread matters.
Again I would suggest chemo.
Also Is Medanta in XXXXXXX a better hospital or Apollo Indraprasta in XXXXXXX for cancer treatment? thanks
Also please advise me if chemotherapy drugs depends on the doctor or is it going to be same treatment/dose irrespective of the doctor and depends on the source of cancer being treated. Reason I ask is because we are from XXXXXXX and currently in XXXXXXX So I am confused whether I should continue the treatment here in XXXXXXX where the doctors are more competent or should I take him back to his hometown in XXXXXXX Thanks
biopsy has confirmed cancer
only for hercept test they probably need more sample. If hercept positive, an antibody called herceptin is added to chemo. But result not much altered. It is very costly also. So if you do not consider adding herceptin, no repeat biopsy required.
Delhi/NCR has strong oncology team. XXXXXXX is also upcoming center. You can take one chemo at XXXXXXX and continue further at /Jammu as per their prescription.
How do we decide whether we should continue his treatment or will he be better off by not doing further Chemo. Some people told me that chemo is so strong that people go to wheelchair straight after that, is it that bad?Will he be able to live a semi-normal life after chemo? He is still able to eat & walk somewhat now, I hope Chemo will improve his quality of life and not deteriorate.
I will be in touch with you constantly throughout his treatment. Thank you for your support & guidance so far.
Many protocols are there
Some blood tests are done before chemo. Echo is also done often.
There are various drugs and regimens for chemo. Commonly used rugs are 5FU, capecitabine, oxaliplatin, cisplatin, epirubicin, paclitaxel, docetaxel, etc in various permutations and combinations. Exact regime will be fixed by treating doctor.
If the patient is generally fit and up and about then chemo is given. Otherwise not. Judgement best taken by treating doctor.
Some patients do respond and have better quality of life but others do not. Very difficult to predict before starting treatment.
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