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What Do These Blood And Urine Test Reports In A Ovarian Cancer Patient Indicate?
Question: my mother age 74 weight 36 KG height 5 ft is suffering from ovarian cancer which was detected late. CAA was 577 and has spread to other parts.She is suffering from uti for last two months . was given tazar and metrogyl iv for a week and thereafter is on nitrofurantoin 100 sustained release bd and lcin 500 od for last 12 days. blood and urine test conducted on 24 Jun and 01 july.Comparison is as under
-haemoglobin fallen from 6.8 to 6.5
-PCV fallen from 21.3 to 20.8
-RBC fallen from 2.58 to 2.5
-MCV within range, risen from 82.6 to 83.2
-MCH fallen from 26.4 to 26
-RDW risen from 18.5 to 19.5
-TLC fallen from 13.03 to 7.95
DLC
-Segmented neutrophils % fallen from 84 to 77.7, now within range
-Lymphocytes % risen from 6.3 to 7
-Monocytes % risen from 9.4 to 14.7, now not within range
-Eosinophils % risen from 0.2 to 0.5
-Basophils % static at 0.1
ABSOLUTE LEUKOCYTE COUNT
-neutrophils fallen from 10.95 to 6.18 , now within range
-lymphocytes fallen from 0.82 to 0.56
-monocytes fallen from 1.22 to 1.17
-eosinophils risen from 0.03 to 0.04
-basophils static at 0.01
-platelet count fallen from 538 to 450 , now just within range
Urea serum was 45.5 on 16 jun and today is 27.8, within range
Creatinine serum was 0.4 on 16 jun and today is 0.3
Sodium serum was 130.2 on 16 jun and today is 120.9
Potassium serum was 3.42 on 16 jun and today is 3.97, within range
URINE REPORT
-specific gravity and pH static and within range
-proteins fallen from 2+ to 1+
-glucose,ketones, bilrubin static at nil
-uribilinogen static at normal
-leucocyte esterase static at positive
-nitrite static at negative
-RBC fallen fron 40 - 60 to 8-10
-pus cells static greater than 120
-epithileal cells fallen from++ to +
-cystals same as last that is calcium oxalate
-casts and others nil
Other symptoms are
- fever is going upto 100
-nausea, vertigo, slight vaginal discharge
-refuses to eat solids
pl advise, should we give iron IV or blood. Any changes in medication?any supplements to be given?
-haemoglobin fallen from 6.8 to 6.5
-PCV fallen from 21.3 to 20.8
-RBC fallen from 2.58 to 2.5
-MCV within range, risen from 82.6 to 83.2
-MCH fallen from 26.4 to 26
-RDW risen from 18.5 to 19.5
-TLC fallen from 13.03 to 7.95
DLC
-Segmented neutrophils % fallen from 84 to 77.7, now within range
-Lymphocytes % risen from 6.3 to 7
-Monocytes % risen from 9.4 to 14.7, now not within range
-Eosinophils % risen from 0.2 to 0.5
-Basophils % static at 0.1
ABSOLUTE LEUKOCYTE COUNT
-neutrophils fallen from 10.95 to 6.18 , now within range
-lymphocytes fallen from 0.82 to 0.56
-monocytes fallen from 1.22 to 1.17
-eosinophils risen from 0.03 to 0.04
-basophils static at 0.01
-platelet count fallen from 538 to 450 , now just within range
Urea serum was 45.5 on 16 jun and today is 27.8, within range
Creatinine serum was 0.4 on 16 jun and today is 0.3
Sodium serum was 130.2 on 16 jun and today is 120.9
Potassium serum was 3.42 on 16 jun and today is 3.97, within range
URINE REPORT
-specific gravity and pH static and within range
-proteins fallen from 2+ to 1+
-glucose,ketones, bilrubin static at nil
-uribilinogen static at normal
-leucocyte esterase static at positive
-nitrite static at negative
-RBC fallen fron 40 - 60 to 8-10
-pus cells static greater than 120
-epithileal cells fallen from++ to +
-cystals same as last that is calcium oxalate
-casts and others nil
Other symptoms are
- fever is going upto 100
-nausea, vertigo, slight vaginal discharge
-refuses to eat solids
pl advise, should we give iron IV or blood. Any changes in medication?any supplements to be given?
Brief Answer:
Need to check urine culture reports
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns. It appears to be Krukenberg tumor, where cancer comes from some other organ like breast, stomach, colon to ovaries. Its treatment is different from ovarian cancer. Have we done any biopsy? If hormone receptor positive on biopsy we can give hormonal therapy even now.
Regarding UTI, we need to check urine cultures. I don't see any of these. As the infection is not resolving, I would suggest IV meropenem or ertapenem pending culture report.
Regarding anemia, I feel blood transfusion will be best now. Oral nutritional supplements like ensure or prosure can help.
Hope this helps. I will be available for further follow-up.
Regards
Need to check urine culture reports
Detailed Answer:
Hi
Thanks for your query.
I understand your concerns. It appears to be Krukenberg tumor, where cancer comes from some other organ like breast, stomach, colon to ovaries. Its treatment is different from ovarian cancer. Have we done any biopsy? If hormone receptor positive on biopsy we can give hormonal therapy even now.
Regarding UTI, we need to check urine cultures. I don't see any of these. As the infection is not resolving, I would suggest IV meropenem or ertapenem pending culture report.
Regarding anemia, I feel blood transfusion will be best now. Oral nutritional supplements like ensure or prosure can help.
Hope this helps. I will be available for further follow-up.
Regards
Above answer was peer-reviewed by :
Dr. Shanthi.E
Mammogram was done in XXXXXXX 15 and it was cat 1 i.e. all clear.
Biopsy was done in feb 14 and it was all clear, at present doctors say she is unfit for biopsy
She was earlier given tazar iv and is now on nitrofurantoin based on urine culture which i have now attached.File name is U1P1
She has lost bladder control since last five days, fever goes XXXXXXX to 100 but breaks on its own, most of times there is slight sweat on forehead even though she is in AC, complains of continuos great weakness, nausea and vertigo for which she is given emeset 2mg. Keeps lying down, only gets up to go to toilet for which she has to be fully supported.Has frequent urge for stool/urine, at times hourly which appears to reduce when she is given half tablet trabest for pain or fever. Wants to keep resting without talking or opening eyes but is mentally alert. Feet are swollen for last 15 days.
We are already giving her prosure. Will albumin/amino acids/ iron sucrose given intravenously be of any use?can we get any other tests done which her frail condition can take?overall what all actions can we take?
Biopsy was done in feb 14 and it was all clear, at present doctors say she is unfit for biopsy
She was earlier given tazar iv and is now on nitrofurantoin based on urine culture which i have now attached.File name is U1P1
She has lost bladder control since last five days, fever goes XXXXXXX to 100 but breaks on its own, most of times there is slight sweat on forehead even though she is in AC, complains of continuos great weakness, nausea and vertigo for which she is given emeset 2mg. Keeps lying down, only gets up to go to toilet for which she has to be fully supported.Has frequent urge for stool/urine, at times hourly which appears to reduce when she is given half tablet trabest for pain or fever. Wants to keep resting without talking or opening eyes but is mentally alert. Feet are swollen for last 15 days.
We are already giving her prosure. Will albumin/amino acids/ iron sucrose given intravenously be of any use?can we get any other tests done which her frail condition can take?overall what all actions can we take?
Brief Answer:
Then only supoprtive treatment
Detailed Answer:
I am afraid to say that it seems that her disease is beyond control right now. We can only provide symptomatic and supportive care which she is already getting. IV albumin may reduce her swelling for few days. It is temporary. We can still give her some IV nutrition (aminoacid, lipid, carbohydrate mixture, like Kabiven). That may improve her general condition.
I am unable to see the U1P1 report. You can email that to YYYY@YYYY with header ATTN: Dr Indranil Ghosh
Regards
Then only supoprtive treatment
Detailed Answer:
I am afraid to say that it seems that her disease is beyond control right now. We can only provide symptomatic and supportive care which she is already getting. IV albumin may reduce her swelling for few days. It is temporary. We can still give her some IV nutrition (aminoacid, lipid, carbohydrate mixture, like Kabiven). That may improve her general condition.
I am unable to see the U1P1 report. You can email that to YYYY@YYYY with header ATTN: Dr Indranil Ghosh
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Doctor
I have mailed you the urine culture report that you could not have a look at. what do you recommend?
I have mailed you the urine culture report that you could not have a look at. what do you recommend?
Brief Answer:
yes I have seen it
Detailed Answer:
It is an esbl bacteria. Even though it is sensitive to nitrofurantoin and piperacillin they may not work and I think that is happening. I would recommend meropenem or ertapenem.
yes I have seen it
Detailed Answer:
It is an esbl bacteria. Even though it is sensitive to nitrofurantoin and piperacillin they may not work and I think that is happening. I would recommend meropenem or ertapenem.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok. Certain issues I would like to highlight are
-no fever for last two days
-at times frequent urge , even half hourly, for stool and urination.
-continuous feeling of nausea and vertigo
-great weakness
-not much pain
-low appetite
-she is taking following medication under prescription
-nitrofurantoine 100 mg bd sustained release for uti
-levofloxacin 50 mg od for uti
-emeset 2mg bd for nausea
-trabest sos, XXXXXXX one and half tab in 24 hours, which appears to also relieve the frequent urge for urine/stool also
-aldactone 50 mg for swelling
-orfer suspension 5ml bd for anemia
-fluka 150 od for fungal infection in mouth
-prosure supplement
- I have been told by other doctors that these may not be the best combination in terms of interaction, effectiveness and side effects particularly with reference to trabest, levofloxacin and emeset
--Therefore what are the best, most effective alternatives available to the above prescription , with least interactions/ side effects that will most effectively address the condition particularly the uti, nausea and vertigo ,frequent urge for stool/ urination and loss of appetite?
-no fever for last two days
-at times frequent urge , even half hourly, for stool and urination.
-continuous feeling of nausea and vertigo
-great weakness
-not much pain
-low appetite
-she is taking following medication under prescription
-nitrofurantoine 100 mg bd sustained release for uti
-levofloxacin 50 mg od for uti
-emeset 2mg bd for nausea
-trabest sos, XXXXXXX one and half tab in 24 hours, which appears to also relieve the frequent urge for urine/stool also
-aldactone 50 mg for swelling
-orfer suspension 5ml bd for anemia
-fluka 150 od for fungal infection in mouth
-prosure supplement
- I have been told by other doctors that these may not be the best combination in terms of interaction, effectiveness and side effects particularly with reference to trabest, levofloxacin and emeset
--Therefore what are the best, most effective alternatives available to the above prescription , with least interactions/ side effects that will most effectively address the condition particularly the uti, nausea and vertigo ,frequent urge for stool/ urination and loss of appetite?
Brief Answer:
please refer below
Detailed Answer:
Trabest is for pain, it can cause some nausea, so emeset for nausea control. No problem with that. Dose of emeset can be increased if required. Levofloxacin is an antibiotic which can go along with these.
For UTI I have already expressed my opinion. However, exact medicines and doses can only be fixed by the treating physician as he or she is the best judge. We can give a general guideline.
please refer below
Detailed Answer:
Trabest is for pain, it can cause some nausea, so emeset for nausea control. No problem with that. Dose of emeset can be increased if required. Levofloxacin is an antibiotic which can go along with these.
For UTI I have already expressed my opinion. However, exact medicines and doses can only be fixed by the treating physician as he or she is the best judge. We can give a general guideline.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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