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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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What does my lab test report indicate?

Answered by
Dr.
Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1546 Questions

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Posted on Mon, 3 Jul 2017 in Cancer
Question: To be answered by Dr. XXXXXXX Sundriyal, Oncologist

The surgery /hemiarthroplasty has been completed 18 days, the incision was healing well and the staples were removed yesterday.
The pathologic report is same as MRI diagnosis.
Please reply me so that I may have some other questions for you, thanks so much.
doctor
Answered by Dr. Deepak Sundriyal 2 hours later
Brief Answer:
Hello. Hormonal treatment can be started

Detailed Answer:
Hello dear. Its good to hear from you. So the hormonal treatment can be started now. You must discuss now with your oncologist. Plwase revert back.
Thanks and regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Deepak Sundriyal 1 hour later
Yes, thanks Dr. Sundriyal, that’s why I would like to share with you the updates below.

On May 18, Zometa 100ml was injected IV. It was told that Zometa will be given once every three months per JAMA report/local oncologist said.

May 19 the surgery was completed, the cancer lesion/right femur was completely removed (about 12cm) and the margin was clear. Stayed in an hospital for two nights and 8 nights in a rehab center, now come back home about 1 week already, can walk with a walker and get physical therapy at rehab center and will start 2 times per week from next week at professional physical therapy center.

Hormone therapy were started on XXXXXXX 1 after pathologic reports came out.
Hormone therapy were given:
Femara 2.5mg/daily
Ibrance 125mg/daily for 3 weeks, stop one week, then start 3 weeks again.
Blood work ordered for CBC weekly to check Ibrance response and side effects. Next week will check CEA to see drug response.
Feeling better and get good appetite, but having night sweat and feels hot.
Visited the surgeon yesterday (6/6) and removed all staples, the wound/incision site was healing well.

Questions are below:
1---Usually, how long the Ibrance should be taken?
2---The pathologic report is same as MRI diagnosis. The prognostic studies showed estrogen receptor/ER 50-90% (+) (varies) , progesterone/PR 0% (-), HER2 0 (-). Your thoughts?
3---Your experience for the prognosis case like this?
4---Also done GCDFD test/stain, not sure about result. Why and for what?
Please let me know your thoughts, thanks.
doctor
Answered by Dr. Deepak Sundriyal 37 minutes later
Brief Answer:
Hello. Everything is fine.

Detailed Answer:
Hello. So as per the details, everything is going fine. Ibrance has to be taken lifelong till the disease is responding, or if there are side effects which are intolerable. The pathological report suggests that this tumor will respond to surgery and the prognosis is good. This hormonal combination must work atleast a period of 3 years or more.
Lastly gcdfp is a marker for tumor of breast origin and is being done to make sure that metastases originated from breast tumor.
Thanks and regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Deepak Sundriyal 17 hours later
Thanks, Dr. Sundriyal.
Today is day 19th after the surgery. Aspirin 81mg is being taken daily since 6/1 to prevent from blood clot at home.
----Per your experience, any prognostic difference between ER+, PR+ and ER+, PR- patient?
----How do you think that mets lesions are found in the PET-CT that involve axial skeleton, left femur, multiple vertebra and thoracic spine? Anything else could be done for these lesions?
----What any other thing as a patient can do to enhance best drug response?
----Drinking herbal remedy/tea would not interact with these drugs?
Your thoughts, thanks again.
doctor
Answered by Dr. Deepak Sundriyal 31 minutes later
Brief Answer:
There is no difference

Detailed Answer:
Hello again.

So there is no difference between er+pr+ and er+pr-. Your doc has already given bisphosphonate therapy to strengthen the bones and that is sufficient.

The only thing which helps is yoga and meditation, consumption of fresh fruits and vegetables.

Rest of the treatment is optimum which you have been prescribed.

Thanks and regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Deepak Sundriyal 47 hours later
Thanks you so much Dr. Sundriyal for your help and support!
Do you think the cancer patient should limit/avoid sugar and/or carbs in diet?

Best regards.
doctor
Answered by Dr. Deepak Sundriyal 18 minutes later
Brief Answer:
Hello. No need for any limitations

Detailed Answer:
Hello. If patient is not diabetic, there is no such need. Eat a balanced diet.
Thanks and regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Deepak Sundriyal 19 hours later
Thank you very much again, Dr.Sundriyal.
Take care and have a good day!
doctor
Answered by Dr. Deepak Sundriyal 4 hours later
Brief Answer:
Welcome

Detailed Answer:
Hello. You are always welcome. Best regards.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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