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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Breast Cancer, Food Pipe Food, Has Ascites. On Chemo. What Else Can Be Done?

Hello, My aunt is nearly 56 years of age, suffering from fourth stage breast cancer . She was initially diagnosed on May 2010 but failed to get treatment at time. She did however visit a doctor in June 2011 and her surgeon advised to reduce the size of the tumor before she could be operated on. Her treatment started in June last year (2011) with 8 courses of AC. Regular checks were done but somehow the chemo did not have an affect. Her hormone receptor tests are negative by the way so the only likely treatment could have been chemo, radiation and surgery. Her oncologist then got her on 5FU which did not have any effect on the tumor as well. Now she has secondary liver cancer as well which has taken over two of the sections of her liver. Her chemo stopped a couple of months ago as she did not want to go through any more of it. She was on pain killers and trying out Reiki treatment to manage day to day aches. She would complain of stomach pains and sometimes had trouble passing stool. Then a few days ago her health deteriorated when she started shivering and was admitted in the hospital. The doctors explained that her sodium levels had gone down. Now over the last few days she has been suffering from what looks like ascites (stomach really blown up and hand and feet hard as wood) but the doctors are not draining her stomach of the fluids. She cries due to the severe stomach aches and her urine has turned almost black. Her eyes are yolky yellow and she is on constant pain killers and catheter for her urine. Her breast cancer is reeking blood and needs regular changing. Today they informed us that her platelet count has gone down to 28,000 but still havent informed us whether we should arrange for a blood transfusion. The hospital she is in is not a cancer hospital as this was the one closest at the time when she fell ill. I personally feel the doctors are not taking this case as an oncologist would as a- they have failed to address the ascites issue b- are treating her like a normal patient even when they have all her reports in front of them. They inserted a food pipe today as well so that they can give her food via that. I just feel that since she has been admitted her health is deteriorating even more. Do you think we should change hospitals. Or is this normal in her case to suffer so much. Concerned niece - El
Tue, 24 Sep 2013
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Oncologist, Surgical,  's  Response
Before i answer your question, let me inform you that i am an experienced oncologist and have been working at a dedicated cancer hospital for some time now. Let me make a few things clear to you before i move on to the specifics. Maybe you know them already, but nonetheless. Firstly, your aunt cannot be cured of her disease by any form of treatment. Secondly, the treatment that she has undergone so far before this admission seems to be largely correct from an oncological point of view. Finally to your query. Treatment at this point is aimed only to provide her a good quality of life and to prolong whatever life we can. From what i gather she has gross ascites and her liver is failing as well due to the disease. So she would benefit in terms of pain by draining the fluid from her abdomen, although it will re-accumulate quickly and need frequent draining. Also, since her liver is failing and platelets are low, this draining procedure will have to be done after correcting her bleeding profile by transfusing plasma and platelets. In short, she will benefit from shifting to a cancer hospital. However two things you have to consider before shifting are whether she is in a condition to be shifted and your finances.
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Breast Cancer, Food Pipe Food, Has Ascites. On Chemo. What Else Can Be Done?

Before i answer your question, let me inform you that i am an experienced oncologist and have been working at a dedicated cancer hospital for some time now. Let me make a few things clear to you before i move on to the specifics. Maybe you know them already, but nonetheless. Firstly, your aunt cannot be cured of her disease by any form of treatment. Secondly, the treatment that she has undergone so far before this admission seems to be largely correct from an oncological point of view. Finally to your query. Treatment at this point is aimed only to provide her a good quality of life and to prolong whatever life we can. From what i gather she has gross ascites and her liver is failing as well due to the disease. So she would benefit in terms of pain by draining the fluid from her abdomen, although it will re-accumulate quickly and need frequent draining. Also, since her liver is failing and platelets are low, this draining procedure will have to be done after correcting her bleeding profile by transfusing plasma and platelets. In short, she will benefit from shifting to a cancer hospital. However two things you have to consider before shifting are whether she is in a condition to be shifted and your finances.