Expert: Claes-Gustaf Nordquist, M.D. - 7/10/2009

Question
QUESTION: Hi Dr Nordquist
Wrote to you last week about my brothers melanoma in the brain. He has finished his 2weeks radiation therapy, and the doctor only wants to see him in 2 weeks time, could you tell me what are the next steps please?? and why does he only see him in 2 weeks time? thanks, you have really been very helpful up to now and I greatly appreciate it.


ANSWER: Honestly speaking - and I'm very frank now - probably because he knows that there is nothing more he can do and he does not expect much results from this radiation treatment. I'm sorry I have nothing better to tell you!


---------- FOLLOW-UP ----------

QUESTION: Hi, am sorry if I am being a nuisance and wasting your time, but my brothers breathing the last few days has been very heavy and his left arm is very cold. Dr Nordquist could he be getting near to the end of his life? My brother is in South Africa and I am in Portugal, and want to have some idea if its time for me to go there and be with him while he is still alive. Sorry once again for all the questions.
Yours faithfully
Caron

ANSWER: Dear Caron, you are certainly not a nuisance in any way! I'm here to help and I did put myself here. Your brother will over time be more and more confused and will sleep more and more. There may also be stroke like symptoms - and this may be such a symptom - and even epileptic fits. When he sleeps all the time his end is near. He will then slip into a coma and then pass away. There will not be much pain - if any. You can use his sleep pattern as an indication when it is time for you to go to South Africa.


---------- FOLLOW-UP ----------

QUESTION: Hi Dr Nordquist, its me again.
This morning I spoke to my mom in South Africa, she was telling me that my brother has a very big appetite, but is very thin except for his stomach which is swollen. Could the cancer have spread?? Feel so bad to keep on asking you questions when Im sure you have more important issues.
Thank you very much
Best regards
Caron

Answer
Dear Caron, since his melanoma has as we know already spread to his brain it may indeed also have spread to other sites as well like his liver or his peritoneum (his inner abdominal lining). Both of these sites could explain his symptoms. You are not disturbing me at all. I'm retired after a stroke and have myself recently had radiation therapy for a prostate cancer - the treatment seems to have been successful - so I have all the time in the world. Pardon my curiosity but your English is very good, so I wonder if you are Portuguese or South African? You are very welcome! Thanks! best regards! Claes