Expert: Claes-Gustaf Nordquist, M.D. - 2/9/2011

Question
QUESTION: mum had a seizure 2 days ago, tests came back with lung primary & brain secondary.  Tests also showed spots in the adrealine glands in stomach.  Mum has lost control of her bladder and bowel & Mum says she is absolutely in no pain.  Should we begin sorting her affairs asap.  the hospital want to take a biopsy from the lesion in her lung to confirm the grade and age of cancer.

ANSWER: Well yes in this situation with a probable stage 4 lung cancer that has spread to her brain and to elsewhere (here at least her adrenal glands) her survival time - even with treatment - can probably be measured in months - at most. So it is probably a good idea to put her affaires in order soonest in order to avoid unpleasant surprises and complications.



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

QUESTION: thank you for your quick response.  today they found a lump on mums neck and want to do a biopsy of that tomorrow.  the doctors also want to do a bone marrow, they have told mum she might not survive the bone marrow test, so why do they want to do this and what benefit could this be???

ANSWER: The biopsy of the neck lump offers a quick, easy, very safe and simple way to have a pathology diagnosis. I do agree that it should be done. A bone marrow biopsy offers the possibility of differential diagnosis (if that is necessary in this case which is uncertain) and of more precise staging. I doubt very much that it is as dangerous as your mother describes it. I think there must be a misunderstanding here. But a bone marrow biopsy is less easy than the one from her neck lump. Even so I have no serious objections to it. Thanks!




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

QUESTION: A week later and we have been told that mum has so much cancer through out her body, however she isn't in any pain at all.  they are suggesting radium for 5 days at 10minutes on her brain, then maybe chemo for the rest of the cancers for 3mths after being assessed.  they've told mum she has 3-4mths.  why do they want to try this if the side effects will be hard for her.  I am scared for mum but supporting her decisions.  I see her so well looking now, and don't want her to go through suffering.

Answer
Well even if she does not suffer now she will eventually unfortunately with so much cancer. Such treatmen MAY be able to reduce that at least to some extent.




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