Expert: Claes-Gustaf Nordquist, M.D. - 7/26/2010

Question
Dear Doctor,

My mother was diagnosed with breast cancer which was spread to the bones last year and had surgery and chemotherapy for 6 months. Now she is on a pill which needs to be taken for 5 years. After the chemo her cancer was not detected in the bones.However, she was diagnosed with the cancer again and and she has a bloated stomach and bloated legs.Iam not with her as I have a little baby and live in another country with my husband. I get second hand information about the situation and Iam unfortunately unable to give you very precise information.Doctor has suggested chemo again and I personally do not feel right about it as my mother is a walking skeleton after the initial chemo.She has severe diabetes and on insulin two times a day. She is even unable to give a blood sample and as does not have enough blood.

I would like to seek your advice in this regard. I can get the reports for your perusal if you could do it for me.

Thank you

Lemali Pathirana

Answer
I'm sorry to read about her - and your - problems! From your description it is obvious that your mother has a stage 4 breast cancer which is also hormone receptor positive (that is why she has been given a 5 year hormonal medication). Since her cancer has spread to her bones (another organ) it is clearly a stage 4 cancer. Such a cancer is at present incurable but it may be controlled. In your mother's case the treatment options are 1. Hormonal treatment which she already has and which in her case has not proved to be very effective unfortunately. 2. Chemotherapy which seems to have worked at least to some extent up to now but which in her condition may be difficult to give. If it can be given it may offer additional control. And 3. Radiation therapy. However in this situation that treatment may have only palliative use here especially for some pain control. Surgery MAY also have a role but that depends on - among other things - where her cancer now has reappeared. Do you know where? As you can see I'm not sure that more chemotherapy can indeed be given BUT in this situation it is that treatment that seems to offer her the best chances. However even if it turns out to be possible to give it her prognosis in this situation unfortunately remains doubtful - to say the least!
Where does your mother live? I'm sorry I have nothing better to tell you!

Thanks! Your description MAY also indicate that her cancer has spread to her liver and maybe also to her abdominal area.






You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128     There is no restriction to the number of questions there.