My Mom..her name is Bonnie... was dx Stage 3A adeno in 08/12. She had her ULL removed, some meditasinal lymph nodes removed. She had seven weeks of concurrent chemo and radiation which commenced six weeks after recovery from surgery. She had a rough time right after her treatment plan had ended in early December. She lost a lot of weight. She had/has SEVERE espohagitis. She had a PEG tube placed and still has it. She is just starting to supplement her liquid diet with food by mouth. She is gaining a little weight. But... she had just seen her care team and had a PET/CT on 03/04/13. She had a CT on 01/04/13 and thank God ..,they stated that she appeared to be NED but on this PET/CT...apparently the PET had picked up too much imflamation to determine any cancer activity so they suggested a definite follow up PET/CT in three months.
1st question: the CT in January did not determine any activity by lesion/tumor size...none detected. Now... this PET/CT on 03/04 picked up what they stated was imflamation at the esphoagus and near the radiation focal path but again they are recommending a PET/CT in early June to determine what exactly is or is not going on.
Should we just wait and not over react to this recommendation of waiting until June?
Also my Mom just recently developed a cough that occurs less often than not but it is concerning as she did not really have one at all. Now...she has had.... for months head/nasal drainage...all of the drainage has been clear. The docs prescribed Previcid and Benadryl.
My Mom's home nurse stated that the recent cough could be due to her PEG tube? Is this true or can be true? Her pulsox has been around 97 to 95. The doctors listened to her lungs and stated they sound all clear. Please let me know if possible and thank you.
My Mom...some questions - 1254689
dkm5859
![]()
Posts:89
Forums
Reply # - March 12, 2013, 10:28 PM
Reply To: My Mom…some questions
I'm sorry she's had such a hard time with her treatment, which doesn't seem surprising in consideration of how aggressively she was treated.
In terms of asking about what to do about her recent scan findings, I'd have to ask what you are proposing as an alternative to waiting until the next scan, as it sounds like she has had an extremely aggressive course of treatment and isn't a candidate for anything more right now. Moreover, if cancer were to be detected, I don't think there would be a clear value to finding it now vs. at the time of a next scan. This is a situation in which we'd often wait to see what the next scan shows, especially since it would be hard or impossible to identify a clear incentive to move heaven and earth to work it up further right now.
I would consider it possible, though not especially likely, for the PEG tube to be causing a cough. Probably more likely would be some post-radiation (chemo/radiation) lung inflammation called pneumonitis that is notorious for causing a cough, often shortness of breath, and sometimes also fevers in the months after radiation to the chest, or especially chemo/radiation given concurrently, has been completed.
Good luck.
-Dr. West
Reply # - March 13, 2013, 06:52 AM
Reply To: My Mom…some questions
Thank you so very much Dr. West for your time, caring & dedication. Yes, we really weighed our options considering the different treatments we were offered. We were told that there were no guarantees from the outset & we acknowledged that. We were advised to try to be agressive as possible and try to hopefully 'nip it in the bud' so to speak when dx'ed.They stated that to to try to 'get the treatment course correct the first time around so hopefully any future treatments will not be necessary for her. My Mom is trying her best like many, many others to fight this and hopefully win. I want to thank you and many others here and her care team for everything and with much effort, help, good luck and or God's blessing... hopefully her and many others become and or remain NED/ stable and live many good healthy years.
Just a follow-up or two if I may...
Would her cough which just recently started within the past ten days or so still most likely being caused from some post radiation(chemo/radiation) inflammation(pneumonitis)EVEN though she did not have this cough weeks and or a couple months ago.. in other words could the cough develop now as opposed to earlier on even if this same condition(pneumonitis) was present earlier also? Sorry for being so verbose and 'picky'...obviously I'm very concerned.
Thank you again.
Reply # - March 13, 2013, 09:19 AM
Reply To: My Mom…some questions
A cough from pneumonitis can start anytime, especially if the person had been taking a narcotic pain medication. Narcotics relax the cough reflex an stops a cough. You said your mom has started eating a bit, that could cause the irritation. In truth a cough can start for any number of reasons and is one of the top reasons for the general public to see a doctor add that info with cough being very common in lung cancer. Your mom's doctors maybe a pulmonologist, would need to check her out.
From a discussion on radiation pneumonitis,
"Pneumonitis is one of the risk factors associated with radiation treatment to the lung. Radiation pneumonitis is an inflammatory reaction that resembles a pneumonia that typically occurs in patients 6-24 weeks after they have completed radiation treatment" from http://cancergrace.org/radiation/2008/08/11/pneumonitis/
managing cough, http://cancergrace.org/cancer-treatments/2009/05/09/managing-cough/
Of course your very concerned, cancer is a dreadful disease. The only reason I'd suggest not to be too verbose when asking a question is for time management of our doctors we ask that you be as succinct as possible. Otherwise if you need to rant we do that too and it's helpful, but we try to keep those posts separate.
I hope this is helpful,
Janine
Reply # - March 13, 2013, 04:16 PM
Reply To: My Mom…some questions
Janine's exactly right. It's possible that the cough is from the chemo/radiation, but of course there are MANY potential reasons for a cough, and there's no way for me to know which of these is the culprit. Only her doctors would be in a position to realistically assess the most likely cause in this complex situation.
Good luck.
-Dr. West