Diagnosed oct/nov 2012, 33 x radiation 66 gy, chemo cisplatin/ etoposide then 2 nd round carboplatin / gemcitabine. Last chemo feb/ March 2014. Hb = 8.9, wt 89.6 kgms, ht 6'5"
Hi there following the last scan, we have heard that the mediastinal lymph node tumour is now 10 cms. This is putting pressure on the oesophagus and also on the bronchus (windpipe). Klaas has a phobia about not being able to breath. Is there anything we can do to help the situation. He has been told his overall health is not good enough for more chemo and there is a small chance he might be offered radiation, they said if there was enough space .... Not sure what they meant. He has just had an MRI for his hip which has become increasingly more painful affecting mobility. He asked if he could have O2 but was told his blood oxygen level of 95 does not merit it
Is there anything we can do to make K more comfortable and to give a better quality of life or to extend life?
Many thanks for any advice you can give me
Current medications, beta blockers, metformin, sinfastine, phlegm thinner, acenocourmarol, diclovenac for hip pain, prednisone 10 mg and protect your tummy medication. Living on nutridrinks and some milk
Reply # - June 7, 2014, 09:36 AM
Reply To: Mediastinal lymph node tumour squamous stage 4
Hi Sarah,
I'm sorry to hear about the latest scan results and the difficulties Klaas is facing. The options to treat the tumor would be chemotherapy, radiation or surgery. If he is not able to tolerate further traditional chemo, it may be likely that surgery also would not be recommended. Both surgery and radiation would face the same hurdle - proximity of the tumor to vital structures. A careful evaluation by his radiation oncologist would be required before radiation would be recommended.
If there is compression of the airway, as Dr. West stated in a previous response a stent might be placed to open it up.
JimC
Forum moderator
Reply # - June 7, 2014, 09:52 AM
Reply To: Mediastinal lymph node tumour squamous stage 4
Hi Sarah,
I'm sorry to hear Klaas didn't respond to treatment. How utterly disappointing all the difficult treatment didn't work, some cancers are just so aggressive they don't respond to medicine's best efforts.
If treating the underlying cause, getting the tumor off the esophagus isn't helpful or maybe until that time opioids are used to treat the effects of shortness of breath. Dr. Harman wrote this about is in her piece on the dyspnea (shortness of breath, "Opioids: Opioids have long been used in the treatment of dyspnea. Why do they work? Chemical opioid receptors, when triggered, dampen the feeling of dyspnea. There is a fear that opioids will cause someone to stop breathing. However, given in moderate doses for dyspnea, they have proven to be efficacious and safe to the point that the American College of Chest Physicians came out with a consensus statement in 2010 on dyspnea in patients with advanced lung or heart disease, recommending that physicians “titrate opioids…for the relief of dyspnea.” Sometimes, treating the underlying cause does not resolve the dyspnea, so usage of opioids can be certainly used alongside other treatments targeting the cause." http://cancergrace.org/cancer-treatments/2012/02/17/dyspnea/#more-1720
I'm sending hopeful thoughts your way,
Janine
Reply # - June 7, 2014, 09:46 PM
Reply To: Mediastinal lymph node tumour squamous stage 4
I do think that opioids are likely to be the most fruitful option.for combating a sense of air hunger. Unfortunately, it doesn't seem that there's a clear fix for his bulky cancer -- I don't have an alternative suggestion for managing his potential complications in the chest if his cancer grew despite chemo and radiation.
Good luck.
-Dr. West