My dad was dx with nsclc 3b squamous in feb 2012
Intense chemo and radio in April 2012
Sep scan showed shrinkage
Jan 2013 scan stable
Apr 2013 slight progression but watch and wait chosen
Aug 2013 progression so chemo started
Jan 2014 lung collapse pleural effusion
Scan showed slight progression tho referred to as stable watch and wait chosen
Taking us to the present- my dad has been experiencing middle chest pain usually worse after eating, upon moving and also when sitting with back against the sofa or flat against something. Dad visited doctor and was told it was indigestion?!
Given tablets but no improvement, was walking with my dad today and whilst not breathless he did get the pain in the middle of the chest, he sort of pants it out till it passes. But I am so worried at what this could be. He will contact oncologist next week as is the weekend now but I am so worried this is progression?
Should mention dad has had no surgery and fluid from lungs was not drained.
Reply # - June 28, 2014, 10:03 AM
Reply To: Worried about pain
Dad also has a touch of pain at rest but only a slight pain. This has all been going on for a couple of weeks but I did not know. Dads next onc appointment not till August, which is why I have insisted he contact onc after the weekend. Dad has also had no scan since January, last onc appointment was beginning of may, breathing exercises showed improvement upon last time.
Reply # - June 28, 2014, 12:54 PM
Reply To: Worried about pain
Hi knic,
Your dad's symptoms certainly sound consistent with those produced by a pleural effusion, so a consultation with his oncologist is definitely the right choice. When an effusion begins to cause pain and shortness of breath, it may be time to drain it. But as Dr. West has said:
"By the formal criteria used in clinical trials to assess for response or progression, a change in a pleural effusion does not constitute a significant change in disease status. This is because inflammation or infection, or even heart failure, can cause an effusion, and it’s also a product not just of production of fluid but also the draining ability. There are enough variables that we prefer to see it decrease or resolve, but we don’t consider a worsening effusion as clear evidence of progression." - http://cancergrace.org/topic/chronic-cough-and-difference-of-opinion#po…
JimC
Forum moderator
Reply # - June 28, 2014, 03:18 PM
Reply To: Worried about pain
Hi Jim
Thank you for your time in replying
My dad can be very stubborn and refuses to go to ER we are in England so it's a&e. He has had the pain a few times tonight but still tho it completely knocks him when it comes and I want to call an ambulance he insists on waiting to talk to the oncologists secretary Monday! I feel helpless and so scared. This has been going on for 3 weeks tho I only found out about it yesterday. I live in a different county and my mum and dad only told me as they come to visit yesterday. 3 weeks and all my dad did was see a doctor! Since it started I think tho he hasn't admitted completely that it has become more frequent. I just can't think what it can be other then progression and I am so so so scared even if my dad is playing it down I can't!!! It seems to come in when exerting himself or even sitting down, he says he feels it coming like a slight pain in his shoulder and the swooping in to an intense pain in the chest. He thinks sitting back in a chair makes it worse as well as walking and sometimes feels it is relieved with burping tho I don't see how and fail to see it's food related when even if food is not consumed it happens. When the intense pain passes he either has no pain or a slight pain but the episodes of intense pain last around 5 minutes or so.
Reply # - June 28, 2014, 11:59 PM
Reply To: Worried about pain
Though it's probably not likely, having chest pain, especially associated with exertion, is also a potential red flag for heart problems, such as angina. And while I know you are aware of this and it is your father's obstinance that is the barrier, the clear recommendation in the setting of escalating chest pain is to get evaluated promptly.
I hope you get both clear answers and a plan for how to manage his issues very soon.
-Dr. West
Reply # - June 30, 2014, 12:25 PM
Reply To: Worried about pain
Hi Dr West
Thank you for your reply and it prompted me to urge my dad to go to the hospital. He has now been diagnosed with angina and given a spray for under the tongue and is waiting an appointment with cardiology, tho has been sent home and told he should be seen within 48 hours.
My question is what does this mean for his lung cancer, it must have an further negative effect?
Reply # - June 30, 2014, 08:41 PM
Reply To: Worried about pain
No, it doesn't have any clear association with his lung cancer, except that it might make it riskier to give aggressive treatments, since anemia (caused by just about all of our chemo agents) can worsen angina (fewer red blood cell "boxcars" carrying around oxygen in the blood, so the heart needs to pump more blood to deliver the same amount of oxygen compared with blood that has more red blood cells.
So it may make cancer treatment more precarious, and/or if the cancer worsens oxygenation of the blood because the lungs aren't able to function as well, the heart will be more vulnerable to ischemia, which is a shortage of oxygenated blood to the heart compared to what it needs to squeeze blood effectively to oxygenate the rest of the body.
Good luck.
-Dr. West