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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 30123
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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Need someone to think outside the box completely. No cost limitation,

Customer Question

Need someone to think outside the box completely. No cost limitation, how can I help my mum with advanced metastatic melanoma that's speak to liver. Apparently she has bad liver and bloods, tried zelboraf but she hasn't responded to it. Doctors here say they can't give secondary option for targeted therapy due to condition of liver and have said she has months left to live.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Chip replied 3 years ago.
Hi again. If you'd rather it not be me this time I'll gladly opt out and let another expert work with you. Just wanted to know if you have any more information about the bile blockage your mother has?
Customer: replied 3 years ago.
They said they cannot do anything for her surgically as the cancer had spread. I know the initial cancer was to big to cut out (10 cm long) with a metastatic spread. So just need someone to be completely brave and think outside the box. I accept that nobody can give me advice that is iron clad and the fact I can't rely on what's said as being definitive as you don't get to see my mums notes or past.
Expert:  Dr. Chip replied 3 years ago.
OK David. Just to recap here what exactly has her oncologist told you?
Customer: replied 3 years ago.
The cancer has grown in her liver and is making the liver dysfunctional,mum has yellowy green eyes and swollen feet. They thought the zelboraf wasn't working because of a blockage in the liver that they might try to remove or stent. But after getting the ct scan back they've said that it is more that the cancer has spread and it is inoperable. Also due to liver function, no other treatments can be used so she is just being left to die.
Expert:  Dr. Chip replied 3 years ago.
I understand. Have they tried any other chemotherapy other than the Zeloraf and remind me has she had radiation therapy?
Customer: replied 3 years ago.
No radiation therapy as she is diabetic. They said they can't safely give her other forms of chemo due to the condition of her liver, something a out it not being able to metabolise the drug properly....
Expert:  Dr. Chip replied 3 years ago.
And have you gotten a second opinion?
Customer: replied 3 years ago.
Not yet, but what can be done treatment wise?? We just want more time.
Customer: replied 3 years ago.
The registrar agrees with the consultant.
Expert:  Dr. Chip replied 3 years ago.
OK David. And what exactly do you mean by targeted therapy?
Customer: replied 3 years ago.
Zelboraf is the product name for vemurafenib a tablet. It is not chemo but more biological
Expert:  Dr. Chip replied 3 years ago.
OK--targeted for melanoma--just wanted to understand what you meant by the term. OK--you asked about thinking outside the box which I'm pretty good at, but are you asking if there are any other medications that might be tried?
Customer: replied 3 years ago.
Or any form of treatment. Her bloods are showing poor liver function which I guess they would with liver cancer. The doctor has take a judgment call not to use ipilumibab (yervoy) type of chemo because he doesn't think mum is well enough but this is his view, he has never put anyone at mums stage through it and as it is a fairly new drug there i can't access info on it.
Expert:  Dr. Chip replied 3 years ago.
Actuall yervoy would be a consideration but do you understand that if someone's overall health is poor, especially with a liver that's failing, there would be very significant risks to using a drug like that?
Customer: replied 3 years ago.
I understand that but I note that our oncologist is going by their limited experience of the drug and having only put relatively 'healthy people' on it. I need to know what options there are for my mum who isn't deemed healthy enough on one consultants opinion. Are there other options going forwards? Trials at home or abroad?
Expert:  Dr. Chip replied 3 years ago.
http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers/melanoma Here's a link to some trials that are ongoing David. If your mum qualifies she can be placed in one of them. That said, I fully understand your concern and your love for your mum but you need to know that there may not be anything that can improve her plight at this time. Certainly there are no cures. Hopefully though, with the proper trial she will respond and her length of time on this earth can be increased
Customer: replied 3 years ago.
Thanks for that info. We're based in England so won't be able to make those trials, i doubt mum would be allowed to travel...I'm going to enquire with some drug companies. Are there options to boost mum enough to be able to take ipilumibab?
Expert:  Dr. Chip replied 3 years ago.
Vitamin B complex, extra vitamin C, echinacea, garlic and ginseng, zinc logenges and healthy diet can all help David. Let me know how it goes
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 30123
Experience: 20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
Dr. Chip and 4 other Medical Specialists are ready to help you
Customer: replied 3 years ago.
Unfortunately mum passed away yesterday evening. We're all gutted.
Expert:  Dr. Chip replied 3 years ago.
So sorry to hear that David My mother finally succumbed to her breast cancer
Customer: replied 3 years ago.
I'm so sorry to hear that. It's a crushing feeling.
Expert:  Dr. Chip replied 3 years ago.
Well, she lived for 11 years after her mastectomy and had two bone recurrences in that time. When it finally hit her lungs she went down very rapidly
Customer: replied 3 years ago.
Mum managed nearly 5 years after finding some skin cancer, we thought it had gone until she got the pains on her right abdomen. I blame myself, I was a bit ill at home and I worry that by making her ill with cold/flu may have caused the cancer to flare up. It's the worst feeling as you can understand, there is no other bond like it.
Expert:  Dr. Chip replied 3 years ago.
Hey David--stop that thought right now--no way that had anything to do with her cancer flaring up. I do have something for you to read though

http://www.drugsense.org/mcwilliams/www.mcwilliams.com/books/books/sur/sr1.htm
Customer: replied 3 years ago.
Ok, I've had a read and I'll go back to it. I appreciate your help. I hope you're ok. Best wishes.
Expert:  Dr. Chip replied 3 years ago.
The book is really about any loss and not just the loss of a lover. Take care David and keep in touch

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