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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 42794
Experience:  Board Certified Oncologist
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Id appreciate your advice on the following please: My 86-year

Customer Question

I’d appreciate your advice on the following please:

My 86-year old mother is due to have a CT Thorax soon. The hospital rang to say that an x-ray of her chest taken when she had pneumonia last December (a year ago…) was re-examined, and a shadow was seen on her left lung which they’d like to investigate further.

It may well transpire that nothing is wrong. However, if it does turn out to be a malignancy that hasn’t already spread elsewhere, please give an indication of what the treatment for this would be. Would it inevitably involve surgery followed by chemotherapy or are there any gentler options? I have read that age alone should not preclude further treatment. She is partially immobile due to a stroke three years ago, and has to take 3 1mg Burinex tablets daily since her pneumonia to prevent a build-up of fluid in her lungs. She takes circa twenty tablets a day for various conditions: hypothyroidism, blood pressure, incontinence etc, and she doesn’t get much exercise because she has to remain seated until someone assists her to walk.

She is relatively well and very content at the moment, notwithstanding her general frailty and various issues. Hence our main concern is that any treatment, even for early stage malignancy, might just be too severe for her and damage her current quality of life – she doesn’t suffer from pain, has a reasonably good appetite, enjoys reading etc.

She has had two traumatic experiences in hospital in the past year: in one case she was left for a very long time on a trolley and on another occasion she picked up a nasty infection. So we dread telling her about the proposed CT scan and only want to proceed if there is a possibility of worthwhile treatments ahead. Reading between the lines, her own GP seems to be somewhat luke-warm about the appointment. I fully appreciate that you don’t know her full medical history, and that you can only give general advice.

Thank you
Submitted: 3 years ago.
Category: Oncology
Expert:  Dr. David replied 3 years ago.

Dr. David :

This is Dr. David

Dr. David :

I am sorry about your mother.

Dr. David :

without a CT scan, we can't say if there is a malignancy or cancer or not.

Dr. David :

it could just be scar tissue in her left lung

Dr. David :

there are many types of lung cancers as well.

Dr. David :

and there are cancers which can start in the lungs and also cancers which can spread to the lungs as well.

Dr. David :

and there are many types of cancers which can start in the lungs.

Dr. David :

so it is too early to talk about types of therapy

Dr. David :

hello?

Customer:

Thanks for your reply. I would just like to know in advance of the CT: if it turns out that an early treatable cancer is there, would the standard treatment be surgery and/or chemotherapy. And would that be considered worthwhile or advisable, given her age and medical conditions?

Dr. David :

if the cancer is early and hasn't spread outside of the lungs it could treatable with radiation and chemotherapy

Dr. David :

at age 86, she might not be able to tolerate chemotherapy

Dr. David :

but there are some oral agents like tarceva she might be able to tolerate.

Customer:

Thank you. My final question please: You haven't mentioned surgery, so is it unlikely that surgery would be involved, even if caught early?

Dr. David :

yes, unlikely

Dr. David :

because of her age.

Dr. David :

it is hard to impossible to do lung surgery on a 86 year old patient.

Dr. David :

best of luck to you and your mother

Dr. David :

let me know if you have other questions.

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Dr. David :

hello?

Dr. David :

do you have other questions?

Dr. David :

hello?

Customer:

Sorry, I had to go away for a while. Thank you very much for your advice.

Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 42794
Experience: Board Certified Oncologist
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