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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 45248
Experience:  Board Certified Oncologist
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hi my wife, aged 64 now, has had 2 x primary cancers

Resolved Question:

hi my wife, aged 64 now, has had 2 x primary breast cancers . the first was 7 years ago a ductile grade 3 for which she had a mastectomy , chemo, radio and herception. 5 years later she contracted lobular cancer in the remaining breast and had another mastectomy followed by chemo and radio. and is now on letrazole.
During this time she also had a raised heart beat so they prescribed her bisoprolol but took her off that in feb 2014. she was doing really well on recovery until recently when her heart rate increased again this time they said it was an svt and stopped the heart and re started it with an injection of some sort..
afterwards they prescribed her amiodarone 200mg to regulate the heart until they can get her in for a heart ablation - and within 24 hours she became really breathless so back to a&e where they gave her a chest x ray and a week later we were told they'd spotted fluffy masses on her lung. (panic !!)
Our gp then sent us for a ct scan (4 weeks on) which they sent to gp (another week of waiting)who made us an appointment with a consultant (yet another week) ! in meantime she can hardly breathe.
consultant says not to panic as he doesn't think its cancer but how can he tell from a ct scan? he says its high up in the lung if that means anything and theres no shoulder pain? he therefore thinks its more likely TB ..now my understanding is that TB involves lots of coughing which she's not doing, some blood coughed up perhaps which theres no sign of and phlegm - which she isn't producing.
any insight would be useful as to what this could be other than lung cancer - they're booking her in for a bronchoscopy by the way and a biopsy probably at same time . in meantime shouldn't she be on something like antibiotics (they haven't even said not to go to work so if it was tb surely they would've done that to stop the risk of spreading it? ) are we getting the soft soap treatment and should we be steeling ourselves for the bad news?? and is there an alternative drug to the amiodarone that they could try (not bisoprolol tho as she has asthma !!)
Submitted: 2 years ago.
Category: Oncology
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

do you have the CT scan of the chest report?

Dr. David :

with the report I can help you more.

Dr. David :

has she been tested for asthma with a pulmonary function test?

Customer:

hi dr david,no they don't give you the scans here in the uk (we're pretty backwards healthcare wise)

Customer:

also she hasn't ahd the pulmonary function test for asthma but has had that decades

Dr. David :

the asthma could be causing her difficulty with breathing.

Dr. David :

radiation can also cause fibrosis and scar tissue at the top of the lungs.

Dr. David :

this is the apex of the lungs

Dr. David :

if the doctors are seeing some fibrosis and thickening at the apex of the lungs, then this is most likely from the radiation therapy she had to the supraclav and axillary lymph node regions.

Dr. David :

have her doctors talk to the radiation oncology doctors

Customer:

the ct scan they showed us had spots at the top of the lung though…and the breathlessness only began after the svt medication which seems odd

Dr. David :

to confirm this

Customer:

okay so why do you think they're suggesting TB?

Dr. David :

I don't know why they think TB.

Dr. David :

maybe they don't know what radiation fibrosis looks like on the lungs.

Customer:

this consultant is a pulmonary specialist so you'd think he would wouldn't you?

Dr. David :

maybe not.

Dr. David :

many doctors don't understand about radiation therapy.

Customer:

lol well i can't disagree with that - is there anything i can suggest to her for the breathlessness

Dr. David :

asthma medication.

Dr. David :

steroids could help.

Dr. David :

she might need oxygen therapy if her pulse oxygen levels are low.

Dr. David :

she might need blood transfusion if she is anemic.

Dr. David :

she might need nebulizer therapy to help open up her airways.

Customer:

she's on a steroid inhaler which she uses when necessary but thats not working and /or the flixotide inhaler

Customer:

okay thx

Dr. David :

best of luck to you and her.

Dr. David :

get her an up to date pulmonary function test.

Dr. David :

and ask her doctors to ask radiation oncology if the chances seen on CT scan are from radiation therapy

Dr. David :

to her supraclavicular lymph node beds.

Dr. David :

best of luck to you and her.

Dr. David :

let me know if you have other questions.

Dr. David :

if done, please leave positive feedback below

Dr. David :

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Dr. David :

http://www.justanswer.com/medical/expert-dr-david/

Dr. David :

is my website if you need to reach me again.

Dr. David :

thanks for using JustAnswer.com

Customer:

thx il'l do that and have a good weekend dr david

Dr. David :

thanks.

Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 45248
Experience: Board Certified Oncologist
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