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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 42332
Experience:  Board Certified Oncologist
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How long will it take for tumour symptoms to diminish after

Resolved Question:

How long will it take for tumour symptoms to diminish after radiotherapy as my dads seem to be getting worse brain Mets sclc
Submitted: 1 year ago.
Category: Oncology
Expert:  tazechip replied 1 year ago.
Hi. Can you give me some more information please? What kind of cancer does he have and when was the radiotherapy? What symptoms are getting worse?
Expert:  Dr. David replied 1 year ago.
This is Dr. David

I am cancer doctor

I am sorry your father has metastatic small cell lung cancer to his brain

this can be a very fast spreading lung cancer sometimes called oat cell lung cancer which is a neuroendocrine lung cancer

I hope he is on dexamethasone steroid therapy to help decrease swelling in his brain from his brain metastasis.

he should get another brain MRI scan to see if his brain metastasis have shrunk from his brain radiation therapy.

if he has 3 or less brain mets, he might benefit from stereotactic radiosurgery boosts of his brain mets to give him longer survival.

let me know if you have questions.
Customer: replied 1 year ago.
Hi dad has received strs whilst still on his maintenance dose of dex,to my knowledge his dose was never upped prior to strs his dex were abruptly stopped days after strs which created problems as dad is a long term user of decks 7 months . Also for 4weeks prior and during radiation dad had severe dehydration and electrolyte problems caused by diareah his stools had been sent for analysis to determine what was causing it four ,weeks later I once again aired my concerns ,it transpired that dad was being dosed laxatives that's why he had diarreah , also dad was neurologically off balance for a week before strs , staff attributed it to the mets although the scan showed not much progression since diagnosis ,dad had been complaining of bladder distention but auxiliary nurse diagnosed there was nothing wrong ,after admission to radium centre it was confirmed dads catheter was retaining ,his penis was badly infected doc had problems retracting foreskin and also catheter was encrusted could all these problems be marring my dads recovery
Expert:  Dr. David replied 1 year ago.
if he is having diarrhea, he should not be taking laxatives.

he should not have stopped his dexamethasone suddenly as well. this can cause adrenal insufficency with not enough steroid hormone in his body.

hopefully the stool testing will help.

if no infection is found in his stool, he should be taking imodium or lomotil to help stop his diarrhea.

if he has only had stereotatic radiosurgery for his brain mets, he might still need whole brain radiation therapy to treat the rest of his brain. SRS type brain radiation does not treat the whole brain and does not prevent new brain metastasis from forming in the brain.

whole brain radiation therapy treats the whole brain.

he should be betting brain MRI scans. often times CT scans don't see brain metastasis very well

if he is having bladder distention and urinary distention, he could have small cell lung cancer mets to his spinal cord. this can cause urinary retention and also loss of stool control and anal sphincter strengthen as well.

he needs a total spine MRI scan to check for spinal cord metastasis.
Customer: replied 1 year ago.
He has been having urinirary problems for 2years he has a problem and was self catherised until diagnosis then it was recommended he had foley ,we have just heard from his urologist that the Foley catheter he was fitted with was too small and that none had contacted his urology nurse they just used the one the found in district nurses cupboard .As for another scan the nurse has told me they aren't going to bother with his next oncology appoitment as it's too much bother they have offered us home care from local council , social work has told me they will come in 4times a day and that although he is still continent he will be sent home with pads and he wll be deficating in them whether he likes it or not as Its too much bother for her carers and that's the way it's going to be she was not very nice dad is distraught as he was promised physio and to but has been told it's a wast of ti e
Expert:  Dr. David replied 1 year ago.
it sounds like he has an enlarge prostate gland which is causing the urinary retention.

I am sorry that his team is not being very nice to him.

that is unfortunate

it sounds like they are giving up on hiim and giving him comfort care only

small cell lung cancer can be very aggressive and if it has spread to the brain, it is a terminal diagnosis with no long term cure potential

but that does not mean that his care givers can be rude or give him bad care.

he should still be having hospice or comfort care for him to keep him as comfortable as possible

he can still get medications like imodium (loperimide) or Lomotil to help stop his diarrhea

he can try to eat foods which slow down his bowels like bananas and cheese

if he is found to have an infection in his bowels like clostridium difficile infection, this should be treated.

if he has pain, he should be treated with pain medicaitons. some narcotic pain pills can cause constipation so that might be a good thing for him if he is having diarrhea.

I hope this helps

let me know if you have other questions.

if done for now, please leave positive rating below the chat box so I can get credit for helping you today

you can always reach me with "a question for Dr. David" if you have any other questions

here is my website if you need to reach me again:

Thanks for using
Customer: replied 1 year ago.
Thanks to. E honest his care has been questionable his peri area on many occasions has been filthy on 2consequetive days he had no water at his bedside the staff nurse who asked me if I could remember when they had changed his catheter also iv fluids marked in care sheet administered on 9thactualy administered on 10th they didn't even notice it was the wrong date my aunt pointed it out to them and they were rude its sad the docs been great but some nurses very rude an in compassionate he was told your in your bed forever more and that's the way it's going to be
Expert:  Dr. David replied 1 year ago.
I see.

I am sorry that he has received poor care sometimes

you should try to report it to the doctors and let them know so they can try to improve the care there

I hope his diarrhea symptoms get better.

and he can get a better foley catheter to help him urinate

do you have any other questions?
Customer: replied 1 year ago.
If my dad has spine mets will it still be possible to take dad out in a wheelchair as social worker says he won't be allowed out of bed because he has to lie flat, you see I'm just home from hospital visit and nurse has dad sitting upright and has given him a bed bath he is in no pain sitting in an upright position and seems much calmer , the nurse who is attending him is a staff nurse and knows his background ,it was her who alerted doc about contacting urologist ,if it was detrimental for dad to be sitting upright she wouldn't have him sitting in that position she is dedicated ,to all the men in dad's ward and doesn't sit in the station chatting she shares her time with treating the whole paitient and not just the disease
Expert:  Dr. David replied 1 year ago.
she sounds like a good nurse

yes, even if he has spine mets, if he can sit up without pain, that is fine for him to sit in a wheel chair.
Customer: replied 1 year ago.
Thank you so very much I thought my dad was going to languishing in a bed waiting to die ,we are all aware dad's disease will progress and take his life , but the object of bringing him home is to live love and be happy you don't know how much your input has meant to me may god bless you x
Expert:  Dr. David replied 1 year ago.
thank you so much

don't forget to leave positive feedback below one of my reponses

we only get credit for helping clients after positive feedback

thanks for using
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 42332
Experience: Board Certified Oncologist
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