Cancer

Are male kidney recipients at the risk of testicular cancer?

How is cancer of the pancreas treated?

What is the treatment for bladder cancer

What is the last ray of hope for someone in the last stage of oral cancer?

How can breast cancer, which has spread to the bones, be treated?

Does my father need chemotherapy?

Why has my wife lost interest in sex after breast cancer surgery?

My mother had breast cancer, will I get it too?

How to manage colon cancer?

How to treat bone cancer?

 

Are male kidney recipients at the risk of testicular cancer?

Q. Are males, young and middle-aged, kidney transplant recipients at the risk of testicular cancer? If so, what are the symptoms and ways of treatment for the same?

A. All patients after any transplantation are on immunosupressive drugs, making them at higher risk for developing malignancies. Most common of these are lymphoproliferative disorders, designated as PTLD (Post-transplant lymphoproliferative disorders). Testicular cancers are rare after the age of 32 years though rare kinds, including lumphomas of testis, may occur later, and in renal transplant recipients.

How is cancer of the pancreas treated?

Q. I have cancer of the pancreas, which has spread to the liver. What could be the treatment apart from chemotherapy?

A. You have a carcinoma pancreas, which has spread to the liver. The best option would be chemotherapy with gemcitabine based chemotherapy. If you are not willing, there is an option of treatment with targeted therapy like Tarceva which has been found to be beneficial in carcinoma pancreas.

What is the treatment for bladder cancer

Q. I want know about 3rd stage of bladder cancer. Is it possible to remove the tumour through operation? What is the best treatment for bladder cancer?

A. Treatment of bladder cancer depends on its depth of invasion.

1. Superficial cancer (not invading muscle) can recur many times and requires removal of tumour by cystoscopy each time. In addition, the patient should also be given intra-vesical BCG. These patients live for many years.
2. Invasive cancer (invading cancer) requires either removal of whole urinary bladder or radical radiotherapy.

What is the last ray of hope for someone in the last stage of oral cancer?

Q. My father-in-law, 57 years old is suffering from mouth cancer and is in the last stage. What is last ray of hope for him? Please help.

A. In a patient with advanced oral cancer, who is not fit for local radiotherapy and chemotherapy, there is development of two new targeted drugs:
1. Gefitinib or Erlotinib
2. Erbitux

How can breast cancer, which has spread to the bones, be treated?

Q. My mother had a painless lump. Suddenly she got back pain and was in hospital for almost 2 months. The doctors were observing her and found out that she was suffering from breast cancer. After realising that it was breast cancer, they gave her chemotherapy and all the reports now tell that we cannot do surgery because it has spread to her bones. Can you suggest me a line of treatment, which will help her survive and where can it be done? We don't know anything what has to be done. The doctors say that usually cancers attack the brain or blood or liver but in my mothers case it has spread to her bone.

A. Your mother has breast cancer that has spread to bones. You have written that she was given chemotherapy and it has spread further.
There are several options:
1. Change chemotherapy protocol.
2. Adopt hormonal therapy if patient has ER and PR positive tumour.
3. Give local radiotherapy to affected bone.
The final decision could be taken based on patient condition and after seeing patient reports

Does my father need chemotherapy?

Q. I trained in India but currently practicing in the UK. My father, who is 74 years old, lives in India and has been diagnosed with prostatic cancer a year ago. A bone scan showed widespread metastases and his PSA was above 20. He was treated with orchidectomy, calutamide, bisphosphonates and radiotherapy. Recently he became clinically jaundiced, his LFTs were abnormal (bilirubin: 4.8) and ultrasound showed multiple liver secondaries. I understand that some drugs have been found to be effective and comparatively safe in this situation like Mitoxantrone. What would you advise and would you be willing to see him as a private patient if necessary? I look forward to hearing from you at your earliest convenience.

A. The patient in question is a hormone refractory cancer prostate progressed while on calutamide and he will be a candidate for chemotherapy. Presently the most effective drug is Taxotere, which is usually combined with presdisolone or estramustine hydrochloride. The other option is mitoxantrone prednisolone combinations that can also be given. But taxotere combination has been found to be better in comparison to mitoxantrone combinations.

Why has my wife lost interest in sex after breast cancer surgery?

Q. I am 40 years old and married for the last 10 years. My wife was operated for cancer of the left breast recently. I am not having any physical relations with her for the past 8-9 months, as she does not take any interest in it. I am getting frustrated. Please help.

A. It is important to empathise with her, for a woman going through a surgery of breast has a lot of psychological impacts, added on to the stress of cancer. Also depressive episodes are common, and talking to a psychiatrist helps. You need to give her time, and be supportive, and let her feel comfortable with her self and the life situation first.

My mother had breast cancer, will I get it too?

Q. My mother suffered from breast cancer. When she was in the initial stage, her right breast was removed and now she is fine. My maternal grandmother too had throat cancer and died as no proper treatment was available. From my father's side no one has suffered from cancer. I want to know the chances of me getting cancer? I am 19 years old and I have 2 married sisters. How can I know my chances of developing cancer? My left breast is smaller than the right one, is this a problem?

A. The incidence of breast cancer is high in relatives if there are two or more than two patients suffering with breast and or ovarian cancer in the family. Since you have only your mother suffering with this disease, your chances of developing breast cancer are the same as in the general population. Still you need to do monthly breast self examination, mammogram at the age of 40 years and regularly thereafter. Difference in the size of the breasts does not appear to be a problem, however, you may have a check done by a doctor.

How to manage colon cancer?

Q. My mother was diagnosed with colon cancer (grade III) two years ago. She was first given chemotherapy and then operated upon for removal of the cancer 1.5 years ago. Following this operation she had a persistent fever that did not go away. Two months later, tests revealed that there was infant recurrent growth and she was consequently operated upon for this growth removal 2 months later. This time she was fitted with a colostomy bag. After this she went through 7 cycles of chemotherapy. Eight months ago, an operation was conducted on her for the bag removal and hernia adjustment. She has had problem of frequent motions, mucus and blood in stools. Tests now revealed that there is infant recurrent growth yet again. There also seems to be cancer (secondaries apparently) in the lung. The measure this time is 5 cms in the colon and 41 mm in the lung. How long can the patient sustain with just chemo and radiotherapy? What is the prognosis? How long can the patient withstand all of this?

A. Your mother has colon cancer for which she has been operated thrice and she has had two rounds of chemotherapy. Now she has recurrence in the colon and
lung again.
It is evident that your mother has slowly progressive disease and that responds to chemotherapy and surgery. We have three main drugs for colon cancer - CPT 11,
Oxaliplatin and 5FU/capecitabine. These are used in sequential fashion i.e., use them one after the other has failed. The drugs can be used as long as the
patient is in good general condition with normal liver and kidney function tests.
If the disease is localised and amenable to surgery, operation can be done. Even local radiation can be given if deemed fit by the doctor. There is no rule in the disease of cancer and if patients disease is responding, chemo drugs can be even repeated.

How to treat bone cancer?

Q. My mother is 67 years old and a type 1 diabetic since the last 7 years. She is diagnosed as having bone cancer. She is being treated at Chennai. The hospital does not reveal the results of the tests undertaken. Also they will not detail the condition of the patient even to the close relatives. However we are having confidence in the institute. She had a previous incidence of breast cancer 10 years back. Mastectomy was done for the right breast and after which she underwent chemotherapy for 15 sittings. The hospital has not conveyed anything regarding the dosage of the drug. She underwent all quarterly check ups till 6 years ago, half yearly check ups till 4 years ago and annual checkups since then, exactly as prescribed by the institute. She was asked to come for the next checkup next month. In the mean time she had severe back pain 2 months ago. We consulted an orthopaedic doctor who asked us to take an x-ray. On seeing the results he immediately prescribed a CT scan. The results were taken to the institute based on which they preferred bone scan and other blood tests. They only said that there is defect in the bone and that chemotherapy and radiations cannot be given. They also started some injection called ARIEDA which they told is to be taken every month. When pestered by us about the condition of the patient they only conveyed that they can only give steroid treatment to suppress the pain and keep up the quality of the life. Now we are not aware of the condition of the patient. Please let us know what is this injection and what for it is given? Is there any other treatment available for such a condition in USA?

A. It appears that your mother has developed bone metastasis from breast cancer. However, a bone scan, Chest Xray, ultrasound abdomen, serum cancer markers need to be seen before a final diagnosis is made.
In cancer of the bone, there is increased incidence of fractures. In order to reduce the bone related symptoms such as pain or fractures, aredia is given. It has no side effects.
There is another drug called ZOMETA that is given for the same purpose with similar results. However, in order to control the cancer, either or a combination of the three modalities need to be done: change of hormone therapy / chemotherapy / radiotherapy.