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?
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
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.
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.
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
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.