Dr. Arshad Hussain Shah
Medical oncology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I have a query regarding my father's PET scan results. My father had pelvic pain, and the doctor suggested a guided CT scan for diagnosis. The reports showed 11 cm growth in the iliac region. Unfortunately, I am unable to upload the CT scan images. Later, a biopsy and PET scan were also taken, which showed malignant and metastatic growth. Currently, he is taking tablets Targin for pain, Pregabalin, and Xarelto for DVT. Kindly help.
Hi,
Welcome to icliniq.com.
I understand your concern. I have reviewed these two reports (attachment removed to protect the patient’s identity). It looks like stage-4 cancer, possibly advanced lung cancer. But more workup is needed to confirm the final diagnosis. The biopsy report lacks details of immunohistochemical markers and molecular studies, which can ensure the origin of the primary tumor. At this stage, it looks like an incurable tumor radiologically, and the aim of treatment will be palliative. After the biopsy review and confirmation of IHC (immunohistochemical staining), I can tell you exactly how much benefit will be anticancer treatment. He needs physical, social, and psychological support. He needs someone close to look after him, whom he loves and trusts.
Kindly revert for more queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
What is the life expectancy in a case like this? I understand the information is limited, but just an approximate estimate would be helpful. Kindly help.
Hi,
Welcome back to icliniq.com.
It depends on the patient's general condition, whether he can look after himself, can walk and do some physical work, his nutrition status, mental health (whether he is suffering from depression, etc.), also whether he is suffering from any chronic diseases like diabetes, hypertension, cardiac diseases, etc.
It looks a stage-4 lung cancer (final confirmation still pending). Only 20 percent survive more than one year. After full details of the histopathology report, including IHC and molecular study, the picture will be clearer, showing responsiveness to treatment and aggressiveness of the tumor.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply. No other chronic diseases are present. But, he has DVT in his leg and a history of gout and kidney stones. He is, however, completely immobile due to the aggressive growth of the tumor on his iliac, and the pain persists despite taking medication.
Hi,
Welcome back to icliniq.com.
I understand your concern. Because he is immobile, that means his performance status is 3. For the pain, I suggest narcotic drugs (Morphine, Pregabalin, and Diclofenac patch) and palliative radiotherapy to the pelvis (iliac area). The medication may relieve his pain and possibly improve his mobility. Then he will be able to fight this aggressive cancer; otherwise, with poor performance status, he will not be able to tolerate aggressive anticancer medications.
Thank you.
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Medical oncology
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