My father has been a patient of recurrent local squamous cell carcinoma. In the last one and half years, he has been operated for cystoprostatectomy and urethrectomy with an ileal conduit for urine bypass followed by lymphonodectomy. After all these surgeries, he had a recurrence seven months back. So, the sinus tract was operated and second line chemotherapy with Carboplatin and Gemcitabine was given. The MRI showed very good improvement. A week ago, he underwent a penectomy, scrotectomy, and a surgery of the pelvic bone. I have attached the recent biopsy report. How should we proceed?
Welcome to icliniq.com.
I have reviewed the information and the biopsy report (attachment removed to protect patient identity). Please understand that this pathological report is incomplete, so it is difficult to advise you the further course of therapy. In fact, further therapy will depend on your father's health condition. For most cancers, if there is a recurrence, that by itself indicates a poor prognosis. Same is the case here, there was cancer that got operated and then came back, we call it recurrence. In your father's case, the risk of this happening was dependent on the original site of cancer and the details of surgery performed, which are not mentioned in your report or the provided information.
Your biopsy shows there is metastasis to the bone that has been removed. This is a very serious thing, it means the tumor has already spread far and wide. There will be many tiny deposits all over his body that are not visible right now but will become evident after some time. Only chemotherapy can take care of those, and that also just to some extent. In essence, it is a very bad sign. Since you mentioned your father has already received second-line chemotherapy, there are two options available.
1) If your father's body can tolerate it, then chemotherapy drugs at the same time with radiation can be tried.
2) If the body cannot tolerate or he decides enough is enough, then best is supportive care.
Kindly attach the MRI reports, both before the first surgery and before this surgery and the patient's discharge summary and operative notes, if you need more specific information. I know that is not a good news, but I think you people and your doctor did their best.
Thank you doctor,
I have attached three MRI reports. What more can be done?
Welcome back to icliniq.com.
Thanks a lot for providing this information, and attaching the PET, CT, and MRI reports (attachments removed to protect patient identity).
I wish I could have been in a position to help. But hope you understood the above. Talk to your doctor about the information mentioned above. Follow-up if you want any clarification after you discuss the plan with your doctor.
For more information consult a surgical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/surgical-oncologist
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