Managing Swelling in Patients Taking Iressa for Lung Cancer Treatment - Oncology

How to improve the condition of leg edema after taking Iressa?

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Hello Dr.
Chen! My father was diagnosed with lung cancer in September 2003, and by the time it was discovered, he was already in stage II.
After undergoing chemotherapy and radiation therapy, his condition improved, and there were no signs of disease progression.
In June 2005, my father developed spots on his legs, and he experienced severe pain in his femur, making it difficult for him to walk.
Following medical evaluation, it was discovered that the lung cancer had metastasized to his femur.
After multiple rounds of radiation therapy, the cancer had destroyed the femur to the point of fracture, necessitating a hip replacement surgery for him to walk.
It has been a year since the surgery.

After the operation, my father underwent six months of chemotherapy until June of this year.
In July, during a follow-up appointment, the doctor indicated that we could only monitor his condition, as there were no signs of further metastasis, and there was no urgency for a third round of chemotherapy.
However, in August, scans revealed that cancer cells had spread again, with findings in the spine and pleura.
The doctor then suggested that my father undergo chemotherapy once more.
My father, possibly due to fear of chemotherapy, began to decline in health, often isolating himself in his room to sleep, and he experienced significant memory loss, resembling symptoms of Parkinson's disease.
My mother decided to retire early to care for him and considered getting him a wheelchair.
Later, during another follow-up, a different doctor suggested that my father try a new medication (Iressa, AstraZeneca: 250mg), as its efficacy is comparable to chemotherapy without the side effect of hair loss.
Therefore, my father started the new medication for a trial period of fourteen days, and if there was no improvement, he could discontinue it.
The doctor also suggested that my father could consider traditional Chinese medicine.
By mid-September, the doctor recommended that my father continue taking Iressa.
He began the new medication at the end of September, and his cognitive clarity improved significantly, allowing him to go out shopping.
Currently, my father is taking the new medication Iressa for the treatment of non-small cell lung cancer, and his condition has improved, with clearer thinking and the ability to walk a few more steps, leading us to cancel the decision to purchase a wheelchair.
In mid-October, during another follow-up, the doctor noted that his cancer markers had dropped from nearly 100 to the 30s.
However, he experienced frequent diarrhea after starting the medication, which the doctor said was a normal side effect.
During this time, my father visited a general practitioner multiple times to take medication for diarrhea to help stabilize his condition, but he continued taking Iressa.
After the diarrhea subsided, at the beginning of this month, my father's legs began to swell, and spots appeared on his skin, resembling burns and sprains on his ankles, making walking very difficult.
Two days ago, my father returned to the hospital for a specialist appointment, but since he saw an intern, the doctor was hesitant to prescribe any medication, even for the swelling.
The doctor advised my father to stop taking Iressa and morphine for pain relief to see if the swelling would improve, and he is scheduled to return for a follow-up on Wednesday, November 22, to discuss with the primary physician.
My father's cancer cells have metastasized to the femur, which is why he had a hip replacement.
Recently, he has been experiencing significant pain at the site of the artificial joint, similar to post-surgical pain, but the cause is unclear.
The swelling in his ankles has worsened, making it extremely difficult for him to walk, requiring the use of two canes to manage.
Therefore, he suggested purchasing a wheelchair for easier transportation during follow-ups and outings.
Which type of wheelchair would be suitable for him? Would a standard hospital wheelchair suffice? Thank you for your guidance! Sincerely, Miss Huang, the patient's daughter.

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muumi, 60~69 year old female. Ask Date: 2006/11/15