Palliative care, Oncology FAQ

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Is Chemotherapy Suitable for My 82-Year-Old Grandmother with Stage 4 Pancreatic Cancer?

Is chemotherapy suitable for a patient with stage IV pancreatic cancer who has insufficient physical strength? My grandmother is 82 years old, lives a regular life, and has no bad habits. She has stage IV pancreatic cancer that has spread to the peritoneum and intestines (diffuse...


Dr. Hu Ziren Reply:
In cases of advanced age and poor nutritional status, where the patient is unable to undergo oral chemotherapy, it is recommended to consider palliative care and symptom management. If palliative care and symptom management are initiated, subsequent evaluations will depend on the...

[Read More] Is Chemotherapy Suitable for My 82-Year-Old Grandmother with Stage 4 Pancreatic Cancer?


Managing Edema and Pain in Advanced Pancreatic Cancer Patients

Pancreatic cancer metastasized to the liver, with bilateral lower extremity edema up to the knees? Last November, a family member (female) was diagnosed with stage II pancreatic cancer and underwent a Whipple resection. Post-surgery, she did not receive adjuvant chemotherapy. Fou...


Dr. Chen Sirong Reply:
Yuyu / 28 years old / Female 1. What does the doctor think should be done in this situation? A: 1.1 The cancer itself may cause cachexia, leading to poor nutrient absorption, resulting in a severe weight loss down to 33 kg. Even with supplementation, it may not be sufficient. T...

[Read More] Managing Edema and Pain in Advanced Pancreatic Cancer Patients


Radiation Therapy Options for Advanced Head and Neck Tumors

Radiation Therapy for Head and Neck Tumors Hello Dr. Chen: My father is a terminal cancer patient (unable to eat, can only take small amounts of liquid, primarily receiving intravenous nutrition while hospitalized). Due to recurrent bacterial infections, chemotherapy has been pau...


Dr. Chen Sirong Reply:
Tinglee / 37 years old / Female 1. In an online consultation without seeing the patient, I cannot claim that my recommendations are better than those of the original attending physician. 2. Generally, I respect the original attending physician. 3. A patient may not necessarily p...

[Read More] Radiation Therapy Options for Advanced Head and Neck Tumors


Understanding Supportive Care in Advanced Cancer Treatment

Supportive therapy Hello, my mother was diagnosed with stage IV ampullary cancer after going to the hospital for diarrhea in March of this year. She has been undergoing chemotherapy since May 10 and has completed four cycles so far. During this time, she experienced slight discom...


Dr. Hu Ziren Reply:
Supportive care refers to symptom management or palliative care, indicating that the patient's condition has deteriorated and is no longer suitable for other aggressive treatments (such as the current chemotherapy).

[Read More] Understanding Supportive Care in Advanced Cancer Treatment


Understanding Brain MRI Reports: Insights from a Tumor Specialist

Dear Dr. Chen, please interpret the brain MRI report. Thank you? 109/09/16 Imaging or pathology report content Outpatient Zhang Yingzhen 4573630-9 F 5099 050 REQ# PROCEDURE: (15020011) Order Date: 2020/06/04 14:30 Corrected Report D55JCM5 MRI/BRAIN (For GK Follow-up) Execution Da...


Dr. Chen Sirong Reply:
Mr. Lin / 57 years old / Male Regarding the interpretation of the report: 1. The images belong to Zhang Yingzhen, not you. 2. Online, you cannot prove that you are his relative; the outpatient clinic requires a dual identification authorization form, or you should have accompanie...

[Read More] Understanding Brain MRI Reports: Insights from a Tumor Specialist


Exploring Treatment Options for Advanced Diffuse Liver Cancer

Diffuse hepatocellular carcinoma in advanced stage? Hello, my husband, who is 51 years old, was diagnosed with advanced diffuse liver cancer in early September. The doctors have said that it is untreatable. His bilirubin level has reached 12. I would like to know if there are any...


Dr. Chen Sirong Reply:
Afen / 51 years old / Female I can only repeat: doctors say it is untreatable. A glimmer of hope: it depends on your definition: everyone will reach the end point, and those with diffuse liver cancer are very close to it. You can try: targeted therapy, chemotherapy, immunotherapy...

[Read More] Exploring Treatment Options for Advanced Diffuse Liver Cancer


Post-Surgery Treatment Considerations for Stage IVA Colon Cancer

Postoperative treatment issues for colorectal cancer? Hello Doctor: A senior in their seventies has undergone surgery for a malignant tumor in the rectum, confirmed to be stage IVA, with a CEA level in the fifties, and multiple tumors of varying sizes present in both lobes of the...


Dr. Chen Yunfang Reply:
Hello: The most suitable respondent to these questions is the attending physician responsible for the treatment (to clarify the responsibility). Medical care is not a mechanical job; each person's experience and skills vary. I will answer based on my approach. 1. Generally...

[Read More] Post-Surgery Treatment Considerations for Stage IVA Colon Cancer


Understanding Persistent Fever and Breathing Issues in Brain Cancer Patients

Breast cancer metastasis to the brain, with persistent fever and shortness of breath? I'm sorry to hear about your family's situation. Here are the translated questions: Q1: The doctor said the wheezing is due to pneumonia, but why does it continue to worsen even after...


Dr. Chen Sirong Reply:
If a 25-year-old woman says: 1. This is your only family member! However, the reality is that the disease has metastasized and has progressed to stage IV. If her physical condition is poor, it can be considered terminal. Generally, even after chemotherapy and radiation therapy fo...

[Read More] Understanding Persistent Fever and Breathing Issues in Brain Cancer Patients


Understanding Stage III Melanoma: Risks of Skipping Chemotherapy

Diagnosed with stage III melanoma? Hello, my mother is 58 years old and was diagnosed with stage III melanoma six months ago. It originated from a black mole on the sole of her foot and has metastasized to the lymph nodes in the popliteal fossa. The doctor mentioned that the exci...


Dr. Chen Sirong Reply:
Hello, melanoma has lymph node metastasis. It is recommended to perform a PET scan (covered by health insurance) to determine if there is distant metastasis for staging purposes, which will help decide on subsequent treatment (pathologically confirmed as stage III, there is actua...

[Read More] Understanding Stage III Melanoma: Risks of Skipping Chemotherapy


Assessing End-Stage Multiple Myeloma: Symptoms and Treatment Options

End-stage assessment of multiple myeloma? Dear Doctor, My father was diagnosed with stage II multiple myeloma six years ago at the age of 65. He did not undergo a stem cell transplant but chose treatment with CyBorD (cyclophosphamide, bortezomib, and dexamethasone). For the firs...


Dr. Chen Yunfang Reply:
Hello: 1. The original physician from Hospital L has returned, and the physician from Hospital Z has asked you to go back to the original hospital for treatment, so it’s quite clear where to go. 2. The symptoms of multiple myeloma are primarily related to the bone marrow. As the ...

[Read More] Assessing End-Stage Multiple Myeloma: Symptoms and Treatment Options


Understanding Left Temporal Brain Tumors: Symptoms, Treatment, and Prognosis

Brain tumor (left temporal lobe) measuring 5x7x4 cm? A few months ago, family members began to experience declines in memory and cognitive abilities. After imaging studies, the doctor diagnosed dementia caused by a stroke. They have been taking medication, but within less than a ...


Dr. Chen Sirong Reply:
Alice / 33 years old / Female 1. Is it malignant? A1. A biopsy is necessary to determine if it is truly malignant. A2. If it is located in the brain, surrounded by bone, and causing pressure on the cranial nerves, even if the pathology is benign, the symptoms can be unbear...

[Read More] Understanding Left Temporal Brain Tumors: Symptoms, Treatment, and Prognosis


Post-Gamma Knife Treatment: What to Expect During Recovery Period

Observation period after Gamma Knife treatment? Hello Dr. Chen: My mother has lung adenocarcinoma that has metastasized to the brain. She has been on targeted therapy (Tagrisso) for about nine months. At the end of August, we discovered that the brain tumor had slightly increased...


Dr. Chen Sirong Reply:
1. How long is the observation period after treatment? Typically, follow-up examinations are conducted one month after treatment to assess the reduction of the tumor. This means that the tumor may continue to shrink for 1-2 months post-treatment. Therefore, the observation period...

[Read More] Post-Gamma Knife Treatment: What to Expect During Recovery Period


Navigating Treatment Options for Stage IV Colorectal Cancer with Lung Metastasis

Stage III colorectal cancer with metastasis to the lungs is classified as Stage IV? Thank you for taking the time to respond to my inquiry on March 8th. Currently, I have white spots in both lungs, so surgery is not an option. After three months of treatment with second-line medi...


Dr. Chen Sirong Reply:
Fen/45/1 I apologize! My personal expertise is in radiation oncology and palliative care, so your question should be directed to a physician specialized in chemotherapy for a more accurate response, which is why my reply is delayed. Essentially, your attending physician's ad...

[Read More] Navigating Treatment Options for Stage IV Colorectal Cancer with Lung Metastasis


Can Palliative Care Be the Only Option for Advanced Cholangiocarcinoma?

Is a 13 cm tumor from bile duct cancer that has metastasized to the liver only eligible for palliative care? In June, the mother was found to have elevated liver enzymes during a diabetes check-up. She had previously experienced an allergic reaction to contrast agents. A subseque...


Dr. Chen Sirong Reply:
Grace: I personally believe that with a life expectancy of three months to a few weeks, the pain from surgery and chemotherapy is unbearable. Other methods to boost immunity may be costly and may not extend survival time. Palliative care is the option that should be accepted at t...

[Read More] Can Palliative Care Be the Only Option for Advanced Cholangiocarcinoma?


End-Stage Liver Cancer: Treatment Options and Patient Autonomy

excuse me? What are the treatment and prevention strategies for end-stage cancer (liver cancer)? If a patient is unwilling to undergo treatment, can they be forced to receive treatment? Or should one consider seeking traditional Chinese medicine?


Dr. Chen Junyi Reply:
In the advanced stages of liver cancer, the focus should be on palliative care and symptom management, and assistance from specialist physicians can be sought.

[Read More] End-Stage Liver Cancer: Treatment Options and Patient Autonomy


Understanding Hospice Admission Criteria for Terminal Cancer Patients

Terminal cancer patients Hello, Dr. Chen. I would like to inquire about the criteria for admission to a palliative care unit. My father has been diagnosed with terminal cancer by a physician at Tzu Chi Hospital in Taipei, with an estimated lifespan of about 3 to 6 months. He is s...


Dr. Chen Sirong Reply:
Hello, the admission criteria for a palliative care unit are as follows: patients with terminal cancer who experience physical discomfort (such as pain, shortness of breath, vomiting, etc.) that cannot be managed in an outpatient or home care setting. Based on your correspondence...

[Read More] Understanding Hospice Admission Criteria for Terminal Cancer Patients


Understanding Treatment Options for Elderly Patients with Gastric Adenocarcinoma

The treatment options for gastric adenocarcinoma include: 1. **Surgery**: This is the primary treatment for localized gastric cancer. It may involve partial or total gastrectomy, depending on the extent Hello Dr. Chen, I would like to ask about a patient who has been preliminar...


Dr. Chen Sirong Reply:
1. Radiation therapy can cause severe vomiting, and chemotherapy administered via injection can also lead to nausea and vomiting. Oral chemotherapy medications may provide some relief. 2. You can visit a large hospital for an in-person evaluation by a physician. 3. For Wester...

[Read More] Understanding Treatment Options for Elderly Patients with Gastric Adenocarcinoma


Understanding Persistent Cough After Chemotherapy: What to Do Next?

Why do patients experience persistent coughing after chemotherapy? Doctor: Hello! I would like to ask you two questions. My father received chemotherapy on October 20, and for some unknown reason, he has been experiencing persistent vomiting since then, almost without stopping, a...


Dr. Fan Sheng Reply:
Xiao Yu: Some chemotherapeutic agents, like Irinotecan used for treating colorectal cancer, have been reported to cause coughing. However, the commonly used antiemetic Dexamethasone during chemotherapy has a higher suspicion of causing coughing. It is recommended to consult your ...

[Read More] Understanding Persistent Cough After Chemotherapy: What to Do Next?


Coping with Terminal Cancer: A Guide for Families Facing Melanoma

Melanoma My father had half of his stomach removed four months ago. A month later, he underwent surgery for a small intestine and had a colostomy performed. Now, he has undergone surgery for a brain tumor, and it has been discovered that there is a tumor in his chest as well. The...


Dr. Fan Sheng Reply:
Fat Boy: Based on what you described, the overall condition is not clear. However, if it is metastatic melanoma affecting the brain and lungs, the situation is indeed quite complicated. Currently, the patient is unrecognizable, so it would be best to have a palliative care physic...

[Read More] Coping with Terminal Cancer: A Guide for Families Facing Melanoma


Stage 4 Lymphoma: Should You Consider Chemotherapy for Bone Marrow Involvement?

Hematologic lymphoma In the case of stage IV lymphoma that has metastasized to the bone marrow, the decision to undergo chemotherapy depends on various factors, including the patient's overall health, specific type of lymphoma, and the presence of symptoms. **If chemothera...


Dr. Fan Sheng Reply:
If the lymphoma is of high malignancy and has progressed to stage IV with bone marrow involvement, there are no other options for life-saving treatment besides chemotherapy. We have to fight it with that. For those with low malignancy who are in their fifties, chemotherapy is als...

[Read More] Stage 4 Lymphoma: Should You Consider Chemotherapy for Bone Marrow Involvement?


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