Any info -thanks in advance & sorry for the length

Brent DePasquale · New User Joined: 19 Aug 2006 Posts: 5

This is a copy of my letter to a Dr. Looking for some answers, please feel free to add any insight or reccomendations at all- thank you in advance-
-also possible Cancer Clinics in the U.S. or Canada who may specialize in this..thanks.

My Name is Brent DePasquale and I had seen you at the Sault Are Hospital on July16/06 in the Emerg. Dept. I want to thank you for all you had done for me while you were here and kind of give you an update on where I am now. I am presently under Dr.Berry's Care for my kidney's and they are progressing from approx. 20% when I had seen you to approx. 40% which is great news and they continue to improve slowly, I have more blood work this Mon.Aug.21/06 . Thank you very much for your immediatte help in this.
Second, Dr. Mainra is my other problem which you discovered and followed up on which was the spot on my right lung, Dr.Reich surgeon did a biopsy (Media incision) and the results came back yesterday confirming cancer in the mass and it has spread to the nodes he believes it is the aggresive type.. His reccommendation is that surgery is not possible and it is inoperable, Dr. Reich stated they will probably suggest performing Chemo and Rad.
He then reccomended I see Dr. Keith's ( Oncologist) who I had a visit with yesterday day in the Algoma Regional Cancer Clinic Aug 18/06., and this is where some confusion mounted as to how to proceed. Due to the fact of my kidney ailment interfering with the cancer treatment.

Dr.Berry has me on the following med's:

90mgs Prednisone once day
175mgs Cytoxan now reduced to 125mgs once daily
10mgs Norvasc once daily
25mgs Metoprolol once daily (just started this on Aug16/06)
(for your info- most recent B.P. readings was (147/82) & Dr.Berry want's my pressure reduced.
Dr Keith's had wanted to proceed with Chemo and Rad immediatelly but believes the meds I am am taking for my kidney's/or the problems with my kidney's will interfere with the proper most effetive cancer treatment for me. He left his office stating that he would try to reach someone In the Sudbury cancer Clinc in regards to this problem and to put together a game plan in which way to proceed.
He also suggested i feel free to get a 2nd opinion whether it be here or in the U.S., but with things happening so fast I'm very confused.
I am presently going to wait for an answer from Dr. Keith's as to his reccomendation on how we should proceed.

My problem/questions are these Dr.
-he said that my kidneys's needed to function properly or the Chemo could kill me if it it doesn't empty out of me correctly
-he also wasn't sure if we could proceed with the the Chemo here in Sault Ste Marie and send me to Sudbury for Radiation or if this would be feasable?
-he would have liked to start the Chemo immediately over this weekend and then send me to Sudbury for Radiation which I would believe would have been the standard procedure but due to my kidney problem's I'm kind of in limbo?
- I am wondering if there are ways around this and if there is such thing as a Cancer/Kidney Specialist who treats this type of ailment
- do they specialize or treat these combination of problems lung cancer/kidney anywhere here in Ontario

It's been a tough emotional journey from the on set and things seem to be getting worse for me as far as complications and I'm scared and very worried to be honest with you.

Any help, insight,reccomendations would be very much appreciated, but I know you don't have the full picture of my case, I guess I'm just reaching for some support and looking for hope in regards to my dilemma. I'm 47 and in pretty good health otherwise,have a beautiful family who support me and I am committed to giving a 110% to do whatever it takes to beat this, I am trying so hard to keep a positive frame of mind. Please do take care of yourself and once again thank you from all the bottom of our hearts for providing me with your care for it was you who followed up on my lung, and with some faith and hope&prayer it is early enough for me to have a positive outcome.

Thank You

Brent DePasquale · New User Joined: 19 Aug 2006 Posts: 5

Hi All : Have gotten no replies at all which worries me- to keep it simple, is there any way of me getting any type of treatment for my lungs and lymhnodes through chemo or rad. Though I only have 40% of my kidney's functioning? There must be someone or someway around this. I'm terribly worried the Dr. here will have no answers? Thank you all for any and all responses & suggestions. Take care... I've searched the web a bit but haven't found much info.

mikes · Senior User Joined: 25 Jul 2005 Posts: 143

In your first post you never mentioned the word "lung" or "nsclc", or "sclc".

In your second post you do mention the word "lung".

Since this is the lung cancer forum, I am assuming you have lung cancer. If you have NSCLC (the more common type). the most common chemo given is Gemzar with Carboplaten. Both can have adverse effects on kidney function even in people with no prior kidney problems.

Also, you mention you are taking Norvasc which would indicate hypertension and possible cardiac problems. Both of these chemo agents can also aggrivate this.

Kidney problems and hypertension are referred to as comorbidities, and these must be taken into consideration before any treatment is begun.

You also did not mention what stage the disease is. This plays a large part in the direction your treatment will take.

You might want to check out Tarceva or one of the other targeted drugs. Alternative treatments include melatonin and PSK.

I think a second opinion would be a good idea.

Hope this helps.

Mike

Brent DePasquale · New User Joined: 19 Aug 2006 Posts: 5

Thank you so very much for your reply. After seeing the surgeon this past friday he stated I had a mass 6.8cm*2.5 in my upper right lung and it had gone down to the center of the lungs lymph nodes which he stated was inoperable and he believed the aggresive type. He did not state stage NSCLC or sclc. I had sen an oncologist just after him on Friday and he didn't know what to do really and was going to do some investigating and try to come up with a plan. You are correct with me having high blood pressure and kidney problems, I beleive my kidney's are functioning at about 40% right now and I'm taking Cytoxan and prednisone for this, and my B.P. is staying around 150/80 and he's prescribed me Norvasc and metoprolol to get pressure down. I've been worried sick all weekend wondering if there will be anything they can do at all for me. We're very limited to Dr's and resources here in Sault Ste Marie, Ontario Canada. He did mention Sudbury, Ontario, Canada. I am situated basically in the center of the great lakes bordering on Michigan and was wondering If I should try a larger center in Michigan, or maybe Toronto or London Ontario for a secong opinion. I don't believe I have coverage for the U.S. and also don't know if the drugs you mentioned are even available here? I'm just so confused and in a panic mode right now and the drugs don't help me to think straight, but your information has given me some relief as to hope and I want to thank you so very much. I'm going for some lab work for my Kidney's in themorning and I'm suppose to hearfrom the oncologist when he has some information regarding my dilemma. Take care & Thanks Again!
Sincerely: Brent

Brent DePasquale · New User Joined: 19 Aug 2006 Posts: 5

Thank you all for all your replies - I've been busy latley having some tests and meeting Dr's etc. It looks better for some type of treatment to start, I'll know next week and keep you informed. Basically the plan is about 33 Rad treatments starting Sept and Chemo at the same time for I believe the 1st wk- and last wk of Ra. The drugs chemo they are considering are Eptoside I.V. & Carboplatin, I was told I would be very sick etc and may need blood, plattlette transfusions etc due to my kidneys and won't be able to swallow or chew etc because of the esphogus but I'm willing to fight thru whatever it takes- if any one has comments or suggestions in regards to these treatments please feel free to respond, I so do very much appreciate all your support- waiting for an MRI on the brain then I should be able to give you a better update- thank you all &do take Care! Brent

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