They can't figure out where the cancer started.

obs · Regular Joined: 10 Aug 2007 Posts: 28

also another thing i forgot to mention was that when i mentioned my dads delusions the dr said it is most likely the meds but it could also be that the cancer spread to his brain, she said she doesnt know because a scan of the brain was never ordered. I dont understand why this was not ordered by the doctors. I just feel like the drs here at mayo are just not being thorough enough and its making me angry.

Muttsmom

If they suspect brain mets, they absolutely should do a CT Scan of the Brain, that's crazy. I know Mayo is a great hospital, just as Cleveland Clinic is, but my best friend used an onco that was at Cleveland Clinic and let's just say, there was a reason he was the only one on her HMO. Great cancer hospitals can still have bad oncologists. Thank goodness, most are very good. It just seems like they have already written your dad off without getting to the bottom of what's going on with him. ( I don't mean that disrespectfully towards your dad, but to the doctors). This is your dad, not a John Doe, and that's not to say that someone that is homeless doesn't deserve to live.... I think you know what I mean. Maybe it's time to write down questions, get with your dad's onco and stay there until you get answers that you are satisfied with. If the doc gets mad, then that in itself tells you there is a problem. It's not like he has a sore throat and you aren't giving the antibiotic long enough to work............ this is unreal.
_________________
Nancy
2/14/02 ILC 43 - 5.5 cm 9+/16 nodes
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FECx6 radsx33
Tamoxifen - Arimidex (chemo induced menopause)
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10/04 Actonel for bone/joint pain from Arimidex
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In memory of Kim 12/1/04

drrahman · New User Joined: 01 Oct 2007 Posts: 4

Hi, Obs
I m not sure whether your dad’s problem been resolved. I ve read through Nancy’s replies and she has always been spot on. So, I ll just adds in a few things:
1. In about 5% of cases, despite extensive work up, we just couldn’t find where the cancer starts. Unfortunately, your dad is in this category. Most of these turns out to be adenocarcinomas which can originate from almost anywhere such as lung and gut. The primary focus could be so small that we are not able to pick it up on our scans.
2. The next task is to decide on the staging and treatment options. With multiple metastases, this is a stage IV disease. The only treatment option is chemotherapy.
3. However, to start on chemotherapy, we would prefer to know the histology so that the appropriate drug combination can be given. This is the issue at the moment.
4. In some cases, we would empirically start on some kind of chemotherapeutic regime that would cover most cancers. This is not an easy decision for us to make.
5. I would also like you to consider alternative or complementary therapies that do not put so much emphasis on tumour type. They may turn out to be your best option.
6. Pleural thickening usually does not mean cancer. Most of the time it is due to previous inflammation. Unless, it is very thick, we don’t really biopsy it.
7. Lung biopsy would be very tricky in your dad’s case. The nodule is small and he has emphysema. Chances of pneumothorax is very high.
8. From my assessment, there is no issue of doctors’ incompetency. They have done as what is expected of them to. However, it is in your best interest to ask for second opinion. Ask around on who is the best doctor in the region.
I hope I have been of help.
Dr Rahman >www.nrmedical.info Laughing

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