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Doctors' Answers to "Frequently Asked Questions" - Lung Cancer


These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Lung Worm
Question: What is the test procedure for Lung Worm in humans?

Answer: Not a common problem, but sputum examination is still the best examination.

Lung cancer
Question: My mother has lung cancer with metastasis to the liver and colon. She is getting chemo. They operated on the colon but did not radiate. They gave her 1 yr. with chemo. Is there any hope of any other treatments?

Answer: I suspect she really has colon cancer which spread to the lung. Chemotherapy is available; however, once it spreads like this, it isn't very effective.

Lung surgery
Question: My father had surgery for a small self-contained cancerous spot on his lung several months ago. However, the pain has not abated. He took morphine in the beginning, but it made him sluggish and he was afraid he was becoming addicted. Since then he has taken some kinds of non-addicting medications, but nothing has helped. He has had subsequent chest x-rays and has been told that nothing seems out of the ordinary and that he will just have to live with the pain. That just doesn't sound right to either myself or my parents. And just prescribing more medications and even a cream to rub on the painful area don't appear to be more than a doctor trying to wipe his hands clean of my father's case. Do you have any suggestions as to why the recovery has continued to be so painful and what my father can do?

Answer: There are many possibilities as to why your father is still experiencing pain after his surgery. Unfortunately, I do not know the specifics of his symptoms. For example, where exactly is the pain? - is it around the incision, or is it the incision itself that hurts? Does the pain travel anywhere, or is it related to activity or breathing? Has he been experiencing other symptoms, such as cough, fever, rash, back pain, chest pain, or "pins and needles" in the area?

On occasion there are some unfortunate patients who suffer from "neuropathic pain" What this means is that long after the injury or (that was a cause for pain in the area) has been completed, there is still pain despite no evidence for on-going injury, inflammation, or abnormality of any kind. This is similar to the commonly experienced pain suffered by individuals who get "shingles" "flare-ups". Scarring, as well as expected tissue changes in the area of the surgery, may all cause pain that can take some time to resolve.

Chronic pain is an extremely frustrating symptom. With continued effort, hopefully the symptoms may come under control. It sounds like both locally applied cream , as well as oral pain medications have not worked. Without a full understanding of your father's symptoms and the exact nature of his surgery, it is difficult to determine your next best course of action. Perhaps a discussion with your primary physician regarding seeing a pain specialist may be in order. This may prove beneficial for your father, and provide you both with a sound source of information and advice.

Medications
Question:I would like to know what is the most effective medicine for lung cancer, especially for such a case that the cancer has invaded limph, brain, and liver, and how to purchase the medicine without prescription because I have to send it back to China.

Answer:There are about 50 different types of lung cancer. Most fall into a class of cells called squamous cell cancers. However, in order to determine if there is any effective treatment, you must know the type of cell. In general, squamous and adeno cancers of the lung do not respond to any "easy" chemotherapies. Once the tumor has spread, effective treatment centers on pain control. Other sub-groups of lung cancers can be treated with different chemotherpies. However, to use these medicines one should be familiar with side effects and toxicities since treatment is a fine line between too much and too little of the drug.

Pain Relief
Question:My 87 year old uncle has stage III or IV nonsmall cell lung cancer with "months" to live I am searching for info on pain medications. My father died 10/10/96 at 81 years of age in "7 on a scale of 10" pain at a local hospital despite my trying to get his morphine increased and despite my complaining vicodin w/ apap was ineffective for his pain, a primary source of which was the class III wound on his coccyx. My uncle's wife is in active decline with congestive heart failure. Her time is probably measured in weeks or days, but only God actually knows. To come to the point, for lung cancer is morphine the best pain reliever? How, other than trial and error, is the proper dose determined? Is time release morphine better at pain suppression than IM/IV/non time release? What, if anything, can be taken along with morphine to avoid the "sedative" effect of morphine? Where are the Web sites with more information on this. Thank you for any response. I am just about out of close family members and would like to get their pain meds "right" before they are all gone.

Answer:Morphine sulfate is still the mainstay of pain relief. There are other drugs which potentiate morphine, but, it is still the major drug available. For most patients, pain relief without sedation is possible;but, it requires careful titration ot the drug and avoiding other drugs which cause sedation. Constipation is usually one of the limiting factors and a aggressive regimen of bowel care is necessary with morphine or any of its cousins. Most cities and hospitals have pain specialists available and injections in different areas can often be very helpful. Time release morphine is extremely helpful as a baseline to add other analgesia to.

Ukarin
Question: A friend of ours has been diagnosed with lung cancer and has been advised that chemotherapy is not suitable for her. She has heard of an alternative drug called Ukrain to help fight the disease. We cannot find any information on this particular drug.

Answer: I'm not aware of this drug either.
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