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Womastin 150mg Injection Health Feed

Asked for female, 52 years old from Ghaziabad
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My mother has developed gall bladder carcinoma it was first diagnosed on 21 march 21, after that her usg guided fnac, gall bladder fossa mass was done in rajiv gandhi cancer institute and research center which shows positive for malignancy - poorly differentiated carcinoma. Her chemo (carboplatin and gemcitabine) was done on 20th april after which she developed cavity infection and further chemo were delayed for more than a month ,her next chemo were scheduled on 4, 11 and 28th june, after 2nd chemo of june she developed pain due to ascites in gb fossa region and perihaptic region which was aspirated on 28th. Ct scan of 26 & 27 show lesion is infiltrating liver parenchyma along segment 4b 5 and 6. Medially lesion is infiltrating antro pyloric region of stomach & lateral wall of 1st and 2nd part of duodenum ,resultant wall thickening ,inferiorly the exophytic component is infiltrating hepatic flexure of colon with frank fistulous communication between mass and colon. Ct of 27th shows progressive disease. She is given 1 chemo of oxaliplatin on 28th july & next chemo will be on 4th. How shall she be treated?

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Master of surgery

General Surgeon•
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You need to be strong as the prognosis is not very encouraging considering the asities and local infilteration.
Chemotherapy is only option which is possible only if the patient is fit enough to bear it which is less likely in your mothers case.
Sorry to give you a unfavorable answer but every caretaker for cancer patients should be informed the facts.
Monitor blood sugar regularly or she may go into hypoglycemia (low blood sugar) with glyciphage 1000 if her oral intake is poor.
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Asked for male, 31 years old from Kolkata
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Dentist•Sonitpur
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Hello sir, better you do warm saline water gargling. In case of unbearable pain, then only you should take painkilllers after food, provided that it is prescribed by the doctor.
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CCMTD, CCEBDM, C.Diabetology, American D...read more

Endocrinologist•Mumbai
U100 and u40 is different. If you will commit mistake in that than there can be dangerous outcome.And your sugar will go haywire. And also both insulin is different. Ask your diabetologist about it.
Asked for male, 57 years old from Mumbai
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My father has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lung and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma. The cancer was detected while he was admitted at a hospital in Mumbai and was undergoing treatment for Acute Paraplegia which happened on 02 Nov 16, due to arteries-Venous Fistula at D-10 level resulting in oedema/ ischemia of the spine from D-5 to Conus. After two failed attempts of embolization, towards treatment of the AVF, surgical clipping of the fistula was undertaken on 10 Nov 16. As part of post-operative rehabilitation therapy for his paraplegia, he was given 65 session of Hyper-basic Oxygen Therapy at 2.4 ata pressure for about two and a half month and about two hour of Physiotherapy for the same duration. My father was recovering well and had started walking with the help of support (walker). MRI of the spine taken in mid Jan & Mid June 2017 indicates that the spinal cord oedema had improved significantly, although atrophy of the spine cord is still present. He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report. Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. The medicine oncologist has however said that the gene profiling of the primary tumour tissue is not sufficient for starting Targeted Therapy and gene profiling of a tissue obtained from any of the metastatic site is necessary for the same. Three procedures have been undertaken to obtain tissue sample from the metastases site, twice from the liver and once from the pleural deposits, and all the three times the cancerous tissue could not be obtained. Due to non-availability of conformed cancerous tissue from the metastases site, a firm treatment plan has yet not been made for my father. In the meantime, the doctor has recently started my father on Erlotinib 150 mg OD as there has been considerable delay in his next phase of treatment due to non availability of metastases cancerous tissue. Could you please help me by answering the following:- 1.Can you suggest anything towards treatment of my father? 2.Is gene profiling of tissue from a metastases site absolutely necessary for starting targeted therapy for my father? 3.I read online that Erlotinib or Afatinib can be used as Targeted Therapy for patient with EGFR Lung cancer mutation. Is this true? If yes, will a daily tablet of these drugs be sufficient for his next phase of treatment, or a concurrent conventional chemotherapy is also required? 4.Can 65 session of Hyper-basic Oxygen Therapy at 2.4 ata given at a stretch of about 80 days, with a daily dose of 02 hour be a cause of his cancer? I have read it online that the oxygen free radical produced during HBOT treatment can cause cancer.

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MS, DNB (Surgical Oncology)

Oncologist•Jodhpur
Hi lybrate-user, You summarize the case very well. I understanding of your case says, he has Ca lung adenoca, treated with dCTRT, that progressed and now disseminated disease, which is not curable by any means. The goal of the treatment in such cases would be palliative only, which means to increase longevity without causing much side effects of the drugs and reduce his problem. Now going towards your questions, 1&2. At this juncture, Gene profiling is not necessary for me but to start the EGFR ...more
Asked for male, 35 years old from South Goa
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My father (age 56 years & weight 70 Kg) has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lobe and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma. The cancer was detected while he was admitted at a hospital in Mumbai and was undergoing treatment for Acute Paraplegia which happened on 02 Nov 16, due to arteries-Venous Fistula at D-10 level resulting in oedema/ ischemia of the spine from D-5 to Conus. After two failed attempts of embolization, towards treatment of the AVF, surgical clipping of the fistula was undertaken on 10 Nov 16. As part of post-operative rehabilitation therapy for his paraplegia, he was given 65 session of Hyper-basic Oxygen Therapy at 2.4 ata pressure for about two and a half month and about two hour of Physiotherapy for the same duration. My father was recovering well and had started walking with the help of support (walker). MRI of the spine taken in mid Jan & Mid June 2017 indicates that the spinal cord oedema had improved significantly, although atrophy of the spine cord is still present. He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. It was categorised as Stage 3B as the pleural effusion was para-malignant and no metastases was noted in any other body parts. He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy to his primary tumour site in his left upper lobe using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report. Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. His doctor has started my father on Erlotinib 150 mg OD since 26 Jun 17. My father has developed Post Obstructive Pneumonia in his left lung and there is consolidation in his entire left lung. This is evident from a recent X-ray. He is having difficulty in breathing, takes short & fast breath, sweats a lot, feels cold, has irritation in his throat and gets tired very fast. He also has issue eating solid food and had greatly cut down his diet. He was started on Oral antibiotic for a week, but did not respond to it. He is admitted in the hospital and is being injected with antibiotics through IVs and injections. His condition remains to be same with no much improvement. His SPO2 level is also low at 90-92%. My father also has severe lower back pain and has also been diagnosed with progressive paraparesis. Because of the back pain he is not able to lie down on his back. A recent screening of the entire spine has confirmed that there is no evident compression of the spinal cord but clearly shows a number of metastasis in the vertebrae (Clivus, Dv2, Lv2, Lv4 & Tail Bone). There are plans to start him on Radiation Therapy for his spine. Is this:- 1.The right therapy for him? 2.What other option do we have for treating his spinal mets? 3.Can Radiation to treat his mets in the vertebra, damage his spine and cause further paraparesis? 4.Could you please suggest anything towards treatment of my father?

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DM - Oncology, MD - Internal Medicine

Oncologist•Noida
If there is localized backache than radiation treatment may be the right choice for the time being. Though it won't cure lung cancer. It may help in resolving the local pain. Patient is on erlotinib since 26-6-17. The medicine should have shown some benefit by now. Continue it for another one month. It may be stopped for the time /days spinal radiation is given by your treating doctor. Add bisphosphonates taking care of creatinine and calcium levels. Ask for appropriate amount of analgesics. Giv...more
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MD - Medicine, MBBS

Cardiologist•Panchkula
Yes you can switch to novomix. But under the supervision of your physician. As the dose has to be adjusted frequently.
Asked for Male, 32 years old from Muzaffarpur
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MBBS, Diploma in Diabetology, DDM, CCACC...read more

Diabetologist•Mumbai
Put him on basal-bolus regimen or add a long lasting basal insulin to the above mentioned medications
Asked for male, 34 years old from Jaipur
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PG Certificate Course In Diabetes Educat...read more

General Physician•Mumbai
You have to use lantus but instead novo rapid, you can use actrapid or insuman rapid, but shift it under strict doctor's monitoring.
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Asked for male, 53 years old from Delhi
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AUTLS, CCEDM, MD - Internal Medicine, MB...read more

General Physician•Faridabad
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yes cheaper alternatives are available..like huminsulin regular and NPH insulin..but lantus and novorapid are better ones if u can afford
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