My father in India, age 72, is postoperative case of CA Urinary bladder and prostate and now presented with liver metastasis.
Overall, he is in good condition, he was recovering well, have a good appetite, have not lost any weight and is quite mobile.
Below are details and my questions are:
Given his condition, my questions are :
What are the treatment options
What do you think of chemo regime they have prescribed, they are going to start this regime from tomorrow i.e. 01/18/08
Would you suggest different chemo regime or medicines
Any opinions you have about overall approach, additional tests, test results, etc
Thanks so much for your time and input
DETAILS
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Date – 01/12/08
CT Whole Abdomen – 01/12/08
CT examination after oral, I/V and rectal contrast administration.
( Follow-up case of Ca bladder with Ca prostate. Underwent TURBT on 07/10/07 and radical cystoprostatectomy with ileal neobladder on 07/13/07. USG done outside on 01/09/08 shows hypechoic lesion in right lobe and cystic lesion in right iliac fossa)
Liver reveals a well defined hypodense lesion in right lobe. IHBR are not dilated.
Gall bladder, spleen, pancreas, bilateral adrenals and kidneys are normal.
Right iliac fossa reveals a well defined cystic lesion measuring 3.8 x 3.4 cm anterior to iliac vessels and an other cystic lesion measuring 3.9 x 2.7cm posterior to iliac vessels possibly lymphoceole.
Urinary bladder and prostate are not seen ( history of surgery)
Neobladeer appears normal.
Measurement Right hepatic lesion 6.4 x 5.3 cm
Suggest : FNAC correlation
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Date: 01/15/08
HISTO PATHIL & CYTOLOGY
INTERVENTIONAL FNAC
Site of Aspiration : CT guided FNAC from hepatic Lesion
Material : Received 6 Slides
Microscopic Examination : Cellular smears show malignant epithelial cells arranged in discohesive cluster and placed singly cytoplasm is indistrict.
OPINION : Positive for malignant cells. Metastatic carcinoma in K/C/O CA Bladder and prostate
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Date 01/16/08
Heamtology
Peripherial Smear
RBC Series : Predominant cells are normocytic normochromic. No nucleated RBC seen. No M.P seen
WBC Series: Leucocytosis with neutrophilia(89%). No toxic granules seen. No immature cells seen.
Platelets: Slightly reduced in number. Few giant platelets seen.
OPINION: Leucocytosis with neutrophilia and mild thrombocytopenia.
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Date 01/16/08
NM Report
Whole Body Bone Scinitigraphy
Impression : No definitive scan evidence of bone metastatis
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---Chemotherapy regimen 3 weekly palliative chemotherapy
Inj Gemcite 1gm IV on D1 & D8
Inj Cisplatin 40mg on D1 & D8
Q3 weekly x 3 cycles
