Cancer & Mexico's Public Healthcare

I am a US citizen living in Mexico City with my fiancee's (Mexican) family.

My mother-in-law  is fifty years old. She has no medical backround to mention here...she does not smoke, she has lived a healthy and active life. She noticed a tumor growth on her cheek bone nearly 8 months ago. At first, she thought it was an infection related to her dental work. Although she experienced no pain, the dentist treated it as an infection. No results were seen. It wasn't until September 2007 when she was diagnosed by an x-ray with a tumor with growth of at least 7 months and a size of 7 x 5 cm. With a bone scan she was later diagnosed with a bone tumor. After another test (I am not sure which?), she was told it was a tumor growing on her bone, but not a bone tumor.( I really apologize since I am loosing a lot of medical terms through my mother'in-law's descriptions and my Spanish - English translations). Blood tests come back compeltely normal. Only concerning symptom is weightloss. She does not have a temperature.

At this point it is assumed / hoped that it is a benign growth. In October/November she started complaining about pain in her shoulders and back and lungs. In the middle of the night in late October / early November she was taken to the emergency room since breathing was extremely difficult. Just to get an idea of what I feel like we are up against - they didn't even check her temperature! They told her she had bronchitis and sent her home with medication. (The system requires her to later return and make an official appointment, and a lot of waiting is involved)

Around this time her doctor had also planned to operate on the tumor directly. However, this was postponed drastically due to the fluid building up in her lungs. They gave her a medication that made a noticable change in her breathing / comfort. However, she was told to take this medication for only a certain time. Following this, the fluid in her lungs built up, again. In early December she returned to the emergency room in the middle of the night, again, where they gave her oxygen and took xrays. They told her the fluid was minimal and she would have to wait for her already scheduled doctor appointment later in the month.

When she made it to her doctor's appointment, they hospitalized her for a week. They physically removed 2 liters of water out of one lung. While in the hospital, they did a mamogram (mammogram), tested the fluid in her lungs, and her blood. All results were negative. During this week, the results of a biopsy on the tumor of her face came back negative...she was told it was nothing more than bland tissue. She was sent home without a diagnoses amd told they would be able to get rid of the ''bland tissue'' build-up with medication and acted as if her lungs would soon be cured.

Following this event they did another scan (Topografia?) where they inject ink into the body and take pictures. This time, they took a look at her lungs. The doctor later explained that ''it looked bad'' in the shoulder bones, the lungs and the part of the liver that they could see. There is still no diagnosis. An operation has been scheduled for today to remove the tumor and send it for testing. Last night they removed more water from her lungs and this morning determined that it was unsafe to operate. They plan to send her home until next week, when they will attempt to operate again.

The degree of my frustration is immeasurable. Private insurance is not available to her. What can I do? What are the chances that cancer hasn't spread everywhere? How can we possibly know where the cancer originated? What origin is most likely? Any suggestions for better medical care?? Is there a chance that this is NOT cancer? Could this be highly curable??






(Please see my profile to better understand the situation)

[Kamal S Saini, MD, MRCP (UK), DM]

I sympathise with you. Getting timely and appropriate medical care in resource-restricted settings can sometimes be difficult.
From your description, it seems she has got cancer that has spread to her lungs and bone (shoulder). There is still no proof of cancer yet, from your description. Cancer is proved calssically by studying biopsy tissue. The 2 litres of fluid removed from her lungs is probably "malignant pleural effusion".
A long time (over 8 months) have passed since her symptoms began. I am afraid this may have allowed her problem to aggravate.
If possible, please consult a medical oncologist for appropriate guidance and care. I am sorry I cannot offer more specific or practical advise.