Am I panicing

[Hazel30]

Hello again Dr.Goodman
Today my Mom is home after a 5 day stay at hospital of grueling GI tests to determine what is causing her severe nausea.  I posted week ago of her condition after removal gallbladder a month ago and her ca-125 doubled since her prior to surgery from 194 to 394.  As of yesterday its 526.  The past few weeks we were hopping that the rise and the severe nausea was due to surgery but after hospital test showing she has absolutely no GI problems, her oncologist says its all due to cancer.  Repeated her CT scan which showed some new seeding around the peritoneum and previously enlarged lymph nodes are more enlarged now.  With this info, the dr is stating that the new peritoneum seeding is aggravating her stomach which causes her severe nausea and discomfort.  The past 2 weeks she began vomiting sometimes in morning, which we also thought was do to the gallbladder surgery. The past 2 days she has not had vomiting since she is eating much less and watching her diet as well.  This really concerns me.  She went from doing fine 2 months ago prior to gallbladder issues to now vomiting & nausea & new seedings.  What does this all mean, are we heading down a bad path at this point or can this be reversed for her to get back to her normal self?  She's starting doxil on friday, the doctor is saying once she starts all the discomfort will go away...yes we know this...but what if doxil doesnt knock down these new seedings?  and if it does, what happens when doxil is not working anymore...will these spots come back?  I just want to know what is going to happen from this point?  I know nausea and vomit is not good when your talking about cancer.  She has never been this symptomatic and she has never had a ca-125 this high except prior to surgery.  Where is this all heading, I am going absolutely crazy about this I cannot watch my Mom suffer like this.  I need answers and reassurance that she will be fine.  Please tell me what you think of this.
Thank You
Fiana

[Annekathryn Goodman, M.D.]

Dear Fiana and Lovelylady
I apologize for my delay.
First to Lovelylady- I am not totally sure how questions get posted (I am on the receiving end) but theoretically it is 2 questions per day. I think sometimes when I get completely overwhelmed with my day job and do not respond for over a week, the site locks down. Please try again.

Dear Fiana
thank you for your complete information.  I am very sorry to hear about what your mother is going through.  You said  " I need answers and reassurance that she will be fine."  I wish I could.  It does sound like your mother is getting very sick now.  The doctor is right - commonly the cancer will stabilize with doxil. It does take 3 to 4 cycles to fully see this. But sometime that is not the case.  Your mother has been living with cancer for a while now.  But if the cancer grows to a certain size or affects too may areas at the same time, a person becomes very ill and may not recover.

Right now, I would say the your mother's pleural effusion and the compression of that part of her lung is an important problem. If that gets much worse, she can have respiratory problems. Ask her doctor about draining that fluid.

I know that watching your mother decline with this terrible disease is heartbreaking. I am so sorry.
take care

[LovelyLady1]

Hello I am LovelyLady1 and I am trying to post a question to Dr. Goodman.  I am having a very difficult time doing so. The Forum keeps telling me that it is full to try again.  There are only two posts for today-so I am confused.  Any help would be helpful-and I would be very greatful to you.  Thank you for your time.  God Bless.

Sincerely,

LovelyLady1

[Hazel30]

Hello Dr. I just received my Moms most recent CT scan report that was done her last hospital stay 12 days ago.
Findings: A noncontrast CT sca of the abdomen and pelvis is performed. Exam complete to prior study 5-12.  There is a moderate to large right sided pleural effusion with right lower lobe subsegmental atelectasis.  Numerous 1.5-2 cm lymph noes are seen scattered throughout the peritoneal cavity including the small bowel mesentery.  Gastrohepatic ligament with numerous 1.5-2 cm omental and peritoneal lymph nodes.  A very small amount of free fluid is noted in both paracolic gutters as well as in the pelvis.  Trace perihepatic ascites is notes. Evaluation of liver and spleen is limited secondary to IV contrast. Surgical clips are present of gallbladder fossa. Bone windows show no lytic or blastic bony lesions.
Impressions:
1. Omental lymphadenopathy with evidence of mild peritoneal carcinomatosis.
2. Trace ascites

Please explain to me how bad does this sound.  The new small bowel mesentery is making me very nervous after reading some stuff on online..is it similar to pancreatic cancer and is this very bad new finding.
Please help me out translating this and making sense.
thank you so much again and again.
Fiana

[Hazel30]

Hello Dr and thank you for responding.  Im not too understanding about your reply.  What do you mean it sounds that my Mom is very sick???  Are you going by what Im saying or by her CT scan report I posted????  They did drain her fluid yesterday and she is feeling better...what does this mean from this point on she will only get worse????

Is there recovery for her????  She doesnt seem that bad for me to assume that its just gonna be worse from this point on.  Please please explain to me.  Im confused and now even more worried.

thank you
Fiana

[Annekathryn Goodman, M.D.]

Hi Fiana
the development of fluid in the lungs can make a person sick. It is good to drain it. It is good to know she is feeling better.  The development of a new problem like fluid in the lungs can sometimes reflect new behavior from the cancer.  That is - the fluid in the lungs can come back. However, if the doxil reduces the cancer, the fluid may not come back.
I understand your anxiety. It is hard not knowing what will happen. But your mother is getting perfect care.
take care