做完肺CT報告 OPINIONS 1. An Irregular and spiculated opacity (2.2x3x2.1) is seen at left lung upper lobe anterior segment Mild air-bronchogram is seen within. It shows mild heterogeneous contrast enhancement. Surrounding spiculated densities and fibrotic changes around are also noted. Overall features could be due to focal consolidation or lung tumour. Further evaluation is recommended. A left adrenal nodule (about Icm) is seen, which is probably benign could be due to adenoma. Several caleified gallstones are noted. Gallbladder fundus adenomyomatosis is seen. No other significant abnormality detected.
This is from Canada Edmonton, my friend he is 58 , he was just diagnosed with pancreatic cancer of the third stage two weeks ago. He was informed by the doctor that he could not go through surgery or radiation. All he could do is go through Chemotherapy to extend his life. He will be having a biopsy tomorrow. I was wondering and would like to ask, because of the advancements of medicine Hong Kong, are there any other better alternatives than Chemo?
謝耀昌
醫生回覆
Thank you for your question.
Currently, the best first line treatment for inoperable pancreatic cancer is still chemotherapy with or without radiotherapy. Target therapy or immunotherapy have clinical data in 2nd or subsequent lines of treatment, when patient fails to respond to chemotherapy.
會員# Raymond Wong
Laproscopic converted to open high anterior resection on Jan5, 2017
病患者男 - 68歲
Colonscopy on Nov 30 showed primary malignant tumour in the sigmoid colon which is 27cm from the anus. CT scan on Dec 8 interpretated mid-sigmoid tumour over a length of 10 cm with staging of T3 Nx MO and cholelithiasia. Laparoscopic converted to open high anterior resection for pt4b N1b (2/25) Mucinous adenocarcinoma high grade of the sigmoid colon, R1 multi focal positive margin at the bladder shave. Indeterminate chest and liver lesions on staging CT scan, too small to characterise. On Prednisone and Azathioprine since 2001 until now for Chronic Imflammatory Demyelinating Polyneuropathy, and IgG kappa paraproteinaemia.
what to do next since surgeon here did not know which area to target for radiotherapy, what sort of chemotherapy is best in this case. Please advise the cost as well.
謝耀昌
醫生回覆
This patient may require chemotherapy (in view of lymph node involvement and stage III disease) and radiotherapy. The target of radiotherapy would be the urinary bladder, where residual is left behind. The choice of chemotherapy depends on the physical fitness of patient, usually involve two chemo drugs. Costs depends on individual Clinical Oncologist.
謝耀昌醫生(男)
謝耀昌醫生(男)