Recently someone asked me about Merkel cell cancer. Relatively rare.
The website I suggested helped him – http://www.merkelcell.org/ Thought it might be worth sharing, in case more people need help with this condition.
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Avastin (Bevacizumab) is a good medication in metastatic bowel cancer (both colon and rectum). It is used for extended periods of time with chemotherapy to control and reduce the burden of cancer.
It is very important to check the urinary protein while on this medication, as it does have a potential to damage the functioning of the kidney. In case, the kidneys are secreting increased amounts of proteins, it is then important to check the quantity and then if needed to stop Avastin till the kidneys recover. We have found that a significant number of doctors forget to check urine protein, while patients are on Avastin. Which are the best Oncology Textbooks?
I think: # DeVita’s Cancer: Principles and Practice of Oncology # Abeloff’s Clinical Oncology are the best ones. There are tons of other books, but these two seem to cover the maximum amount of information in the best possible manner. People who have been driving their vehicles for several years (most times decades) are really upset when we tell them that they should not be driving their cars.
In Australia the onus is on the clinicians to get affected patients to stop driving their cars. The treating clinician is meant to tell the patient to stop driving and send a letter to the Driving Authority to withhold/revoke the patient’s driver’s license. The number of clinicians who even know about this is minimal!! If a patient’s cancer has spread to their brain, the chances of seizures or altered consciousness are quite high. There is no specific time or place when things can get out of control. Also these patients have had radiotherapy, surgery, are on high dose steroids, narcotics, etc… and thus the mental cognition and reaction time is dramatically altered. The conversation is a difficult one. But a very important one. It could save the patient’s life and others on the road. Medicine in Australia is top class. It may not be as cutting edge as some hospitals in the US or Western Europe, but for all practical purposes… medicine in Australia is fantastic.
There is a talk about dearth of the latest molecules, but in terms of being pragmatic and the true value for the dollar… there is almost everything available. When I talk about being available, I am talking about being funded by the government (which means free to the patient). Everything, which is not funded by the government, is available on the market (for a price). The quality of care even in remote towns is great. If a facility is not available or there is a emergency, the Royal Flying Doctors help out. What is the evidence of low bacterial diet in patients with chemotherapy for solid tumours? I could not really find anything conclusive in the data available.
Can someone help me out here. Most of the data is anecdotal about a patient getting this illness or that illness, but the majority of the patients get along fine with clean, cooked food. This concept of scaring patients and their families into only eat this or that and avoid this and that…. it a complete overkill. Now patients undergoing a bone marrow transplant with sustained neutropenia… that is a completely different story. I am talking only about patients with solid tumours undergoing chemotherapy. The period of neutropenia is relatively short and patients bouncy back fairly soon. Eat well. Stay strong and healthy. All doctors working in public and private hospitals should get the best possible medical indemnity insurance for themselves. Most doctors working in the public system have insurance with the govt health dept, but they also need extra insurance to cover themselves.
I think it is worth the effort. Also it is tax deductible. I signed up with Twitter. Am trying to figure this whole social media thing out 🙂
My Twitter account is @Med_Oncology See you on Twitter!! All pain is not the same in cancer.
Different types of pain requires different medications: Anti-inflammatory medications – paracetamol, ibuprofen Opioids – morphine, oxycodone, fentanyl, hydromorphone, methadone Neuropathic agents – pregabalin, gabapentin, amitryptilline Most times it is a combination of these drugs which would help. |
Rohit JoshiCancer, Medicine and Life: A cancer and medicine blog to help on the journey of life. Medicine and Medical Oncology are rapidly changing fields and is hard for most people to keep up. A diagnosis of any illness, in particular cancer is devastating news for anyone, and the hope is that we can share knowledge and support each other. Archives
April 2024
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