Saturday, August 15, 2015


     I have always known that there is unpredictability of life or in life . I have seen that in medical practice many a times and around me in people that I know . One of our close friends daughter was married to a doctor . His son had persistent pain after a basketball injury and needed narcotics to control the pain . So further work up was done and it turned out to be a bone cancer of the pelvic bone . He got radiation treatment and then the chemotherapy . He was OK but the chance of  cure is very rare. One of the days when he was going for the chemotherapy, the father took his motorcycle to get a oil change . Some one hit him and he died on the spot . The kid died latter on of his cancer . This is the uncertainty of the life .But this could be considered as bad luck . But today I want to tell you a story of one of the patient to let you know on the uncertainty in medicine.
     I was consulted on this some 60years old patient, who was admitted with the fluid around the lungs . I saw the patient. Her history was that of a patient who does not believe in the current medical system or the treatment and would prefer 'natural' cure or at the treatment. She was out of country and was diagnosed to have a cancer of the cervix. She did not want the surgery or any additional treatment. This diagnosis was done about year and a half . She was back in US . But continued not to go to see a physician .In last 4 weeks , she developed swelling of the legs and swelling of the left arm and some shortness of the breath. So she came to the hospital .She had CT scan of the chest and the belly and the pelvis. The scans showed that she had fluid around the  lungs. She also had several lymph node enlargement in the chest , neck and in the belly . She also had abnormality in liver and tumor in the pelvis . She had hard nodes in the groin and they were pressing on the venous drainage and so she had swelling . In short she had what I would call "wide spread metastatic cancer ."
      We had discussion with her and her several family members. We talked about conventional treatment with chemotherapy, but also talked about 'alternative ' treatment with things like antioxidants and many things that are talked about ,like sour sap leaves it's pulp and pyknoginole and shark cartilage and many other things. We drained the fluid and then since it was positive for cancer cells , put in catheter on both sides to drain the fluid . We were draining about 300 ml to 400 ml a day. She agreed for the chemotherapy .After the 2 cycles of the chemotherapy, her swelling was gone .I could not feel any lymph nodes. and the fluid drainage was minimal. she was walking without any shortness of the breath. Now the need for the drainage was less than once in 10 to 12 days .
     When I saw this lady she had incurable , wide spread cancer and I was not sure how she was going to do . She had avoided all the available treatment . Now agreed for all the treatment and RESPONDED. The jury is still out on the long term prognosis . But certainly  how she responded was unpredictable !

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