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side effects or something more?


Teresa

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My Mother was recently diagnosed with stage IV NSCLC on Dec 02, 03. She has tumors in both lungs, one is the size of a small fist and is wrapped around her windpipe, also the Adrenal gland and again is the size of a small fist. The cancer was found due to her not feeling well and going to the doctor, they did blood test and sent her home, later that day they called her and asked her to come check into the hospital, her calcium level was extremly high, I took her to the hospital, after she was checked in they started her on meds to get the calcium level down, they succedded, they then performed chest x-rays, Mri and a biopsey, also she required a blood transfusion of 2 units. She was released from the hospital 4 days later.

She went thru 2 treatments of Gemzar and Carboplatin, after 2 weeks she went back for more x-rays, the tumors have grown, she just went thru a treatment of Camptosar and Taxotere last Thursday, this last week has been extremly diffcult for her, she has fatigue and sever abdominal pain. My mother is on steroids to help her with her appetitie, she is on another steroid she took a day before, the day off and the day after this last chemo. She also has sleeping pills and pain pills she takes, she has lost her appetitie and is extremly weak, She is able to drink some ensure each day but eats no solid food. She might sleep for 2 hours a night, then gets up for 3 or 4 hours and sleeps for another 2, that is the extent of her sleep in a day. Her breathing is labored, she coughs all the time and is coughing up phlem.

Her doctor tells her the abdominal pain is due to the chemo, but its so server she can't walk, and when she does she needs to sit down cause the pain is so sever. What I'm looking for is some help from anyone who has experienced this be it themself or a loved one. I have read thru the message boards and can find nothing in regards to high calcium levels, not sleeping, sever abdominal pain after her last chemo treatment. Sometimes I feel her doctor is not being truthfull, he tells us shes doing good. But with what shes experiencing, I feel that its worse then the doc is telling us. My question is.. is she nearing death or are these normal side effects and she will once again get stronger and enjoy more of life. Please, be it good or bad,, help me understand..

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She had hypercalcemia. This is often caused by bone mets. Or it could

be related to a thyroid problem not the cancer. I would ask the Dr.

With the tumor wrapped around her windpipe ... I think sometimes they would do radiation if she is having breathing problems.

If you don't feel confortable with the doctor go to a cancer center.

Here is a list of the ones designated by the National institute of Health, the National Cancer Institute

http://www3.cancer.gov/cancercenters/centerslist.html

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Hi Teresa,

I have experienced the sleep problems that you speak of.I posted a request for suggestions and got many,many helpful responses.I actually slept for 6 hours last night.In a row.Reading those posts may help.I hope they do.I am not sure what made me sleep last night but I really think it was just being a bit more comfortable about things since joining this message board and seeing and feeling all this love and support.You can find the post in the intro section.Hope this help.You and yours are in my prayers and good luck.TBone

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Hi,

Your mother may be more comfortable sitting up to sleep. If you have a lazy boy or other overstuffed chair, try that and holding a big fluffy pillow you can lay your head on while being upright/forward.

The calcium levels can go with the tumor, mine did, and I also need 2 units of red cells in addition to getting the calcium levels straightened out.

Too much steroids can cause sleeplessness. There's an alternative to steroids for appetite, it's a hormonal based I think medication called "Megace".

When things taste funny and your stomach acid is off and your esophagus is sore and you can't swallow well, it's hard to eat. Remember small bits of things that are easily swallowed, like mashed potatoes, rice, custard, applesauce, frozen pureed any kind of fruit... but you have to know that you need to eat, even though it isn't any fun especially.

I hope your mom feels better soon. These symptoms are part of the roller coaster, they come with the package ( or variants of them do). Ask your oncologist for advice, maybe he has a nutritionist in his office or some literature he can give you to help. I know the National Cancer Institute has loads of pamphlets about stress, nutrition, saving your strength, advice for caregivers, etc.

You are in our prayers,

MaryAnn

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MaryAnn is correct. I did not know cancer could cause high calcium levels besides bone mets. It is great that there are so many people here that can help.

The main thing from the article below is to stay hydrated and also try to move around some. Keeping hydrated will help

the kidneys flush out extra calcium. It will help other problems due to cancer and the treatment also.

" .......

Humoral hypercalcemia is mediated by circulating factors secreted by malignant cells without evidence of bony disease. [5] [6] It is now believed that hypercalcemia is due to the release of factors by malignant cells that ultimately cause calcium reabsorption from bone. [1]

One such factor is a PTH-like protein known as parathyroid hormone-related protein or peptide (PTHrP). PTHrP is a primitive protein that appears to have important roles in calcium transport and developmental biology. It shares partial amino acid sequence and conformational homology with normal PTH, binds with the same receptors on skeletal and renal target tissues, and affects calcium and phosphate homeostasis as does PTH. [6] [7] [8] Increased blood levels of PTHrP have been found in patients with solid tumors, but not in patients with hematologic malignancies who develop hypercalcemia. [1]

Circulating growth factors may also mediate hypercalcemia. Potential mediators include transforming growth factor (TGF) alpha and beta, interleukin-1, tumor necrosis factors (TNF) alpha and beta, and interleukin-6. [9]

Potentiating Factors

Immobility is associated with an increase in resorption of calcium from bone. Dehydration, anorexia, nausea, and vomiting that exacerbate dehydration reduce renal calcium excretion.

Hormonal therapy (estrogens, antiestrogens, androgens, and progestins) may precipitate hypercalcemia. Thiazide diuretics increase renal calcium reabsorption and may precipitate or exacerbate hypercalcemia. [10]

...."

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Would like to thank those who replied and provided me some insight, the high calcium level was due to the tumors, I do beleive the steroids shes taking is the reason for her not sleeping, as for the server abdominal pains and the constant coughing and the coughing up phylem I have no answers, I tried to get her to see her ONC but she feels shes bothering him, shes very moody, also suspect steroids..

I think she doesn't want me to interfer with her treaments, she wants to remain in control, last chemo treatment, she requested I nor anyone else go with her. She seems to get irritated when I suggest she speak with her doc about this or that. My only concern is I want to understand and be kept totally informed, possible shes doing this to protect me??

any ideas?

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