Tumour marker exploded

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The swelling of dad's feet has subsided slightly. However, his back pain level gradually increased. For a brief period, he manage to rely mainly on paracetamol (1000mg every 4 hours) and took tramadol only when the pain intensified, which was like once every other day. But this didn't last. I advised him to go back to tramadol 3 times a day by default (same as previous prescription) and to top up with paracetamol in between intake if needed.

As instructed by oncologist, dad went for tumour marker CA 19.9 test. It had exploded from 241 to 951 😢

On the appointment day with the orthopaedic oncologist, as I expected, they ordered a second infusion of pamidronate. We were fortunate that they called in my dad much earlier than his queue number. Because of that, my dad was warded (day care, not overnight) earlier, the drug arrived much earlier than previously and the infusion ended 3 hours earlier.

However, his back pain increased in intensity at random times of the day. It would take a combination of tramadol and paracetamol to help to rein it down...after an hour or two @@

After discussion and some checks, PCU doctors
  • suspected that the back pain was due to muscle stiffness/spasm
  • prescribed diazepam to be taken whenever he's about to relax
  • prescribed Celebrex to be taken only when the pain intensifies greatly
The specialist prescribed Celebrex despite our concern about its adverse effect on my dad's remaining kidney. It appears that his view was that my dad was going to die soon anyway and so spoiled kidney doesn't matter (?!). This despite his astonishment at my dad's longevity if it's true that the cancer originated from the pancreas. However, the doctor who attended to my dad most, speaking in Chinese dialect (so that the specialist couldn't understand), suggested to try an alternative (something he failed persuading the specialist to do so) i.e. Norgesic. He understood our intention to protect the kidney as much as possible.

Given that there was no sudden deterioration, the oncologist suggest monitoring and
  • ordered a CT TAP with contrast to observe the progression of cancer and to serve as a baseline for future chemotherapy (last scan was done in Oct 2018)
  • ordered an x-ray and blood test
It was quite troublesome though:
  • firstly, need to a blood test before getting appoint for the CT scan
  • get the next follow-up appointment with oncologist only after the appointment for the CT scan was obtain
  • once the appointment with oncologist is fixed, then determine when to do the blood test and x-ray

Comments

William said…
A distressing turn of events. :(
April 23, 2019 at 4:12 PM
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