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gardenmama
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10/28/2008 20:25 #46395

Cancer questions
I have a friend who is battling esophageal cancer. Her sister sent me the following update, which I received today:

A few weeks ago she had a lung drained and they were going to drain the other the following week. After a week's delay due to the stomach flu she went in to have the procedure done. They determined the same lung had filled up again (worse than the lung they hadn't touched yet) and drained it again. As per (patient), they have no intention of draining the untouched lung. They stopped chemo (fluid in lung is side effect of chemo) and don't plan on resuming it until after Thanksgiving. They're keeping an eye on her lungs and she'll have a CAT scan just before Thanksgiving to determine how to proceed with chemo so that her lungs don't continue to fill with fluid (other side effects are tearing eyes, which (patient) says are much less teary since stopping chemo and thick crusty nails which she is grateful it's glove weather so she can hide her hands now, and also total exhaustion which she hopes, with these weeks off, will help her regain some strength).

I am curious as to why they wouldn’t drain the second lung, especially if it’s causing her pain, as is my understanding. Also, is this really a side effect of chemo (I don’t remember this being a problem with my husband)? Does anyone know?

gardenmama - 10/28/08 21:49
Thank you both for all the info. Tiny, yes, she used to be a smoker, but not an everyday smoker, usually only an occasional social smoker. Whatever her form of cancer, the dr.s said it was some rare type and that she doesn't really fit the demographic for it at all. Yes, the treatment has been primarily pallative and trying to buy some time. She has a teenage daughter whom she's pretty determined to see graduate from H.S. next June; though she has already surpassed what they initially expected - I'm guessing out of sheer stubbornness.
tinypliny - 10/28/08 21:41
Thanks for clearing stuff up, (e:jenks).

Good luck to your friend (e:gardenmama). She will be in my prayers.

jenks - 10/28/08 21:25
p.s. I've never heard of cancer cells in the saliva, unless I suppose it was cancer of the salivary glands...
Won't say it's impossible, but i haven't heard of it.

Unfortunately, esophageal ca is a 'bad actor'.

And stage IV anything is usually inoperable. I'd have to check the guidelines, but even chemo/radiation is usually more palliative than curative at that point.

Even if surgery were an option, an esophagectomy is no joke.

I'm sorry you're having to deal with this... best wishes to everyone.
jenks - 10/28/08 21:21
I must have felt you calling my name tiny, after four months away, I'm baaaack....

minor correction tiny- fluid in the lung like that (technically in the pleural space, between the lung and the chest wall) is called pleural effusion. Pulmonary edema is a little different. But nonetheless...

I don't know side effects of all chemo all that well, but effusions (malignant effusions) are unfortunately pretty common in advanced cancers (particularly breast). May well also be due to chemo. Usually they will tap the fluid a few times, but if it keeps reaccumulating, they will try a procedure called pleurodesis, in which they put a chemical irritant (usually talc, or sometime doxycycline or bleomycin) in the pleural space- it makes the lung 'stick' to the chest wall, so the fluid can't accumulate. If that doesn't work (it doesn't alway) they may have to do surgery to accomplish the same thing, or if surgery isn't an option for whatever reason (patient too sick etc) they may just leave a tube in to drain the fluid.

As far as only doing one side... Any time you stick anything into the chest, there's a risk of collapsing the lung. Which is bad enough, but collapsing both is even worse, so usually they'll only do one at a time, just in case. But if they really have "no intention" of EVER tapping the other side... I'm not sure why that would be.

But side effects depend on the specific chemo regimen- which may be why her husband's experience was different. Nausea/vomiting/fatigue are pretty universal, though.

And one last comment, effusions aren't usually PAINFUL per se, but cause (sometimes severe) shortness of breath.

Hope that helps!
tinypliny - 10/28/08 21:17
What I meant was PCR is very sensitive and picks up EVEN small number of malignant cells in the saliva.

Based on what you are saying, it would seem that this patient had large number of shed malignant cells in the saliva. So PCR may not have been necessary.
tinypliny - 10/28/08 21:15
Some more questions - was she a smoker? Did the lung have any traces of cancer? Sometimes malignant cells can be detected in the saliva when you carry out a PCR (Polymerase Chain Reaction) assay on the saliva. But this technique picks up small number of malignant cells in the saliva.

:/ I need to read up about this!
tinypliny - 10/28/08 21:10
If she didn't have surgery, it does sound like she was receiving neoadjuvant (to shrink the tumour to a manageable size) before surgery. I am not really familiar with the treatment protocol for advanced stage esophageal ca so I need to read before I say anything completely inaccurate.

Hmmmm.... were the cancer cells shedding in her saliva? I need to read up about this.

(e:jenks)?

gardenmama - 10/28/08 21:01
No Tiny, no surgery. I'm not sure of all the details but when she was diagnosed it was stage 4 and she had a tumor the size of a golf ball. Also, there's something about the "type" of cancer that it is that's not the "usual". I could have this messed up but I believe it involves something with there actually being cancer in her saliva/her saliva being cancerous? Anyway, she's been through radiation and was in some type of chemo study but then had to stop it because she became too ill. So they went to a different type of chemo.
tinypliny - 10/28/08 20:50
And to answer your other question, yes, it's possible that pulmonary oedema is a side-effect of chemotherapy (neo-adjuvant/or otherwise) but no, it doesn't always occur is all patients.

With regards to your question about why they are not attempting lung drainage again or even in the other lung, I don't really know. Maybe the bonafide surgeon (I am looking at you, (e:jenks)) could give us some insights of postop/post-chemo edema management?
tinypliny - 10/28/08 20:37
Did she have esophagectomy - surgery dissecting out the cancer + lymph nodes before chemo? Pulmonary edema is the #1 postop complication after esophagectomy for thoracic (lower-part which is in the chest cavity) esophageal cancer.

10/27/2008 21:48 #46375

Top 10 things I like...
Category: movies
...about going to the movies; and top 10 movies I want to see that are out right now:


Does it ever seem like the movie industry releases a bunch of movies at a time that you want to go see, or there is nothing out at all that you want to see? Why can’t they spread the good ones out so that there’s always something worth seeing? Anyway, I don’t know exactly why, but I love going to the movies.

So, here are the top 10 (random) things I like about going to the movies:

1. Approximately two hours of escape from your own reality
2. The smell of the popcorn (though I usually don’t eat it)
3. Big screen
4. Laughing out loud and/or having a good cry
5. Comfy seats with cup holders
6. No telephone (if you don’t stupidly mess up turning off the sound - like I did last time I went. I hate that!)
7. Sometimes the movie surprises you, taking unexpected twists
8. Sharing an evening with a friend
9. People watching in the lobby
10. Happy endings

Top 10 (random) movies I want to see that are out right now:

1. Nights In Rodanthe
2. Righteous Kill
3. The Secret Life of Bees
4. Miracle At Saint Anna's
5. Body of Lies
6. Burn After Reading
7. Rachel Getting Married
8. The Dutchess
9. The Women
10. The Dark Knight

(Most of them I probably won’t see till they’re out at Blockbuster-and, yes, almost half of them are "chick flicks.")
metalpeter - 10/28/08 17:04
Wow You are a very lucky person to get a Happy Ending at a movie, HA. There are some other cool things about going to the movies like seeing good previews for other good movies. Going to see and Event like Death Note and Death Note II. I still haven't seen anything in Imax. Someone was telling me some of the movies that where at the cheap show and there where a bunch I wanted to see. I think they where the ones that came out as I was on the weekends watching the Olympics so I missed a bunch of them.
tinypliny - 10/27/08 23:31
I am a movieholic (but I have been falling behind on my movie viewing habits for the past couples years or so). The movieholic in me is mildly anxious that I haven't heard of any of these movies you mention.

The last movie I watched was stardust - which is very recent, I think. But whoa, I used to stay on top of the movies a lot more back home, than I do now. Of course, movies are always released a week or two later than here. Hmmm... so even if I was on top of the movie release schedule back home, I was still late by real movie-release standards here. Maybe I wasn't such a movie addict at all...

10/26/2008 18:26 #46353

Costume shopping
Took my daughter Halloween costume shopping today to the Spirit costume store. I could not believe how ungodly expensive costumes are. She got this little woodland ferry-ish/nymph costume (which is way too short and revealing), that really doesn’t have much to it, for $50. It is pretty cute - but $50? GEEZ! She actually wanted two costumes, one for school and one for Halloween night, but her friend and I talked her out of that. (There was no way she was getting a second costume.) She’s going to put something together for school from stuff she already has. We then went to the Blvd. Mall to pick up a few accessories. We were going into Spencers and my daughter said something to me in reference to the “type” of store it was (meaning it had “dirty” or otherwise “inappropriate” stuff), as if it would somehow offend my sensibilities. I thought the whole thing was rather funny. Still don’t have my costume together - having a hard time making a definitive decision but guess I better figure it out if I’m going to wear one. Eve or Lady Godiva are definitely out of the question, and I don't really do the slut/hooker/sexy whatever very well either - I'm not exactly 20-something, or even 30-something, anymore...

Went to the Battle @ Buffalo last night. We really enjoyed it. Turns out my niece knows the guy whose studio it is, and a couple of the dancers; the guy at the door collecting the $ went to high school with my son and niece; and my old next door neighbor was there with his kids. Briefly got to meet Felly and Lauren, which was also cool. It was a fun night and relatively inexpensive family entertainment. Pretty likely we’ll go again - only earlier next time - to get some seats.

metalpeter - 10/27/08 19:07
What I'm guessing about spencers is that your daughter doesn't want to be in the store with you. That is a great place to run into friends, besides looking at the naughty stuff with mom could be kinda weird. Costume wise I haven't heard of that place.
fellyconnelly - 10/27/08 06:24
oh and a very nice to meet you gardenmama! Glad you enjoyed the battle!
fellyconnelly - 10/27/08 06:24
I would sew my costume if i had a machine, but instead I've been working with 'liquid stitch'. if my costume fall off at the party, now you know why.
tinypliny - 10/26/08 20:52
I am going to try and sew a costume on Thursday night. You will all see how many minutes it holds together on Friday. Heh
gardenmama - 10/26/08 20:11
Yes, I always think making a costume is great in theory, unfortunately it requires forethought and planning and I tend, too often, to fly by the seat of my pants.
paul - 10/26/08 20:03
Ya, next year I am going to get the sewing machine out and actually make something. Costumes are so expensive.

10/24/2008 22:20 #46314

Halloween silliness
A little Halloween silliness to share:

http://minibytes.mondominishows.com/poo/main.asp?affil=email

is better with sound on
tinypliny - 10/24/08 22:26
HAHAHA... that was priceless. LOL

10/25/2008 17:12 #46327

Early Halloween and New Car
I picked up my new car today - yay! I'm pretty excited. The dealer told me Buffalo has the highest car theft rate in NY state - I had no idea. I don't really think the car I bought is a usual car theft target - it's not exactly a luxury car or sports car.

Anyway, I was driving my daughter's friend home (who lives off Elmwood) and we saw a bunch of families out walking around with kids dressed up in costume. I guess there is some type of early celebration on the strip today.

Also, I had to stop at Wegman's this a.m. to pick something up for my sister and most of the employees were in costume. I guess they're all being encourage to dress up just this weekend. it was kind of funny.

Wanted to take my grandaughter to the Halloween thing at the Zoo last night but she had a party at school, and I have plans for this evening (going to the breakdancing competition Lauren posted about) so we can't go tonight either. Oh well, guess there's always next year.

Oh yeah, the dead dear in the parking lot thing was gross. I hate that I really like chinese food because you hear so much disgusting stuff about what chinese restaurants do (cats, dogs, rats, pigeon, now deer) that it really makes you not want to eat there. It's sad. ;(
tinypliny - 10/25/08 17:46
I am sure they cook it well, roadkill or not. :) I think the best (and most healthy) Chinese food is inevitably the one made at home.