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2014-12-22
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Welcome to Columbia's physician chat. Columbia is the nation's largest
healthcare services company with more than 320 hospitals, 125 outpatient
surgery centers and 150 home health agencies
JTaorm : Tonight we have Dr. Scott here to answer your
questions on oncology
JTaorm : Welcome Dr. Scott to tonights chat.
MDONC : $ jim i am here, dr.`scott $done
MDONC : thanks I am glad to be here
MDONC : $done
JTaorm : Doctor are you ready to answer some questions?
MDONC : of course
MTK2Door : a friend has a tumor on one kidney and a total to 10
tumors in his lungs. he had magliant melamona
MTK2Door : removed 8 years ago, what do you think his chances
are?
MDONC : how old, any prior therapy??
MTK2Door : 44--removal of the mole and surrounding area
MTK2Door : no therapy after surgery
JTaorm : Tonight Dr. Scott's screen name is MDONC.
MDONC : there is a new therapy that came out about 5 years
ago. It is called Interleukin 2. It has
MDONC : a fair amount of activity. I have seen patients live
several years after taking it yet the
MDONC : average is quite poor
JTaorm : Doctor, I have a question I ask all the phuscians
that come online.
MDONC : I would suggest that mkt2door's friend get to the
national cancer institute for a protocol
JTaorm : What is the toughest part of your work?
MDONC : with this new therapy. My most successful outcome
with melanoma came at the national cancer
MDONC : institute
MTK2Door : is that in DC?
MDONC : my work is incredibly rewarding.
MDONC : once you realize that you can't cure everybody, you
set realistic goals and try and exceed
MDONC : you get positive strokes from families even with
minimal benefits like pain control. I love
JTaorm : Can you tell us a little about your practice?
MDONC : my patients and I like the fact the fact that i get
to see them on a regular basis
MDONC : It is a large practice in
JTaorm : If you have a question please feel free to ask.
JTaorm : Tonight we have Dr. Jeffery Scott here to answer you
questions on cancer.
MDONC : ATLANTA GA. I GO TO NORTHLAKE REGIONAL, DEKALB
MEDICAL AND GWINNETT
MDONC : THERE ARE 19 MED ONCOLOGISTS AND 2 RADIATION DOCS. I
SPECIALIZE IN GENERAL
MDONC : ONCOLOGY BUT WITH A SPECIAL INTEREST IN BREAST CANCER
MDONC : BY THE WAY, THE NCI IS IN BETHESDA MARYLAND OUTSIDE
D.C. FOR SPECIAL TUMORS SUCH AS
RodgersSP : Dr Scott, I have a question about thyroid cancer. My
mother-in-law had surgery to remove
MDONC : MELANOMA THEY OFFER SOME EXCITING TREATMENTS
JTaorm : Tonight we have Dr. Jeffery Scott here to answer you
questions on cancer
RodgersSP : her thyroid but they have found an spot that is still
active.
MDONC : IS IT PAPILLARY OR FOLLICULAR OR MEDULLARY OR
ANAPLASTIC
RodgersSP : I'm not sure
MDONC : THYROID CANCER IS A FASCINATING TUMOR. BECAUSE IT
TAKES UP IODINE WE CAN MAKE
Teri Ucla : Dr Scott, my 62 year old mom was diagnosed with
Ovarian Ca 4/96 and is on her 4th treatment
MDONC : MAGIC BULLETS OF RADIOACTIVE IODINE THAT ARE
SPECIFICALLY TAKEN UP BY THE TUMOR.
MDONC : THIS ALLOWS VERY EFFECTIVE AND SPECIFIC TREATMENT FOR
THYROID TUMORS AND IS
MDONC : ASSOCIATED WITH AN EXCELLENT PROGNOSIS EVEN WITH
DISEASE OUTSIDE THYROID
Teri Ucla : of chemo Taxol and cisplatin and she has such body
aches and generally not feeling well what
RodgersSP : but it seems to have not worked the first time. can
they do that again?
MDONC : YES RADIOACTIVE IODINE CAN BE REPEATED
MDONC : TO TERI THIS IS A VERY TOUGH TREATMENT. i WOULD
EXPECT SIGNIFICANT NAUSEA, VOMITING AND
RodgersSP : is it a safe thing to do again. what are the chances
it wont work again
Teri Ucla : can we do for her so she can get thru the week after
chemo?
MDONC : BODY ACHES. SOMETIMES IF MD GIVES PATIENT A STEROID
-MEDROL- MID TREATMENT CYCLE IT
MDONC : CAN PREVENT BODY ACHES
MDONC : TO RODGERS- THERE IS SOME ACTIVITY WITH CHEMO BUT AS
LONG AS A THYROID SCAN IS POSITIVE THE
MDONC : TUMOR PROBABLY WILL STILL TAKE UP RADIOACTIVE IODINE.
IF THERE WAS ONE RECURRENT SPOT I
MDONC : MIGHT CONSIDER REGULAR RADIATION.
JTaorm : Tonight we have Dr. Jeffery Scott here to answer you
questions on cancer
MDONC : TO TERI OVARIAN CA IS A BAD PROBLEM IF IT RECURRS MOM
SHOULD DO THE BEST SHE CAN BECAUSE
JTaorm : What are the chances of a smoker getting some type of
cancer?
MDONC : IT IS NOT REAL CURABLE IF IT COMES BACK
CajunFlash : I'm trying to find out about Baker111 category on
breast implants
MDONC : IF PEOPLE DIDN'T SMOKE I WOULD BE OUT OF WORK.
JTaorm : Does smoking cause breast cancer?
MDONC : THE FIRST OR SECOND CAUSE OF ADULT DEATH IS CANCER
AND OVER HALF OF CANCER DEATHS ARE SMOKIN
MDONC : RELATED
MDONC : I DON'T THINK THAT WE HAVE DATA TO SUPPORT SMOKING AS
A CAUSE OF BREAST CANCER
Teri Ucla : Are there any nutritional suggestions you might have?
MDONC : TO CAJUN I AM NOT SURE ABOUT IMPLANTS
JTaorm : If anyone has a question for the doctor please feel
free to ask.
MDONC : ADEQUATE NUTRITION IS IMPORTANT BOTH CALORIES AND
ADEQUATE VITAMINS
MDONC : I AM NOT SURE THAT THERE IS ANY STRONG DATA TO
SUPPORT HIGH DOSES OF ANY VITAMINS
MDONC : DURING TREATMENT.
MDONC : HOWEVER I HAVE PATIENTS THAT IN ADDITION TO
CHEMOTHERAPY ARE ON A NUMBER OF
CajunFlash : I also have fibromyalgia
EST735 : Is the MD specialist here?
MDONC : HOMEOPATHIC TREATMENTS LIKE SHARK CARTILAGE, GARLIC,
VITAMINS.....
JTaorm : Tonight we have Dr. Jeffery SCott here to answer your
questions on cancer.
MDONC : YES I AM BUT I DON'T KNOW ABOUT FIBROMYALGIA
JTaorm : Dr Scott's screen name is MDONC.
XPN : any suggestions of where to discuss radio frequencey
ablation
EST735 : ?
MDONC : YOU GOT ME. I HAVE HEARD ABOUT IT BUT NOT SURE IF IS
USED IN PRACTICE
Teri Ucla : Do you recommend Chinese teas or something called
"Citrine?" My mom does very well except
CajunFlash : Can you tell me when someone will be able to give me
info on these conditions
Teri Ucla : the week after Chemo for about 3 or 4 days.
MDONC : CITRINE HAS NOT CAUGHT ON HERE IN ATLANTA BUT I HAVE
HEARD OF ITS USE
EST735 : My husband has chronic active hepatits C, is there
any way to help prevent it turning to
EST735 : cancer?
EST735 : He is only 42 and does have liver damage
MDONC : WOW,,, THERE IS A HIGH RISK OF HEPATOCELLULAR
CANCER(LIVER) IN PATIENTS WTIH CIRRHOSIS.
EST735 : he has cirrhosis
XPN : where can i reference information on cardiovascular
surgery
EST735 : it is mild but there
MDONC : INTERFERON MIGHT HAVE A ROLE IN REDUCING LIVER
DAMAGE. FORTUNATELY IN THIS COUNTRY
EST735 : he already took two series of it with no success
JTaorm : Tonight we have Dr. Scott here to answer your
questions on cancer.
MDONC : WE DONT SEE MUCH LIVER CANCER BUT IT IS THE MOST
COMMON IN THE WORLD
MDONC : CAN HE GET A TRANSPLANT???
JTaorm : Tonight we have Dr. Jeffery Scott here to answer you
questions on cancer
MDONC : IF NOT HE SHOULD BE WATCHED CAREFULLY BUT RISK IS
STILL NOT GIANT. NO OTHER
EST735 : Would not even be considered at this point he is
asymptomatic and lives a normal life
MDONC : PREVENTITIVE TREATMENTS THAT I KNOW
Dpf2000 : Can anyone tell me what Solumedral tgm is?
MDONC : HOPEFULLY HE WILL DO WELL FOR A LONG TIME.
EST735 : Thanks
MDONC : SOLUMEDROL IS A TYPE OF MODERATE INTENSITY STEROID
Dpf2000 : Are there any known side effects?
MDONC : LIKE ALL STEROIDS HAS WEIGHT GAIN, HIGH BLOOD
PRESSURE AND FACIAL HAIR
MDONC : ALSO CAN CAUSE INCREASED BLOOD SUGAR
Dpf2000 : How come I can not find this steroid in the med ref?
MDONC : LOOK UNDER METHYLPREDNISOLONE ITS GENERIC NAME
JTaorm : Tonight we have Dr. Scott here to answer your
questions on cancer.
Dpf2000 : Thanks!!!
RodgersSP : Dr, I have one more question about the Thyroid
cancer. if someone had a total thyroidectomy
RodgersSP : got the iodine treatment and 20 months later found a
residual tissue spot that took up the
RodgersSP : iodine, does this mean it is cancer or what could
cause this?
XPN : d
MDONC : IF A THYROID CANCER IS POSITIVE WE WOULD ASSUME THERE
IS A METASTASIS OR RESIDUAL AREA OF
MDONC : THYROID TISSUE PRESENT. IF IT OUTSIDE THE THYROID IT
WOULD BE ASSUMED MALIGNANT
MDONC : BY THE WAY I MEANT THYROID SCAN
RodgersSP : so eventhough it took up the iodine it can be assumed
malignant?
JTaorm : We are nearing the end of tonights chat.
JTaorm : If anyone has any last comments or questions now is
the time.
MDONC : IF IT IS OUTSIDE THE NECK AND WAS PREVIOSLY NOT
POSITIVE IT IS MOST LIKELY MALIGNANT
MDONC : IF IT PERSISTED DESPITE TREATMENT I WOULD CONSIDER A
BIOPSY
RodgersSP : it is too small to biopsy
MDONC : THYROID CANCER IS VERY NON AGGRESSIVE AND SLOW
GROWING. IF MY PATIENT HAD
MDONC : A PERSISTENT SMALL FOCUS I MIGHT OBSERVE IT IF IT
FAILED I 131 RADIOACTIVE TREATMENT
JTaorm : Doctor thank you for joining us tonight. I sure you
have had a long day and we appreciate you coming o
JTaorm : online.
RodgersSP : so should we just watch and see.
MDONC : THANKS AND MY BASKETBALL TEAM APPRECIATES YOU LETTING
ME OFF EARLY
JTaorm : One last question. How can you be contacted for
future help?
JTaorm : Go Wildcats.
MDONC : TO RODGERS I GOT TO GO BUT IF YOU CAN EMAIL ME A
MESSAGE AT AOL OR TO MDONC@ATL.MINDSPRING.
JTaorm : great. thanks doc.
RodgersSP : thankyou for your time.
MDONC : COM I WILL BE HAPPY TO ADDRESS FURTHER TO YOU OR
ANYONE ELSE....
MDONC : BYE
JTaorm : This ends tonights chat.
JTaorm : Copyright Columbia HCA Healthcare Corporation 1996.