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This question was answered on Wed 16, Jul 2008 08:58pm by Dr Paul S, MD

Translate my medical records to blue collar terminology


    
Asked by user (Male; 43; 43 yo male,, extremely healthy (minus the cancer),, runs 4 miles a day,,works out daily,,bench pressing 275 lbs. oligoglioma right temporal lobe 1988,, craniomity +radiation therapy,,thyroid cancer 1998,, thyroid removed,, radiation therap+radioactive iodine. Carcimona 2006 left neck,, surgery; Relevant drugs:dilantin,, tegretol,, synthroid, dexamethasone ) on Sun 29, Jun 2008 03:28pm

Sir,,, Below is exactley what is written in my medical records from a VA oncologist, not going to mention sny names or locations. Could you please give me your opinion. March 09-08- Metastic melanoma-brain-lungs. Discussed disease status, prognosis is poor maybe in months. Treatment options include probale brain surgery as he has had WBRT in the pastpallative +/- immunotherapy. 1. Neurosurgery Consult April ,09,08, Metastic melanoma, brain lungs. Discussed disease status, prognosis is poor, but maybe in months. Treatment options include probale brain surgery as he has had WBRT in the past pallative therapy +/- chemotherapy. April 16, 08 Discussed disease management again needs neurosurgery consult then plan further therapy. 1. Proceed with neurosurgery 2. Continue decadron. 3. RTC after NS consult. May,19,08-- Pts wife called wants to come talk to me worried that her husband is recieving no treatment. I asked her to come to the clinic tomorrow, sometimes the therapy for this is no treatment, they can also seek a 2nd opinion to help sort out their treatment options May,20,08-Metstic melanoma-brain,lungs. Discussed disease management, treatment of brain mets. his previous history of brain tumor & RT, possibilty of brain hemmorrage when he becomes thrombocytopenic during chemotherapy. At his time i believe his brain lesions have to be addressed first then lung lesions have to be addressed. May 29, 08 f/u for metastic melanoma brain+lung h/o oligodendroglioma. Pt told he can have a neurosurgical procedure at Tulane. Addendum.: Pt wants evaluation by thoracic surgeon for resection of lung lesion will do that after pet/ct 1. Proceed with neurosurgical procedure/ 2. Proceed with pt/ct 3.RTC after pt/ct June 06,08, Metastic melanoma involving brain,lungs, and skin. Discussed disease status with pt and wife, very upset with the new. Advised them to get a second opinion to help them deal with the disease as he has private insurance. At this time thoracic surgery is not appropriate. 1.Proceed with neurosurgery procedure 2.RTC after procudure (consult) 1. Proceed with evaluation for GammaKnife 2. RTC 1wk to discuss further evaluation plans. My current status: I am one week post GammaKnife,, feeling GOOD!! seMPer fidelis, Dave
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Answer by Dr Paul S, MD  on Wed 16, Jul 2008 08:58pm:

Hi there. It is good to learn that you are feeling fine after the gamma knife procedure. The records only shows the doctor's journal of his consults with you and outlines the treatment plan or what he has in mind. I believe that his primary treatment plan for you is to address the brain metastases through the neurosurgery or gamma knife approach. However, there are still some points of clarification regarding why the lung lesions are left alone. Resecting the lung lesions will be of very good help in terms of over-all prognosis and this should still be discussed further. Regards and God bless.

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