Gastric Cancer Case Study
REASON
CHIEF COMPLAINT: Stage IV gastric cancer.
HISTORY OF PRESENT ILLNESS
Mr. Mahdi is a very pleasant 56-year-old man who presents to the oncology clinic for evaluation and treatment of a stage IV adenocarcinoma of the stomach. In 12/2016, patient developed abdominal pain associated with eating, early satiety, and nausea and vomiting. He was brought to an ED for further evaluation and was diagnosed with a peptic ulcer and placed on acid blocking agents. In 01/2017, he was seen by gastroenterology and underwent an upper endoscopy which revealed a 6-8 cm mass in the lower body/antral junction causing obstruction. On 01/19/2017, he underwent exploratory laparotomy with a gastrojejunostomy and peritoneal biopsy. Pathology revealed an …show more content…
Generally, this is a thin man sitting comfortably in no acute distress. Skin is warm and dry. HEENT: Head is normocephalic, atraumatic. Pupils equal, reactive to light and accommodation. Sclerae are anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart is regular rate and rhythm. Abdomen: Soft, nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is …show more content…
Mahdi in regards to his diagnosis, prognosis, and treatment options. At this time, I will continue his Taxotere every three weeks. I will increase his dose to 100 mg/m2 with Neulasta given on day two. However, if he does not tolerate the increased dose we will go back to 75 mg/m2. Potential side effects of the chemotherapy may include and are not limited to febrile neutropenia, other cytopenias, peripheral neuropathy, renal insufficiency, liver insufficiency, secondary malignancies and temporary alopecia. Patient voiced understanding above plan and wishes to continue with the Taxotere every three weeks. I will repeat a CT scan after his fourth cycle. He should continue taking iron gluconate as
CHIEF COMPLAINT: Stage IV gastric cancer.
HISTORY OF PRESENT ILLNESS
Mr. Mahdi is a very pleasant 56-year-old man who presents to the oncology clinic for evaluation and treatment of a stage IV adenocarcinoma of the stomach. In 12/2016, patient developed abdominal pain associated with eating, early satiety, and nausea and vomiting. He was brought to an ED for further evaluation and was diagnosed with a peptic ulcer and placed on acid blocking agents. In 01/2017, he was seen by gastroenterology and underwent an upper endoscopy which revealed a 6-8 cm mass in the lower body/antral junction causing obstruction. On 01/19/2017, he underwent exploratory laparotomy with a gastrojejunostomy and peritoneal biopsy. Pathology revealed an …show more content…
Generally, this is a thin man sitting comfortably in no acute distress. Skin is warm and dry. HEENT: Head is normocephalic, atraumatic. Pupils equal, reactive to light and accommodation. Sclerae are anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart is regular rate and rhythm. Abdomen: Soft, nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is …show more content…
Mahdi in regards to his diagnosis, prognosis, and treatment options. At this time, I will continue his Taxotere every three weeks. I will increase his dose to 100 mg/m2 with Neulasta given on day two. However, if he does not tolerate the increased dose we will go back to 75 mg/m2. Potential side effects of the chemotherapy may include and are not limited to febrile neutropenia, other cytopenias, peripheral neuropathy, renal insufficiency, liver insufficiency, secondary malignancies and temporary alopecia. Patient voiced understanding above plan and wishes to continue with the Taxotere every three weeks. I will repeat a CT scan after his fourth cycle. He should continue taking iron gluconate as