Persistent cough & fever.

Chief Complaint A 44 y/o female presents with the complaint of cough and low-grade fever for about a month with no relief on medication. History Patient is hypertensive. No other past medical or surgical history. Vitals BP: 135/85 mmhg, HR: 76 bpm, Resp rate: 16 bpm, Temp: 98.4 degree F Investigations Radiograph was done because of persistent cough. It shows an uneven area in the left lung. We decided to go for CT thorax, shows nodule in the left lung with lymphadenopathies. FNAC was done which was indicative of small-cell lung cancer. No metastasis was noted. Treatment What is your advice?



Chronic myeloid leukemia was having poor prognosis 10 years back, Imatinib changes the whole picture, now with treatment of Imatinib, it's very common to have moving term survival with chronic myeloid leukemia Monoclonal antibodies are changing the outcome of metastatic cancer, the picture is changing very rapidly Denosumab and nivolumab has changed the outcome of lung cancer dramatically, with this treatment we are now looking at long term survival in lung cancer as long as 5 - 10 years survival This was unimaginable 10 years back when metastatic lung cancer had survival of 6 months to 1 year As time progresses newer and more effective treatment are going to come, the picture of cancer treatment is changing rapidly with advent of monoclonal antibodies directed to the cancer cells, specifically killing cancer cells, they are found to be highly effective

Small cell lung cancer is one of the most aggressive lung malignancy. Combination chemotherapy remains the best option in this case Cisplatin + etoposide remains the mainstay of treatment Alternatively Carboplatin + etoposide can be used . Generally six cycles at 3 weeks interval are required. Radiotherapy may be included in the treatment regimen


Tnx Dr Vipin Bihari Jain sir

PET scan. Oncologist reference for expert management.

Obviously it requires operation, histopathology of node and further management as per Oncologist

Thanks Dr. Kute Ankush , Dr. Shivraj Agrawal

Staging of cancer followed by resection ..oncology opinion

Surgery. Radiotherapy

Chemoradiotherapy Sos surgical intervention

Thanx dr Vipin Bihari Jain