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This week we will combine safety concerns with some therapeutics. It is especially important this week to check on the source of the information to be sure it is clinically relevant and applicable in this particular situation. Please come up with a plan for him—I would like to see some reasonable, concise, do-able plans with specifics.
52 year old Caucasian male
Sam was diagnosed with metastatic colon cancer a few weeks ago. At that time he had surgery to remove a small section of his colon and a much as the cancer as possible. He has kept enough of his colon to have altered, but normal, bowel function.
Sam will undergo chemotherapy and radiation to eliminate remaining cancer cells. He is worried about how he will handle the treatments. Prior to his diagnosis he experienced IBS like digestive symptoms for the previous 12 years and has always had a tendency to acid reflux. He also experiences some ostero-arthritis and frequent fatigue. Since his diagnosis and surgery he has been sleeping poorly and has lost much of his appetite. His blood work reports that his white blood cells are also a bit low.
He doctors are worried that he is not well enough to tolerate the chemotherapy and radiation, and would like you to help support him. They report that his current health concerns are not a result of the colon cancer. They want to make sure whatever you do is safe for him, but also need to see enough of a change in him to make the necessary treatment a possibility for him.
How can you support Sam? What is a clinically applicable, safe and realistic regimen to put Sam on?
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