Discuss radiation therapy and endocrine therapy

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Case study: Mrs. Flett, the experience of cancer

Mrs. Annie Flett, 68 y.o. was diagnosed with breast cancer originally 8 years ago. She underwent a total

Mastectomy on the L side, chemotherapy, radiation therapy, and endocrine therapy. She was deemed cancer-free at her 5-year follow-up. Two months ago there has been a recurrence of cancer this time with metastasis to the bone. She was diagnosed because of severe back pain that was eventually found to be a compression fracture of the spine secondary to bone mets. She received a course of urgent radiotherapy for the compression fracture and once this was completed, she started on chemotherapy 2 weeks ago as an outpatient. She has been staying in Winnipeg for her treatments along with her sister and husband in a room arranged through Cancer CareManitoba.

HxPI: Two days ago, she presented to the emergency room with a fever and is admitted with "febrile neutropenia". She was also experiencing stomatitis, nausea, vomiting and diarrhea. The diarrhea has since resolved and the emesis has reduced but nausea persists. The pain in her mouth makes it difficult to eat or drink. Her back pain from the compression fracture has decreased a great deal but with this illness, the increased time in bed has aggravated it somewhat.

Social: Mrs. Flett is married has 4 adult children and seven grandchildren with her current husband. She and her husband live in St. Theresa Point First Nation Community. Their children live in various areas of the province. She also has a son from a previous relationship but they are estranged. Her husband has several chronic illnesses and Mrs. Flett was the one who generally coordinated his care before her cancer returned. She also provided daycare for 2 of her grandchildren most days. Her sister Mary accompanied Mr. and Mrs. Flett to Winnipeg from St. Theresa Point. She is helping out Mr. Flett with his medications and getting to the hospital due to mobility issues and a diabetic foot ulcer. Her one daughter, Laura and two teenaged granddaughters are in visiting today.

Reference no: EM131665591

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