Q: A patient is suffering from lung cancer that has spread to the spinal cord breaking one of the bones. He is in the 4th stage and has recently undergone radiotherapy. As a result the patient has developed a number of side effects that is causing extreme discomfort. The patient is unable to get sleep for 4 days consecutively because of the discomfort. The doctors are not providing sleeping medicines also. Please give your suggestions.

A:The patient in question has Stage IV lung cancer and has received RT to the spine for his metastatic disease. Mostly that should take care of the pain. For insomnia treatment can be given provided there is no other over riding factor or contraindication for such treatment. There is no mention of side effects of RT that the patient developed. Insomnia is not likely to be RT related. It might be more because of anxiety related factors. It is also worthwhile trying some chemotherapy and bisphosphonates (for bone pains) if thought worthwhile by the treating oncologist.