Ascites, ovarian/abdomen or recurring kidney cancer

Hi Roxi,

My name is Gail and I’m one of the Macmillan Cancer Information Nurses on the Support Line. I’m sorry to hear your mum is feeling so unwell and you’re still waiting on the results of the biopsy. These results can take approximately one to two weeks.

If the doctors can determine the primary cancer, it will allow them to decide on the most effective treatment plan. This can help impact the cancer cells best. But we understand how difficult this must be as a family, especially as you’re seeing your mum suffering so many symptoms.

If your mum is allocated a clinical nurse specialist, it’s important to let them or a member of her cancer team know of any changes in your mum’s health. They can assess her symptoms and prescribe medication that may help her whilst you’re waiting. There are many anti-sickness medications they could consider prescribing to help relieve this.

It’s important her symptoms are monitored to make sure any prescribed medication is helping, as if not, they can look at alternatives.

They may also check her bloods as sometimes weakness can be related to anaemia or other abnormal blood levels that cancer can cause. If abnormal blood levels are contributing to her sickness or weakness, the doctors can look at any interventions that may help with this, such as a blood transfusion or medication.

I wonder if you have the appropriate support at home just now. Whilst you are waiting to find out her cancer treatment plan, please ensure you also let the GP know about how your mum is feeling. They can organise community nurses or district nurses to help observe her symptoms, whilst also helping support you as a family.

It sounds as though you’re all going through such a difficult time, I wonder if it may help to  give one of our nurses a call directly on our Support Line to talk things through. I hope this information helps but please don’t hesitate to get back in touch if we can offer any further advice or support.

Ref;AMcG/LM

Hi, It is been a while since I posted the above message. Finally managed to give an update on the situation. The biopsy result shows that it is renal cell carcinoma. She is currently taking Cabozantinib, she is on her 3rd cycle now. Since the first drain, she had 4 more drains: 3l, 2l, 5.5l and 6.4l (still fluid left, but the doctor decided to stop the drain). She had a DVT when she was in her 2nd cycle and is currently taking Apixaban for it. She is not well in herself, very nauseous all the time, and mostly stays in bed, despite the medications for it. She is afraid of going out because she is weak, and doesn't have the strength for it and also afraid she will vomit. Also, she was hoping that the ascites will stop building up with the treatment, but it looks like it builds up quicker now. 

Was wondering if there is anyone who is experiencing the ascites with RCC and if it stopped with the treatment. I have also updated my profile with all her history.

Hi, Roxi

Thanks for getting back in touch.

My name is Eileen, and I am one of the Cancer Information Nurse Specialists working on the Macmillan support line. 

I’m sorry to hear about your mum. It sounds like she is having a really tough time and I can appreciate that you’d like to know whether ascites is something that can be experienced in people with renal cell cancer.

Ascites can be a feature of many types of cancer. It is rarer in people with RCC but if the cancer has affected the peritoneum it can lead to the accumulation of ascitic fluid.

To determine if the Cabozantonib is working, your mum’s treating team would usually undertake further scans. The scans will be compared to those taken before treatment commenced and allows them to see whether her disease is responding to the drug. If the drug is working, over time we would expect to see an improvement in symptoms caused by the cancer.

It sounds like the nausea your mum is experiencing is having a major impact on her quality of life and is very debilitating. Whilst nausea can be a side effect of Cabozantonib, ascites can also contribute to feeling or being sick.

You don’t say whether your mum has made her treatment team aware that despite medication to help with nausea she is still experiencing it all the time. If they are not aware, please encourage your mum to contact them today to inform them in order that she can be reviewed. She should have a 24 hour Chemotherapy contact number for the hospital.

I do hope this information is helpful but please know that you can call one of our nurses to discuss things further.

Take care and best wishes,

 Eileen

(Cancer Information Nurse Specialist)

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref:KM

Hi Eileen, thank you very much for your reply. She is now on Lansoprazole once a day and Prochlorperazine twice a day. She is on them since last week. She says she has  nausea all the time and sometimes is more intense and needs to lay down so she will not vomit.  Before she was on Metoclopramide 3 times a day, and Famotidine 2 pills a day. She is also on dexamethasone 4mg a day. She is on dexamethasone since 23 of February, started with 6mg a day and than decreasing gradually to one per day any other day. But than she had the blood clot in her leg, loss of appetite, and ascites was drain again(5.5l) and she was put back on 4mg a day. We are going to see her consultant next Wednesday and we are also waiting for her CT scan appointment.  

Hi Roxi,

Thanks for getting back in touch. My name is Amy and I am one of the Cancer Information Nurse Specialists on the Macmillan Support Line.

I just wanted to check in with you and see how things are. It sounds like your mum has been having a really tough time. Hopefully you get a date for the CT soon and the consultant can help on Wednesday.

It might be worth getting back in touch with her chemotherapy treatment line number in the meantime. There are different types of anti-sickness medications available. You can read more about others ways to try manage nausea and vomiting here.

You are welcome to give our support line a call if you think it might help to chat. We often find we can explore more complex situations and questions over the phone.

I hope this helps.

Take care and Best wishes, 

Amy C, Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref: AC/LJ