Dr. Clara Hwang

Please contact your oncologist for an evaluation. There are many reasons why people may feel fatigued, some of which are serious, some of which can be easily treated, and some of which are relatively benign but difficult to treat.

After the evaluation, your doctor can tell you what the fatigue means and how to cope with it.

Please discuss this with your personal oncologist. Treatment options for leptomeningeal disease include chemotherapy delivered directly to the spinal fluid, radiation therapy for some patients, and systemic therapy for some patients. For some patients, the best treatment option is supportive care with transition to hospice. The doctors taking care of you who have access to the details of your case are best equipped to help you make the right decision.

Yes, testicular implants can be placed at the time of surgery to remove the cancer. However, implants have both risks and benefits. You should discuss these in depth with your surgeon to make a decision that is right for you. You can also have the implant placed later, after the cancer surgery or any other cancer treatments that are needed.

The vast majority of headaches are not caused by brain tumors. In addition, brain tumors generally cannot be prevented.

I would recommend age-appropriate health maintenance behavior that is personalized to you by a knowledgeable primary care physician. There are no specific health maintenance activities that prevent cancers of the brain other than smoking-cessation and general cancer-screening.

If you have an occasional headache that is easily treatable with over-the-counter medication or simple measures like rest and hydration, there is no reason to be concerned.

If you have persistent or severe headaches, please seek medical attention. In addition, headaches with neurologic symptoms such as seizures, weakness, visual changes, balance problems, are concerning and should be evaluated by a physician.

If thinking about the possibility of health problems makes you anxious, please talk to your care provider about your anxiety.

Some patients with pancreatic cancer have deficiencies in the enzymes that are released by the pancreas to digest food. If your doctor diagnoses an enzyme deficiency, he or she may prescribe replacement pancreatic enzymes.

There are no general recommendations for pancreatic cancer patients to take extra vitamins or supplements unless there is a deficiency. Some vitamins and supplements interact with cancer treatments, so if you would like to take other vitamins or supplements, please discuss them specifically with your oncologist.

The term for this treatment is "brachytherapy." The "seeds" are radioactive and deliver radiation to the cancer when they are left in place. It is appropriate for certain kinds of prostate cancer.

Almost all cervical cancers are caused by HPV infection. Other factors that may play a role in the development of cervical cancer include reduced immunity, smoking, or other infections. Please ask your doctor if any other factors are thought to be relevant for your case.

The side effects of treatment depend on the specific chemotherapy regimen being prescribed by the oncologist.

Recent advances in lung cancer mean that oncologists will typically run special tests to see if patients should get immunotherapy, new targeted agents, or more traditional "cytotoxic" chemotherapy.

Side effects from these various regimens vary significantly so it is hard to give a simple answer to this question. The severity of side effects also range from mild to occasional severe side effects.

I recommend a personalized discussion with the treating oncologist about the specific regimen being prescribed.