What does pain & swelling in ankles in patients with multiple organ tumor suggest?
Patient: My mother has one kidney after nephrectomy due to renal cell carcinoma. She is out of state on a trip and ct has revealed mutiple organs with tumors as the cancer has spread. She was released from hospital thursday and we have a flight for tomarrow to bring her home. She just called and said her ankles are swelling. What do i do? Can she fly? Emergency room?  Is she in renal failure? She is weak and tired as cancer is taking over. I am a 5 hour plaine ride away, help Doctor: Thanks for your question on HCM. I can understand your situation and problem. In my opinion your mother should avoid flight journey. There are many causes for her ankle swelling and pain.  But the common causes are1. Renal failure 2. Hypoproteinemia 3. Liver metastasis 4. Heart failure due to heart metastasis. So better to consult doctor and get done renal function test, liver function test,  serum protein level,  2d echo to rule out above mentioned causes. Prognosis in her case is very poor as she is having metastasis in other organs. And ankle edema will further deteriorate her life expectancy. So better to consult doctor and first treat her.