Oncologist

Smithfield Cancer Centre

305 ST

Melbourne VIC

11 July 2019

Re: Mr Bruce Brew, aged 36

Dear Physiotherapist,

I am writing to transfer Mr Brew, who has been treated for stage 3 gastroesophageal cancer. He
requires urgent evaluation for chemotherapy and ongoing management at your care.

On 6July 2019, Mr Brew presented with paleness in his appearance. He was malnourished and
looked distress. His blood pressure 132/92, Pulse rate 88, and respiratory was 14. He lost his 10 kg
weight in past 6 months. Recently, his weight was 62kg and BMI 18.5. He had swallowing difficulty
from past 4 to 5 months. He was in intense gnawing pain just below the sternum. His joint was
appeared prominent with an evidence of muscle wasting. In addition, on palpation was in epigastric
pain.

Under our care, Mr Brew was compliant with oxycodone 1mg per ml in 0.9% saline and 5% dextrose
intravenously. On 07 July 2019 to 08 July 2019, he performed endoscopy and barium swallow test.
These results were attached to file. He was compliant with weakness to perform his routine
activities.

Mr Brew was a regular jigger and suffer. He was a non-smoker but consume alcohol approximately
60 cans of beer in a week. In addition, he was treated with OTC medicine for heart burn since 2001.
His father was died of stomach cancer.

In view of the above, I would be grateful if you could arrange urgent chemotherapy treatment to
him.

If you have any queries, please do not hesitate to contact me.

Yours faithfully,

Charge nurse.