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Ask The Expert Archive

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GI Cancer Archive Questions

Below are Dr. Hanna’s answers to GI Cancer questions
received through the Ask the Expert feature.

This content is provided for informational purposes only, and is not intended
to be a substitute for individual medical advice in diagnosing or treating a
health problem. Please consult with your physician about your specific health
care concerns.

Now displaying records 1 to 15 of 34.

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Q : 1

I have had three abdominal resection surgeries and have numerous surgical staples. Is it safe to have and MRI of the spine?

The surgical staples will not interact with the MRI, therefore it is safe to have the procedure.

Q : 2

My father-in-law has been diagnosed with mucinous adenocarcinoma of the appendix with advanced peritoneal carcinomatosis. Today he was told he has a PCI score of 39. The cancer is contained in the peritoneum but has coated the surfaces of the small and large intestines, liver, diaphragm, stomach, and lining of peritoneum. What are his treatment options?

A score of 39 is the highest possible score which also indicates that the possibility of complete cytoreduction is unlikely. I would highly recommend neoadjuvant chemotherapy hoping that he would respond to treatment and improve his chances of getting good outcome with the HIPEC.

Q : 3

Do you perform surgery to remove tumors and complete a chemo wash for patients with pseudomyxoma peritonei who have already had two surgeries?

Yes, we do perform this surgery.

Q : 4

Is the ileo-anal pouch anastomosis the same as the J pouch?

Yes. A J-pouch is made from the end of the small bowel and attached to the anal canal to form a pathway for the passage of stool.

Q : 5

My brother has pancreatic cancer that has spread to his liver. I read in your Q&A that in July 2010, you said that chemotherapy was the only option at this stage. Has any new treatment been discovered since last year?

There is a more effective chemotherapy regimen than the standard gemcitabine. You should discuss this with his treating physician.

Q : 6

My husband has been diagnosed with stomach cancer. He is only 35. We are going to get a second opinion because his doctor wants to remove his entire stomach. I think that is too invasive for a 35-year-old. Any suggestions?

Chemotherapy before surgery may be a better option. He will also need to be evaluated for a possible hereditary syndrome, since he is so young.

Q : 7

I was diagnosed with anal cancer and treated with radiation, chemo and removal of lymph nodes in the right of my groin. I noticed the development of lesions on my scrotum and I have had two surgeries to completely remove them. Now I have severe swelling. I was told it would take time to go down, but is there anything else I can do?

It is going to take some time before the swelling goes down. There is no magic treatment - scrotal elevation is best option for now.

Q : 8

My husband had cytoreduction and HIPEC at the end of December. Is systemic chemo a standard practice after this type of surgery? I believe the CC rating was a 01. What does that mean?

It is common that we recommend systemic chemo after a patient has HIPEC, but the decision is dependent on many factors. A CCR of 1 (if that is what you're referring to) means there is small volume of disease left behind.

Q : 9

I have been experiencing what feels like constant spasms in my rectum. I was treated for prostrate cancer last year. Is there any connection between the two?

You should have a colonoscopy if you have not had one recently. If you received radiation therapy, it could be related to radiation irritation.

Q : 10

Why is it that metastasis never occurs from the brain to the liver?

Brain cancer is uncommon and difficult to treat. Unfortunately, those who are diagnosed with brain cancer often have a short life expectancy.

Q : 11

Can radiofrequency ablation be applied to small accessible tumors in general? It seems to offer less side effects. Is that sometimes a treatment option for patients with tumors under your care?

RFA is not for all tumors. It is mostly used to treat tumors in the liver, lung and bones. It is not a treatment option for tumors in pancreas or bowels.

Q : 12

Would you suggest the internal heated chemo wash for a pancreatic cancer believed to be in a very early stage ?

No. The most appropriate treatment for early stage pancreatic cancer is the Whipple surgery.

Q : 13

My uncle was diagnosed with pancreatic cancer that metastasized to his liver. I read about the Selective Internal Radiation Therapy (SIRT), could this be an appropriate treatment for him?

SIRT would not be a good option for metastatic pancreatic cancer. Chemotherapy is really the only option.

Q : 14

My sister has just been diagnosed with stage IV pancreatic cancer with liver involvement. What can we expect as far as her quality and quantity of life?

Chance of survival is limited when there is incidence of metastatic disease. However, chemotherapy may help to improve her quality of life.

Q : 15

Are there statistics on the percentage of people with cholangiocarcinoma who are cured after surgery and have the tumor completely removed with no cancer in the lymph nodes?

We always refer to 5-year survival and not cure since they are still at risk of recurrence. This also depends on the stage of the cancer and whether or not it is extrahepatic or intrahepatic.

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