Q
: 1
12/15/2009 |
Both my brother and mother died of signet cell positive diffuse gastric cancer at age 52. They were not genetically tested but I was and tested positive for a truncating mutation of CDH1(E-Cadherin). I am looking to move forward with a prophylactic total gastrectomy. I am 50-years-old and in good health. Last CT and endoscopy one year ago and both were negative. Does your team offer total gastrectomies and if so how often are they done at your facility?
Yes, we do perform total gastrectomies at our hospital. I personally do the procedure very frequently (three times this month so far) with J-pouch reconstruction to maximize nutritional recovery.
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Q
: 2
11/13/2009 |
My mother (82) had cancer of the rectum removed several years ago. Over the last year, her bowel problems have become increasingly worse. She has no muscle in the rectum and therefore has no control over her bowel movements. Her surgeon said she could go with a colostomy, but only if she really has to. She does not want this. Is there anything that can repair this problem?
Unfortunately, colostomy is the only option for a patient experiencing the same symptoms as your mother.
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Q
: 3
10/11/2009 |
I'm confused about a lot of the information I have read about pancreatic cancer and the Whipple procedure. If a person has stage I pancreatic cancer and has the Whipple procedure, is life expectancy significantly reduced? I have read that only about 20% of post-Whipple patients survive beyond five years. Is this the case? Does chemo/radiation therapy help to improve life expectancy after the surgery?
Life expectancy without the Whipple procedure is very very short. The 5-year survival for pancreatic cancer treated with surgery (and other modalities) is about 25%. This includes stages 1, 2, and 3. Chemo/radiation is generally indicated after Whipple surgery if node/margin positive or T3.
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Q
: 4
09/29/2009 |
My husband was just told he has cholangio carcinoma in the bile duct in the pancreas with the possibility of 2 lymph nodes near the liver affected. Biopsies of the large bile ducts were negative. All other areas looked good. We have an appointment to visit the surgeon to see if surgery is possible. The Whipple procedure was mentioned. What prognosis might we be looking at?
Prognosis is dependent on the stage of the cancer, which is determined after surgery. The key factor is having the surgery. Therefore, it is essential that your surgeon is an expert. If you are told surgery is not possible, you can get a second opinion to confirm.
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Q
: 5
09/14/2009 |
My step-mother recently had a sigmoidoscopy and said that she was placed under general anesthesia. Is this always used?
It is very unlikely that general anesthesia would be administered during a basic procedure like a sigmoidoscopy.
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Q
: 6
06/18/2009 |
My mother (53) has been diagnosed with secondary cancer in the liver. The doctors have not been able to determine the site or source of the primary cancer. She has one large tumor of about 5cm by 5cm and several smaller ones. The biopsy has not revealed the primary cancer as they have said the cells are too abnormal. However, they have said that the cells do indicate that it is an upper GI cancer and could be from a bile duct or the pancreas. They said that the tumors are inoperable and she has started a course of chemotherapy both through IV and tablets as palliative treatment. Would Selective Internal Radiotherapy be an option?
I think that if she responds well to chemotherapy, then she should be reevaluated for surgery. In the future, she could be a candidate for Selective Internal Radiotherapy.
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Q
: 7
06/06/2009 |
My brother (52) was diagnosed with Cholangiocarcinoma with CBD. The Whipple surgery was performed and adjuvant radiation/chemo therapy (gemcitabin/oxyplatin) was completed. Recently, a PET scan detected metastases peritroneal/mesenteric nodules in aterior abdominal wall. His physician is looking for an appropriate combination of chemo treatment and says that surgery or radiation may not be feasible. Is this correct?
Yes. Chemoradiation is the best treatment at this stage.
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Q
: 8
05/12/2009 |
I am a 74 year old male who had an emergency appendectomy. An invasive mucinous adenocarcinoma tumor had perforated my appendix. I had an open right hemicolectomy which showed one tumor in a lymph node. An oncologist is suggesting that I have 6 months of chemotherapy. The suggested chemo drugs are oxaliplatin, leucovorin, 5-Fu, and Flo Fox. He said that the cytoreduction with HIPEC is not usually done after age 60. Do you have any other suggestions? How successful is this kind 0f 6 months of chemotherapy?
Cytoreductive surgery can be done at any age if your medical condition is good(my oldest patient was 82 with appendiceal cancer about 2 months ago). The chemotherapy recommended is for colon cancer and is being used for cancer of the appendix since we do not have a better regimen. I think you should tolerate the therapy well and follow up with a CT scan until a tumor shows again. Another approach we have used has been to treat for 3 cycles of chemo then do the HIPEC.
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Q
: 9
03/09/2009 |
Does a chromograin A level mean that a goblet cell carcinoid tumor has recurred?
If the levels have been normal before and are now increasing, it should be investigated for possible recurrence.
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Q
: 10
02/01/2009 |
Is cholangiocarcinoma likely to be hereditary?
It is very unlikely.
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Q
: 11
11/30/2008 |
I am 42, female diabetic, hypertensive, my triglycerides are 2237, and I once had an acute pancreatitis three years ago. I have positive 1/5 anti-islet cell antibody (ICA). What does that mean? I want to know everything as clearly as possible, what I am supposed to do especially. I am in Egypt. If you recommend any doctor if you know.
Your pancreatitis is likely related to the high triglycerides. No much concern for the antibody. You need to seek treatment of your high triglycerides as it can lead to heart disease. If you are overweight, you need to loose weight. I do not know much about doctors in Egypt. You need to see an internist or cardiologist to treat your triglycerides and hypertension. A diabetic specialist is also helpful.
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Q
: 12
04/20/2008 |
I'm looking for information about a condition that has to do with the pancreas and the bile duct. I think it is called spidel dysfuction or something similar. Do you have information about this condition?
You are likely referring to sphnicter dysfunction causing gall bladder symptoms. It is benign condition, but may require invasive intervention.
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Q
: 13
08/15/2006 |
I had a younger sister die less than 4 years ago from gastric cancer, and now my older sister has been diagnosed and is terminally ill with gastric cancer. I am very scared of getting it. Are there any preventative measures that I can take?
There is no screening test, but if you develop any GI symptoms, you should get an upper endoscopy.
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Q
: 14
04/26/2006 |
I am a 26-year-old with a strong family history of bowel cancer. I have had genetic testing and have been told that I have the cancer-causing gene. I have had 2 colonoscopies over 2 years and nothing was found. I just had an endoscopy and a polyp was found in my stomach. Will I be at as much risk for cancer from this stomach polyp as I would be from a polyp found in the colon?
I presume you are refering to familial adenomatous polyposis (FAP) syndrome. The polyps that have risk for cancer include colonic and periampullary (polys in the duodenum).
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Q
: 15
02/20/2006 |
My wife was just diagnosed with GIST. What is your, and your center's, experience with this type of cancer?
We treat all types of GIST tumors at UMGCC, including those at unusual locations such as the rectum. In fact, we a have a special conference discusing GIST tumors on Friday. We will be glad to see your wife. You can contact me at 1-800-888-8823.
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