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Pancreatic Cancer Archive Questions

Below are Dr. Hanna’s answers to Pancreatic 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.

Questions about this topic have been organized into several categories.
Click on a category name below or select "View All" to read all the Q&As in this archive.

. Diagnosis
. General information
. Treatment
. View all Questions
. All Questions

Now displaying records 1 to 15 of 62.

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Q : 1

What is your experience with treating post-Whipple patients with Folfirinox when evidence of metastasis is found early?

The Folfirinox regimen is a strong combination. If he has recovered from the Whipple to his baseline, I would expect him to tolerate it provided there are no other major comorbid conditions and his performance status is good.

Q : 2

Doctors wanted to perform a biopsy to confirm pancreatic cancer in my mother, but were reluctant to do so because she is diabetic. Though there is no confirmed diagnosis, she is experiencing many of the symptoms of pancreatic cancer. Is there a diagnostic test that doesn't involve biopsy? If it is pancreatic cancer, are there treatment options that don't involve surgery?

She should have endoscopic ultrasound of the pancreas or a pancreatic CT to identify the tumor mass. The only potentially curative option incorporates surgery.

Q : 3

A CT showed a 12mm mass in the head of the pancreas which was classified as a pseudocyst or cystic neoplasm. Will an ERCP give me an accurate diagnosis and how fast do these cysts grow?

You should get a EUS and FNA of the lesion to help develop a treatment plan. Serous lesions can be managed expectantly without surgery unless symptomatic. Small mucinous cystic neoplasms need close follow up.

Q : 4

Before I had my gallbladder removed, I suffered an acute pancreatitis attack. I recovered from both and have not had any problems. Do I run a greater risk of developing pancreatic cancer as a result of the attack?

No, this would not increase your risk of developing pancreatic cancer.

Q : 5

My father-in-law was just diagnosed with pancreatic cancer. They are not going to do a biopsy for 3 weeks to find out what stage he is at. Is this a normal length of time to wait for a biopsy? I am pretty sure it has spread to the lymph nodes.

This is an unusually long period of time to wait. You should consider getting a second opinion.

Q : 6

What body systems are affected by pancreatic cancer and how would you determine which ones are being affected? Are they based on the stage of the cancer? And if so are they always the same for each stage?

If the cancer is localized, it affects only the pancreas and bile duct. If locally advanced, it can affect adjacent organs and large vessels. If it spreads, it can affect other organs, most commonly liver and peritoneum.

Q : 7

My father has recently been diagnosed with pancreatic cancer. He is 75 and has already undergone 2 chemo sessions of Gemzar as recommended by his doctor. He is taking medicine for his bowel movements and appetite, but it is not working. Do you have any recommendations on what to do or take in order to regain his quality of life? He can't eat and is losing a lot of weight.

Options are limited. Gemzar is easier to tolerate than Folfirinox, which is more effective, but has more side effects.

Q : 8

My father just found out he has pancreatic cancer. He's in a hospital now and he still hasn't had a biopsy. His wife has said to me that his cancer is inoperable and she is sending him to a rehab place with a DNR. How can she determine his fate when he hasn't even had a biopsy yet?

If there is evidence of widespread metastasis seen on imaging studies, doctors are able to determine the extent of the cancer without a biopsy.

Q : 9

I have chronic pancreatitis. Is the whipple a suggested surgery?

Whipple surgery can help if the pancreatitis is localized to the head. Pain can be recurrent in up to 30% of patients even after surgery.

Q : 10

Can a patient with stage IV pancreatic cancer who is inoperable be treated?

Pancreatic Cancer is a very aggressive disease. The best treatment option at this stage is palliative care to maximize the quality of life.

Q : 11

What does it mean if a person has a CA19-9 count over 7,000?

CA19-9 of that level can be seen in malignant tumors of the pancreas and also the bile ducts. It can also occur in severe cases of pancreatitis or cholangitis. It could also suggest tumor recurrence following treatment for pancreatic/biliary malignancies.

Q : 12

What is the best treatment for pancreatic cancer T3N1 after Whipple procedure for adenocarcinoma? Is radiation effective, or is chemotherapy the treatment of choice?

There are two schools of recommendations: one is chemoradiation, the other is to do induction chemotherapy followed by chemoradiation. The new chemo recommendation is Folfirinox.

Q : 13

My boyfriend has pancreatic cancer and is having the Whipple procedure. Is it possible that he could live for more than 5 years?

Pancreatic cancer, when treated at an early stage, can have a 5-year survival rate of up to 25 percent.

Q : 14

My husband was diagnosed in February 2009 with pancreatic cancer with metastasis to the liver and bone. How long does this cancer grow before diagnosis can be made? Is it as fast growing before diagnosis as it is after?

Most cancers develop silently for several years before they become symptomatic and start growing faster after that.

Q : 15

How often is it possible for a patient with pancreatic cancer to undergo paracentesis? How long can the body tolerate these treatments?

This treatment should be given as needed.

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