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Pancreatic cancer and DVT - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3631 Questions
User :   I had a DVT and PE. No real risk factors, or provoking event other than using support stockings to the knee and spending a lot of time at a desk job. Labs did not suggest clotting disorder...CT scans were negative except a 7 mm pancreatic cyst....CA19-9 was normal. Had EGD and C-scope about 2 years ago that were I need to be concerned and do any more? I have a follow up CT of the pancreas at 3 months....could I have occult pancreatic or other cancer???
Doctor :   Hi
User :   hello
Doctor :   May I know your age?
User :   49
Doctor :   Can you also describe your symptoms and the reason why these scans and tests were done?
User :   had swelling in left leg...minimal LE ultrasound...diagnosed DVT...also had CT which showed some pulmonary emboli....
Doctor :   Ok
User :   hem doc said it was an "unprovoked" could be occult malignancy
User :   cloting studdies were all negative (done before I started anticoagulaation)
Doctor :   Ok
User :   The ony "prvoke" I could see it that I had started to wear these suppor dress socks that went to knee....they did pinch a bit in the poplital area behind the knee...where the DVT extended to
Doctor :   Ok
User :   but that may not be a father ied of colon cancer at age a concerning familty history
User :   i hvae ben getting scoped since I was 40
User :   evertthing ok
User :   the pancreas thin worrys me....pancreatic ca can be associated with DVT/PE
User :   blood work ok
User :   no gi symptoms, weight loss etc
Doctor :   Let me brief you.
User :   dont smoke
User :   ok
Doctor :   Yes, occult malignancies such as pancreatic cancers can cause blood clot in the systemic vessels leading to DVT's.
Doctor :   I wouldn't have been concerned if your first scan was normal.
Doctor :   based on the reports of the further evaluations, things are looking fine now.
User :   but what about the pancreatic cyst...cant they progress to cancer?
Doctor :   Not definitely pointing towards pancreatic cancers.
Doctor :   Pancreatic cyst is the only worrying feature.
Doctor :   Theoretically small non growing cysts are never cancerous.
Doctor :   They are usually benign and non concerning issues.
User :   some mucinous cystadenoma can progress....from what I read..can they not?
Doctor :   However, occasionally small cyst can grow in size, which is a feature of cancer.
Doctor :   Hence, you will need to watch out for symptoms of cancer. Symptoms such as abdominal pain, recurrent vomiting,
Doctor :   loss of appetite, weight loss,
User :   should I do anything else...upper cope, c-scope etc?
User :   BTW....prostate was enlarged...but PSA okay
Doctor :   Regular ultrasound checkups /CT scan can be done to monitor the size of the cyst.
User :   I thunk think that is the oftern and how long?
Doctor :   FNAC sample from the cyst will give a definitive result on what the cyst might be.
Doctor :   Presently the size of the cyst is small to obtain a FNAC sample.
User :   ok
Doctor :   Hence keep monitoring the cyst by regular scans,
Doctor :   if at all a growth in the size is seen, FNAC will be necessary.
User : long to monitor if no change? 1 year? 2 year? 5 year?
Doctor :   Theorectically, the chances of small cyst becoming cancerous is less than 3-5%
User :   one last thing
User :   IF the cyst is atble at 3 and 6 I saty on coumadon?
User :   not 100% if provoked....but kind of young to be on life long coumadin
Doctor :   Since there are no risk factors, you can get regular ultrasound scans/CT scans once a year for the next 3 years and there after once in two years should be fine.
User :   ok...and the rat poison?
Doctor :   As there are no risk factors, your medications may be reduced, but again, that will depend on how your symptoms progress from now on.
Doctor :   I would suggest you to take an opinion from a hematologist regarding the use of the anticoagulants
User :   ok....thaks
Doctor :   as my expertise in that field is restricted.
User :   thnaks
Doctor :   Do you have any other query?
User :   appreciate your input
User :   no
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
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