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Could This Not Be Metastases?

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Posted on Wed, 21 Feb 2024
Question: mum was diagnosed 3 weeks ago with metastatic pancreatic cancer stage 4 that has spread to lymph nodes, blood vessels and a dot on the liver. We haven't asked about prognosis as we don't want to live to numbers. Mum is just on palliative care and has had a metal stent for biliary duct as she was jaundiced. She is much better now and jaundice has gone. Can mum be here in 12 months or longer with no chemotherapy. The MDT don't think mum is fit enough to endure the chemo and mum doesn't want to pursue with this as she worries it will make her too poorly.

Please help me as soon as you can i am worried sick and crying all the time.

Mum's blood tests are all normal apart from abnormal liver function tests

Mum has adenocarcinoma

CT REPORT
Measurements for pancreas

4.7 x 2.8 cm mass centred on the head of pancrease

Small volume peripancreatic , periportal and probably
retroperitoneal lymphadenopathy, example:

- Portacaval lymph node, 2.1 x 1.4 cm (2.452).

- Peripancreatic lymph node, 1.8 x 1.1 cm (2.433).

- Aortocaval lymph node, 1.4 x 0.9 cm (2.467).

Few small liver hypodensities. Although these are too small
to definitely characterised on this study, they are new
since the previous CT from August 2022 suggesting
metastases. Example,

- Segment 8 liver lesion, 1.1 cm (2.310).

- Segment 6 liver lesion, 0.7 cm (2.465).

Mum doesn't want chemotherapy she just wants palliative care as that it was consultant recommends as she isn't strong enough

Mums staging on letter is T4 N1 M1

I dont understand how mum has metastases when report says they too small to be characterised.
Could this not be metastases?

Is there anything we can do to try and prolong mums life I really dont want to lose my mum its heartbreaking and she is too young at 73.
doctor
Answered by Dr. Shinas Hussain (2 hours later)
Brief Answer:
Prognosis is not good

Detailed Answer:
Hello,
As per the report there is a fairly large pancreatic tumours with likely metastasis to liver, the adjacent nodes also involved.
The prognosis of advanced pancreatic cancer is not good and without treatment survival rate is low. As of now palliative chemo/RT will be an option only if she is physically fit.
Hope I have answered your query.
Thanks
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Shinas Hussain (9 hours later)
Can mum be here in 6 to 12 months? Mum is actually feeling quite well in herself at the moment other than tiredness. She is still WASHING, dressing and pottering around is this good for now
doctor
Answered by Dr. Shinas Hussain (25 hours later)
Brief Answer:
Average survival is one to two years.

Detailed Answer:
Hi,
Advanced pancreatic cancer patient may survive one to two years, if you opt for palliation overall survival will be good.
Thanks
Above answer was peer-reviewed by : Dr. LAKSHMI
doctor
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Follow up: Dr. Shinas Hussain (4 hours later)
Palliative chemotherapy is not an option. Only on palliative care. So can mum still have a 12 month life expectancy she has had a permanent metal biliary stent that's all
doctor
Answered by Dr. Shinas Hussain (28 hours later)
Brief Answer:
12 months is possible.

Detailed Answer:
Hi,
The exact duration depends on many patient related factor especially general health, we can expect for one year.
Thanks
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Shinas Hussain

General Surgeon

Practicing since :2015

Answered : 23672 Questions

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Could This Not Be Metastases?

Brief Answer: Prognosis is not good Detailed Answer: Hello, As per the report there is a fairly large pancreatic tumours with likely metastasis to liver, the adjacent nodes also involved. The prognosis of advanced pancreatic cancer is not good and without treatment survival rate is low. As of now palliative chemo/RT will be an option only if she is physically fit. Hope I have answered your query. Thanks