• question-icon

    How can loss of appetite due to pancreatic cancer be treated?

default
Posted on Wed, 9 Aug 2017 in Cancer
Question: I have been on this site for several years and my worse fear came to pass. Since May of this year I was diagnosed with locally advanced pancreatic cancer. I have been devastated.My GI doctors have been following my IPMN lesions since 2014. How could this happen? I have had 2 PET scans, 3CT's, several MRI's and EUS. In everyone of these scans no primary tumor is found. The Lesions are always stable and show no change. The cytology shows the cancer originating in the Pancreas, but no tumor. My Ca antigen 19-9 is only 18. My cancer encases the celiax and SMA and at this time is not resectable. But I did meet with a specialized surgeon at the Mayo clinic who can do surgery on locally advanced adencarcinoma. I started Chemo with Folfirinox. I have no appetite and continue to lose weight. I have lost 15 pounds since February and need to stop this trend. Please comment on my cancer that shows no primary tumor and how can that be possible? Also I am desperate to find a way to start eating. This has caused much torment and I believe it should have never got to this point because of the supervision that took place. Also, what is new or another type of treatment in the event the chemo doesn't work? Finally is a feeding tube a possibility if my no appetite continues?
doctor
Answered by Dr. Deepak Sundriyal 36 minutes later
Brief Answer:
Hello. Sometimes primary may not be there

Detailed Answer:
Hello dear. I have gone through the details.

So it is sometimes possible that the primary gets autolysed and hence not visualised but the immunohistochemistry marker of the tumor suggest a pancreatic origin.

Since you have a locally advanced tumor, Folfirinox in the beginning follwed by surgery at the time of tumor shrinkage is the right approach.

If somehow that doesn't work, chemoradiation will be the next strategy.

For your feeding, I will advise a feeding tube straightforward. You should not wait for the appetite to be normal.

Thanks and regards
Feel free to ask further


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Deepak Sundriyal 18 minutes later
If the primary tumor gets autolysed how can the existing cancer spread? Is it a good thing or a bad thing to have no primary tumor?
doctor
Answered by Dr. Deepak Sundriyal 2 minutes later
Brief Answer:
Hello. It doesnot make good or bad

Detailed Answer:
Hello dear. Existing cancer has its own blood supply. The prognosis doesnot depend on the presence of primary tumor. If it is respectable, it has to be taken out. You are getting the right treatment.
Thanks and regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
default
Follow up: Dr. Deepak Sundriyal 35 hours later
I had a chest Xray and chest CT Scan yesterday. My Xray show a new 1.5mg nodular density in left lower lung zone. The CT does not mention this nodular. What could this nodular represent?
doctor
Answered by Dr. Deepak Sundriyal 5 hours later
Brief Answer:
Hello. That can be anything

Detailed Answer:
Hello dear. Difficult to say but that can be anything frin a calcified lesion, infected lesion or a fibrotic lesion.
Thanks and regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Deepak Sundriyal 1 hour later
Dr XXXXXXX is it possible that the new nodular found By Xray in the lower left lung region could be spread from my pancreas cancer? The Ct scan report does not mention this nodular.
doctor
Answered by Dr. Deepak Sundriyal 5 hours later
Brief Answer:
Hello. It may be possible

Detailed Answer:
Hello. Ideally speaking, the sensitivity of ct to pick smaller lesions is greater than that of xray. So i dismiss the xray lesion as nonsignificant if it is not there on ct. Still one cant be 100 percent sure and only an fnac or biopsy can tell with surity.
You need not to worry.
Thanks and regards

Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
default
Follow up: Dr. Deepak Sundriyal 3 days later
Dr XXXXXXX my ca antigen 19-9 went from16 to 35 in two months. What does this mean? I started my chemo the day it was at 35.
doctor
Answered by Dr. Deepak Sundriyal 12 minutes later
Brief Answer:
Hello. It. Means disease is progressing

Detailed Answer:
Hello dear. Although still in the range, rising ca 19.9 crudely suggest that the disease is slowly progressing.
Thanks and regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
default
Follow up: Dr. Deepak Sundriyal 31 minutes later
More to worry about. What does in range mean? And does slowly progression have any benefit?
doctor
Answered by Dr. Deepak Sundriyal 2 minutes later
Brief Answer:
Hello. Nothing to worry

Detailed Answer:
Hello again. Nothing to worry as you are on treatment. Moreover, its a crude marker and not a guaranteed one. Lastly, we take upper limit of range as 37.
Thanks and regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
Answered by
Dr.
Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1546 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Immunohistochemistry

doctor1 MD

What kind of blood tests would you order for CLL other than a cbc ? I have had this for 15 years. My white blood count is about 140.

doctor1 MD

I was diagnosed with tumors on my omentum the largest of which is 3cm what could be the possible causes. I have crohns disease and all but 6 inches...

doctor1 MD

Hi...latest reports of biopsy states that "Section shows hyalinised fibrocollagenous fragments infiltrated by liner trabeculae, nests and ill...

doctor1 MD

hi I am worried ecause i went to my dermatologist because i have alot of light pink almost skin colored spots growing around my belly,back,chest...

doctor1 MD

Hi Doctor, My father aged 63 yrs has a tumour @ right supravaculear (Size 3 Cm) in ight side of the neck. After FNAC it was confirmed as Squamacell...

Get personalised answers from verified doctor in minutes across 80+ specialties

154 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Deepak Sundriyal
  • Q - What causes inflammation in the lungs while treating pneumonia?

  • Q - Can nodules in the lungs be cancerous?

  • Q - What are the long term side effects of Cytoxan and Taxotere?

  • Q - What does this biopsy report indicate?

  • Q - Suggest treatment for cough, headache and nausea

  • Q - Suggest treatment for a large tumor in the abdomen

  • Q - What is the prognosis for metastatic ampullary carcinoma?

  • Q - Suggest treatment for iron deficiency anemia

  • Q - What does my lab test report indicate?

  • Q - Is missing a dosage of medicine during anti tubular lymphadenitis...

backtotop2