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Is it worth taking chemotherapy for liver and pancreatic cancer?

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Practicing since : 2002
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my father was diagnosed with liver and pancreatic cancer also in the duodeum(? spelling?) also prostate cancer. His Liver and pancreatic cancer a at stage 4 and he was diagnosed in begining of april-11 and he has lost 50lbs. so far and is taking tranvex(?) chemo pill and also having regular weekly chemo at the hospital. His pain seems to be getting worse and has such a bad rash that i feel like rash is not right word its everywhere!! Will there ever be another good day, is it worth getting this chemo and becomming more sick i really don't understand how why what my parents are doing they don't want to answer any of my questions having a very hard time dealing with this!! If it only prolongs your life for a few more months or even a year why would you want to be sick from all of the medication?? Please help me understand, I thank you for your time and input to this as it is hard enough but i feel like they have put the blinders on me..How long can you live like this, it's tearing the families apart!! Please help if you can! Thank Lisa Ripa
Posted Mon, 30 Apr 2012 in Cancer
Answered by Dr. Robert Galamaga 1 hour later

Thanks for your query.

Your question is a very difficult one and one that has been the subject of discussion and debate among physicians, patients and ethical specialist. From what you tell me about your father. He has very advanced stage type of cancer. It sounds like he most likely has a primary pancreatic cancer which has metastasized to the liver. The other possible case here is that he has a primary liver cancer in addition to having a primary pancreatic cancer along with the prostate cancer you mentioned.

Regarding these types of malignancies they are very difficult to treat when advanced stage occurs. We do have chemotherapy which as you mentioned can prolong life but sometimes can't compromise the quality of life with side effects.

I think it is reasonable to consider that chemotherapy may not be providing a quality benefit at this point. This is often the case when the cancer continues to advance and people to struggle with issues of pain and weight loss.

Regarding the pain there are certainly good medications which can provide relief. Sometimes in patients with pancreatic cancer. The pain becomes so severe that even these medications are not quite effective. There is a procedure which can be performed by a gastroenterologist called a celiac plexus block. What this basically does is causes local anesthetic response to the major block of nerves which causes pain in this population of patients. You could enquire about this procedure with your father's oncologist. Of course, at this point we want to try to palliate the symptoms of pain as much as possible so that we can improve its quality of life.

I recommend that you sit down with your father and have a heart to heart conversation about what the real goals of care are at this point. If you both agreed that continued chemotherapy which provides a limited benefit at this point may be reasonable to stop then you have the possibility of considering something we call hospice care.

Hospice care is a type of organization which specializes in patients who have advanced illnesses for which no real beneficial treatment is available. The hospice specialist can help you with pain management as well as managing your fathers needs at home. There are two options regarding hospice. There is an invitation option where a hospice facility will be able to take care of your father for the remainder of his life should it be most difficult for you to do so at home. The other option is what is called home hospice. This is where a hospice nurse or hospice specialist will visit the house on a regular basis to attend to his needs. I encourage you to discuss this with his oncologist and read about it as much as you can to see if this might be the best option for your father and for you.

I thank you again for submitting your question. I realize this is a very difficult issue to struggle with and I'm glad you have reached out to us. If you have additional concerns regarding this I am available to address them.


Dr. Robert
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