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Metastatic Pancreatic Cancer Stage 4 That Has Spread To Lymph Nodes, Blood Vessels And A Dot On The Liver Should I Need Go For Chemo?

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Posted on Wed, 28 Feb 2024
Question: My 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.
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Follow up: Dr. Dr diwashish biswas (3 minutes later)
I forgot to say mum has a plastic pancreatic stent done via ERCP and a permanent metal biliary stent
doctor
Answered by Dr. Dr diwashish biswas (3 hours later)
Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,

As stage Is 4N1M1, SO DEFINITELY METASTASIS.
So go for Chemotherapy, if your doctor is suggesting.
I Hope Your Query is clear now.
Thank You.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr diwashish biswas (1 hour later)
I suggest you read my query again as I have said in query mum cannot have chemotherapy. I also asked if mum can be here in 12 months
doctor
Answered by Dr. Dr diwashish biswas (7 hours later)
Brief Answer:
Please see detailed answer

Detailed Answer:
Hi,

Duration of life would be probably 6 months to 1 year,but may extend in few cases.
If chemo is not possible, then only palliative therapy is possible and which is being give.
Continue with palliative care.
I Hope Your Query is clear now.
Thank You
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
Dr.
Dr. Dr diwashish biswas

Internal Medicine Specialist

Practicing since :2007

Answered : 1024 Questions

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Metastatic Pancreatic Cancer Stage 4 That Has Spread To Lymph Nodes, Blood Vessels And A Dot On The Liver Should I Need Go For Chemo?

I forgot to say mum has a plastic pancreatic stent done via ERCP and a permanent metal biliary stent