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Noticed spot on pancreases. Have chronic back pain. Prostate removed about 10 years ago due to prostate cancer. Suggestions?

Apr 2013
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Answered by

General Surgeon
Practicing since : 2008
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My husband was just told that he had a "spot" on his pancreas which was apparently there last year (which he didn't know about) but it hasn't grown since then. He also was told that he has a hernia but there probably wasn't anything that can be done. He is 76 years old and has been very active despite chronic back pain. However, since we were in Italy where we walked constantly, he has had a great deal of pain in his groin area and has difficulty walking for any length of time. Prior to this he was walking about 4-5 miles a day. He also had his prostate removed about 10 years ago due to prostate cancer. He has no fever, just the pain. He has been to his urologist who said there was the spot but hasn't grown and he probably isn't a candidate for surgery for the hernia. He also went to his doctor who specializes in "elder medicine" who said he probably can't have surgery and he didn't know about the spot until he reread the CAT scan and MRI from last year and noticed it was mentioned then, but he "didn't notice it" so did not tell my husband. Until now, XXXXXXX has been actively involved with playing bridge, going to the symphony, art museum, etc.., along with the hiking and traveling often. He is now feeling that he won't be able to do any of these again and, although he won't talk about it, seems rather depressed. He has been putting off a trip to England to visit his family but now feels it is not possible since he has all these issues. I would appreciate any suggestions you have. He also goes to a pain management doctor for his back. Thank you for your anticipated response.
Posted Sat, 28 Sep 2013 in Cancer
Answered by Dr. Ivan R. Rommstein 1 hour later
Brief Answer:
hi and welcome to XXXXXXX

Detailed Answer:
first, it should be evaluated is this back pain caused by arthritis which is common in his age or this is a symptom of pancreatic disease. Spot on pancreas can indicate benign calcifications,fibrosis,cyst or malignant tumors. Pancreatic tumors are extremely XXXXXXX and should always be ruled out by mri, tumor markers such as ca-19-9, and biopsy. also,tumors can cause back pain so it is questionable what is the right cause of his back pain.
hernia isn't problematic until it become strangulated or inflammed. I don't think that his age is contraindication for hernia repair unless he has cardiorespiratory diseases.
So in conclusion,I wouldn't ignore pancreatic spot,it should be evaluated and cancer must be ruled out. Hernia can be repaired especially if there are symptoms of hernia and signs of strangulation. Depression should subside after his physical pain subside.if not,he ll need psychiatrist work up. Wish you good health. Feel free to ask. Regards
Above answer was peer-reviewed by
Follow-up: Noticed spot on pancreases. Have chronic back pain. Prostate removed about 10 years ago due to prostate cancer. Suggestions? 50 minutes later
Thank you for your response. XXXXXXX does have arthritis. What type of specialist should we contact to further evaluate the pancreatic spot? He did have an MRI, which did not apparently show anything--although this was his doctor who also didn't notice the spot on his pancreas last year. If it has remained the same size, is that a positive sign?
Also, what would be some of the signs of strangulation for the hernia? He does have a name of a surgeon to contact regarding that. I assume a surgeon is the specialist he would need?

Please give me an idea of what type of specialist we should contact for the tumor markers and biopsy . Thank you!
Thank you again.
Warm Regards,
Answered by Dr. Ivan R. Rommstein 41 hours later
Brief Answer:

Detailed Answer:
he should visit gastroenterologist who can do endoscopic ultrasound for more detailed evaluation of this spot.marker ca 19-9 can be done in every better lab. If there is no growth this is very good sign and obviously this isn't can be cyst,calcification or fibrosis and neither of these are XXXXXXX all he needs is mri or ct follow up in a year or two .
Strangulation is manifested by intensive pain, abdominal bloating, absence of bowel movements.
Hernia can be managed by abdominal surgeon and this is routine procedure today. His arthritis should be treated by antiinflammatory medicines.
Above answer was peer-reviewed by
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