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Pancreatic cancer, 5FU chemo treatments, radiation. Tumor removal possible ?

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Practicing since : 2002
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I was diagnosed with Pancreatic stage 1or 2 cancer seven weeks ago. I have been undergoing 5FU chemo treatments 24x7 coupled with the radiation. I want to get to M.D. XXXXXXX to look at the possibility of removing the tumor. My question is; should I go ahead with the second round of chemo ( infusion and oral) before I have the second CAT Scan? If they can remove the tumor would subjecting my body to more chemo make any sense?
Posted Sun, 22 Apr 2012 in Cancer
Answered by Dr. Robert Galamaga 8 hours later
Hello and thanks for the query.

It is very important to know the exact stage at diagnosis. Would it be possible for you to send me copies of clinical consult notes from your oncologist and or imaging reports from CT scans or PET scans which have been done? It is critical to know the size of the primary lesion, if there was spread locally near the pancreas, to the lymph nodes or to other organs more distant from the pancreas.

I would think that if you had very local disease confined only to a small part of the pancreas that they may have discussed possible surgery. The surgery for this is quite extensive and is known as a Whipple procedure and should only be done by a physician who is skilled and has experience in oncological surgeries.

Sometimes it is actually more beneficial to give chemo prior to surgery. We refer to this as neoadjuvant chemotherapy with the benefit being that the tumor bulk can be reduced so much that surgery offers an even better prospect of cure.

Last question for you is - have your doctors discussed the possibility of a surgical approach? If so have they mentioned pros and cons as well as potential risks and benefits?

I thank you again for submitting your query and hope my answer will prove to be both informative and helpful. I await your reply. If you need to attach images or notes you can send them to my attention at YYYY@YYYY .


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: Pancreatic cancer, 5FU chemo treatments, radiation. Tumor removal possible ? 12 hours later
The tumor is less than an inch in diameter,located towards the tail, there is no spread to any other organs etc. My current oncologist says that since the tumor also encompasses a blood vessel that surgery is impossible. I have heard that M.D. XXXXXXX is doing some innovative things such as blood vessel bypass? in order to remove the tumor. My doctor has not been very helpful in explaining options which is why I was wondering about the second round of chemo.
Answered by Dr. Robert Galamaga 11 hours later
Hello and thanks for the followup.

I agree with your oncologist that if the tumor is such that it is in intimate contact with a blood vessel then surgery is generally not warranted and would only be considered experimental. If you want to go to MD XXXXXXX for a consultation that is certainly reasonable for you to gather more information. I would be firm with the surgeon however and ask him for statistics on how much he thinks he can improve your changes of long term control of the disease. If he cannot guarantee you cure then I really don't see a reason to pursue a XXXXXXX surgery with an unknown benefit.

I would continue a full course of chemo as advised by your oncologist. I realize that you want the best possible outcome and cutting edge technology at a state of the art facility may seem preferable. I think you should go to MD XXXXXXX and get the opinion so you at least have the satisfaction of knowing all your options fully.

I thank you again for the query and hope this has served to be helpful for you. I am here if you have any further followups.


Dr. Galamaga
Above answer was peer-reviewed by
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