Suggest treatment for pancreatic cancer

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Posted on Mon, 21 Sep 2015 in Cancer
Question: HI MY NAME IS XXXXXXX MY WIFE WAS DIAGNOSED WITH PANCREATIC CANCER IN APRIL. HER CA-19 WAS 6000 SCAN SHOWED TUMOR IN HEAD OF PANCREAS AND SOME LYPH NODES. DOCTORS RECOMMENDED A FLORIRINOX ROUND, THEN RADIATION, THEN WHIPPLE. CA-19 WENT DOWN TO 3000 AND WE WERE ABOUT TO DO RADIATION BUT WIFE HAD SUDDEN RISE IN CA-19 TO 31000, PET SCAN NOW SHOWS IN LIVER. SURGEON SAID WIFE WILL NEVER BE A CANDIDATE FOR SURGERY NOW. PLAN NOW IS GEZMAR, AND ALBAXANE WHICH WIFE JUST STARTED. WE ARE TERRIIFIED. HAVE YOU EVER SEEN GEZMAR BE VERY EFFECTIVE? DO YOU AGREE WITH WHAT THEY ORIGINALLY DID AND DO YOU SEE ANY OTHER OPTTIONS???PLEASE HELP. FEEL LIKE MAYBE SHOULD HAVE BEEN MORE AGGRESSIVE AT FIRST AND DID WHIPPLE FROM BEGINNING.... XXXXXXX
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Answered by Dr. Prasanna Heijebu 6 hours later
Brief Answer:
GEMZAR is a excellent drug to offer palliation.

Detailed Answer:
Hello, Sir.

I understand your concern.

I feel sorry your current state of affairs.

Pancreatic cancer often presents in late stages.This is the nature of the disease.It is difficult to diagnose it in early stages.

Liver metastasis and rising CA after an indicate poor prognosis post-surgery.

Re-operability is a life-risking procedure in such cases.

Chemoradiation is the only palliative measure that is currently available worldwide in such cases.

GEMZAR is an excellent drug-Gemcitabine monotherapy is for symptomatic patients with metastatic or locally advanced unresectable disease with poor performance status.Statistically significant, improvement in overall survival with gemcitabine versus 5 FU(5.7 vs 4.4 mo). Additionally, gemcitabine improved the quality of life in approximately 25% of patients.

FOLFIRINOX/5FU is the first line drug.

Your doctors have so far done the best possible management.I totally agree with their management.

At the time of diagnosis, 50% of all patients have a distant disease and 25% have regional spread. The relative 1-year survival rate for pancreatic cancer is only 25%, and the overall 5-year survival post surgery is only 5%.

Based on above facts early Whipple procedure will not offer an advantage in all cases.Only 20% of patients undergo successful resection.The best predictors of long-term survival after surgery are a tumor diameter of less than 3 cm, no nodal involvement, negative resection margins and a diploid tumor nucleic acid content.Hence, multiple pre-operative factors guide its outcome.

Aggressive measures right from the outset will not offer therapeutic guarantee always, considering the notorious course of pancreatic cancer.

Post your further queries if any,

Thank you.










Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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