Return of cancer 18 months after op

[Jim]

In 2014 my mum had a distal pancreatectomy removing part of pancreas and spleen. Recovered well up until recently and was admitted to hospital last week, turns out her pylorus was blocked so stomach couldn't empty. Going to have a stent fitted so she can eat normally. She already has come along way in the past week nutritionally. It does appear though that the cancer has returned to pancreas with mets spread to liver and some in lung. Her last scan was in December with nothing!!

Not yet at the oncology stage but the take from the GI consultant is that the prognosis is poor with chemotherapy possibly being the only option.

Is there nothing that can be done surgically to the liver?

Help appreciated.

[Didge]

Hi Jim

Your mum has done well! Sometimes the parts of the liver can be resected but I believe that might be if that is the only place it has come back. My partner had a distal pancreatectomy and his came back 8 months after the op and he was give folfirinox at that point which he tolerated well and reduced the liver tumours significantly with several disappearing. Sadly he was not able to tolerate it after 5 months but it did work well for a while. Or they might offer gemcitabine with abraxane - it all depends how fit your mum is and what the oncologist thinks appropriate.

I hope you get to see the oncologist soon so that you know what next steps are available.

Didge

[jay]

Hi Jim,

My husband had a whipples but the cancer came back after 2 months after the op. He tolerated gemcitabine really well for 6 months. Hope you get to see the oncologist soon to discuss the various options.

love Jayne

[Jim]

Hi, thank you for the replies.

The clinical nurse came to see mum today and it looks like Gemcitabine and a combination will be offered. Mum tolerated 6 months of post op Gemcitabine pretty well. Only side affect was fatigue. They want to wait 4-6 weeks until mum is stronger but the wait is due to how busy they are too. Bit concerned about that but not going to jump the gun at this stage.

[PCUK Nurse Dianne]

Hi Jim,

Sorry I had missed your post earlier, and thank you for asking the questions about surgery. In instances such as you would find in your mother's case, surgery is currently not considered an option in metastatic disease. Of course with all conditions, we have heard isolated cases where patients have had surgery to remove a single metastase that has occurred in the liver or lung. Regardless of this, the treatment in the first instance would be to undertake chemotherapy in attempt to slow disease progression and also treat the recurrent disease. If surgery was ever considered in situations such as this, the patient would need to be in their best state to undertake this.

You mention the wait until Mum is stronger, is it only fatigue that is her problem or is she having issues with weight loss, nutrition, pain or other? I would suggest if you feel Mum has improved dramatically in the next 2-3 weeks that you touch base with the clinical nurse and ask for a review. Of course if we can help with any support or nutritional advice please do feel free to be in contact with us (support@pancreaticcancer.org.uk or free phone 0808 801 0707).

Dianne

Pancreatic Cancer Specialist Nurse

Support Team

Pancreatic Cancer UK

email: support@pancreaticcancer.org.uk

support line: 0808 801 0707

[Jim]

Hi Dianne,

Thank you for your reply. I waited to respond until mum had the second attempt at having the stent fitted (duodenum). This went ahead on Friday and was successful meaning she can now eat normally. Prior to this my mum had the nose tube since she was admitted. She now can focus on building up again nutritionally. The past month has hit her hard in this respect.

My mum saw oncology this week & they are saying no to chemo at this stage given her current level of strength

however they have agreed to another appointment in a few weeks time. The only other symptom aside the weight loss is fatigue and I feel that mum can get stronger with food & getting back home (will be this week).

Are there any other treatment options we can be considering in the meantime?

Thank you.