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good results with gemcitabine


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hi everyone.i have not been looking at the forum for a few weeks. in the midst of dealing with my aunts pancreatic cancer,my father died. he was 72yrs old and we are devastated. my aunt has completed 7 wks of chemo.her main side affect was extreme fatigue and no appetite. when commencing chemo she had a 3.8 cm in the head of the pancreas and 7 spots at approx 1cm each in the liver. at the meeting discussing her results yesterday, she had wonderful news. 7 spots on liver has now become 1 spot, and pancreas tumour has gone from 3.8cm to 2cm. gemcitabine chemo resuming 3 dec with 3 wks on and 1 wk off and so on.

i would appreciate it if anyone could give me their opinion relating to the following questions.

very many thanks and best wishes to all


are the above results unusual, or does the chemo always go in guns ablazing to begin with?

have the other 6 spots disappeared or will they still be sitting there even if very small?

is it rare that this has happened?

can anyone suggest what she might enjoy eating aqnd would be tolerated by her digestive system?

many thanks,

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Hi Laura

I'm so sorry to hear about your Dad, my sincere condolences to you and all the family.

I'm pleased, though to hear that your aunt is doing so well. That's fantastic news.

My experience is that although chemo is given as pallative care, it can help to reduce tumours - my husband's was reduced by about 30% during his six months of chemo. I was told that this is fairly rare and that he had responded very well, so a reduction of almost 50% in the pancreatic tumour is great!

As to whether the spots on the liver have actually disappeared, I can't give the answer to that. I have heard on the board of small tumours disappearing after treatment but I don't have any personal experience.

Diet is very important and it's essential that your aunt tries to keep her weight up. If her lack of appetite is caused by nausea then there are tablets to combat this. Otherwise, she should eat whatever she fancies and (providing she is not obese) the more calories the better! Obviously a varied diet including lots of fruit and veg is important. My husband isn't a great one for veg so I try to get it into him any way I can - he loves cottage pie for example. Often people who haven't got a great appetite find that the foods they ate in childhood are comforting and enjoyable. If your aunt doesn't want to cook (I know you're a long way away from her), then ready meals from the supermarket can be a route towards regaining appetite. I know they're not ideal but it's better than nothing.

Laura I'm so very pleased that your aunt is responding to chemo and I hope she continues to have such great results.

Kind regards

Nicki x

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PCUK Nurse Jeni

Hi Laura,

I would like to echo Nicki's sentiments in offering my sympathies to you after the death of your father.

This must be a very emotional time for you - sadness at the loss of your dad, and feeling happy for your aunt.

This is an excellent response she has had to chemotherapy. As Nicky said, the chemo would be classed as "palliative". This means treating the symptoms of the disease, rather than aiming to cure it. It is a wonderful spin off when the chemo does more than control the disease, but actually shrinks it down! The response your aunt has had is not unusual, though somewhat better than is generally seen in such cases. it also depends on how chemo-sensitive the tumours are - in your aunt's case, it appears as though they were very sensitive to the treatment, hence the good response. Often, it is a pretty chemo-resistant disease, and the results may be ok, but maybe at one site or another (ie: in the liver or the pancreas, often not both)

So, all in all, it is great news! Gemcitabine is a good drug, and does have an effect on the cancer.

Regarding whether the 6 spots are "there" or not, then a CT scan will measure anything from about 5mm upwards, which is very tiny. And with further chemo, it may shrink things further.

Regarding diet, if it is just no appetite, ask for some steroids. These will make her hungry. Otherwise, she should have what she fancies, little and often.She can have high calorie supplements to add to her intake -fortisip, fortijuice, ensure.

Hope this helps,


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