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Pancreatic Cancer or Something else?

Pancreatic Cancer | Last Active: Jun 28 7:36pm | Replies (24)

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@dfly

Hello, I am new here. I first visited this site the other day. The messages here are comforting and informative. Like many, I'm grateful for it's existence! I felt sharing my own experience might help guide others who are experiencing similar symptoms, as others' sharing has been helpful for me.

8-9 months ago I had a bout of what I assumed was a stomach flu. I got hit hard and fast, and it took a lot out of me. I haven't felt the same since. Not that I haven't felt any better, but I haven't felt fully well after that. I'm 45, and hadn't been to a doctor in almost a decade minus a kidney stone episode that landed me in the ER a few years back, and a single visit to a GP over back pain the other year I associated with a past injury. I didn't bother going to see or even telling anyone regarding the various things going on with me since then, and wrote them off for one reason or another. But at some point this spring, I read an article that ran a red flag in my head, and I began to tie them together...which is what led me here. I would like to document my progress during my health investigation so I and others can use it to help understand if it's "...cancer, or something else?"

After my apparent stomach flu last fall, there began noticeable changes to my health. I began feeling nauseous, which initially I connected to recovering, then started noticing it seemed at times I ate too much sugar (e.g. a single glass of wine; a single dish of ice cream). I began naturally avoiding them due to that, and so began my weight loss. In addition to that, somewhere along the way I began to notice a very disturbing feeling, which was a general feeling of all I can describe as "rottenness," in the pit of my upper abdomen. If I twist or turn or put my waist at certain angles (as I do in stretches, for example, or even just to get settled on the couch), there was/is a feeling inside that makes me jump, it's so uncomfortable - like I can feel my organs inside, like something is pressing on them in the center there. It's like I'm feeling parts of my organs I'm not supposed to feel. It's such an uncomfortable sensation I can't stay in the position. (Over time I've adjusted how I do things so that it doesn't bother so much, but it's there if I press it, which is generally upper central abdomen, almost centrally between the belly button and sternum, and then also bending to the right). I've felt weak and frequently nauseous, maybe a few times a month had episodes in winter/spring where I had to lay down for an hour or so since I felt so heavy and sick. I thought it was holiday overindulgence. I also started getting heavy night sweats, as well as a couple of times during the day - my sheet/shirt would be soaked to the point I would have to change/lay a towel on the bed to go back to sleep. I blamed it on possible perimenopausal symptoms. Deciding to try and get back to basics, I used the Lenten season to abstain from all junk food and alcohol. I continued to drop weight, to the point I was getting a little concerned - 10 lbs over 6 months, and then another 3 in the span of a few weeks from late March to early April. Once Lent concluded, I decided to let myself eat whatever I wanted and see if I could put on a little weight, or if I would continue to drop. It went up, which was a relief, but then I was back to eating foods that made me not feel well (although the nausea never really stopped, even when I was abstaining, just the severe episodes subsided - and haven't returned). And even though I was trying to exercise to strengthen what felt like was a weak core, I had more muscle but still felt weak and terrible at my core.

One day back in March I read an article that connected night sweats with cancer...and I just froze. After consulting a family member with nursing experience, I decided to go to the GP late April to run regular bloodwork, including TSH levels. Everything came back normal, except a couple vitamins were low and my blood sugar, which had been stable in the past, was in the onset pre-diabetic range, which was very surprising to me. The GP told me to visit GI if I continued to have stomach issues. I have an appointment with them on 6/28.
Since my GP visit, I have realized that the blood sugars taken in late April would have mostly reflected my time during Lent when I was abstaining from a lot of junk. This, plus my previously stable glucose levels (true, it's been 10 years...). When I told a friend I was officially considered pre-diabetic type II, she was also surprised, b/c I am slender and generally try to be healthy and active. Then very recently I thought of looking up the area of my abdomen I was feeling so rotten for the past 8-9 months....and saw it was basically exactly where the pancreas is. I decided to read up on pancreas issues....and it all began to tie together: nausea; weight loss tied to nausea/food avoidance; night sweats; "sudden"(?) onset type II pre-diabetic; location of discomfort. Since then, I have tried to pay attention to other things. My stool has been, in recent memory, thin, light-colored and oily-type. I had a strangely horrible episode of constipation last spring (only had constipation twice in my life, and that's with 2 pregnancies). In the last few days, I've noted that my stool has been light, broken up and either floating or sunken. In addition, there is a new sensation tied to the nausea...a strange, pin-prick, ghost-like scattering of needle-like pain within the abdomen that almost seems like the onset of an episode of a stomach bug, which gets me feeling vaguely nauseous - but then it just sort of fizzles away... This has been re-occuring throughout the last week or so, with very subtle increases in intensity over time. Eating is getting more difficult. Today I had to pace about to distract myself from the discomfort afterwards.

I am dreading and eager for this appointment with GI. I do not want to bother family or friends with my worries. I do try not to worry, but none of this seems right. I am hoping documenting this will help me makes sense of things, as well as help others. I will try to post another update after my GI appt.

Thanks and God bless and have mercy on all of you on your journeys.

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Replies to "Hello, I am new here. I first visited this site the other day. The messages here..."

We all hope this is not tied to Pcan. But so very glad you will see a GI and so be sure to bring up your pancreas and ask them to do CA19-9 and CEA tests when they run your blood.
Lab work at GP was all fine for me precious to being finally diagnosed . Pancreas is not always a GI’s “go to”

Back around 2015, Surish Chari MD who at the time was at Mayo established the link between sudden onset of diabetes in patients age 50 with no risk factors like obesity, diet or family history and pancreatic cancer. An opportunity was missed at early detection because this link was not previously known…especially with PCP’s and GP’s. They would treat as if diabetes when in actuality, it was the beginning of the development of pancreatic cancer. From the time a patient saw a physician noting elevation and difficulty in regulating blood glucose levels until a diagnosis of pancreatic cancer was within 36 months.

With the onset of symptoms of diabetes at age 45, that is close enough that a GI specialist will want to include a work-up for neoplasms of the pancreas including Interductal Papillary Mucinous Neoplasms (IPMN’s) found in the main and branch ducts of the pancreas. An MRCP is now the preferred method to image/surveil cysts. An Endoscopic Ultrasound is the most sensitive of the imaging techniques to detect a neoplasm of the pancreas.

The CA19-9 test is not 100% specific for pancreatic cancer. It has a couple of drawbacks and why it is not used as a diagnostic test…it can be elevated due to inflammation, benign and malignant conditions of the GI tract and has also been found to become elevated with some medications and Vitamin B-7 (Biotin). Of the different types of pancreatic cancers, it is only associated with Pancreatic Ductal Adenocarcinoma (PDAC) and 10% of the Caucasian population with a PDAC tumor in the US are non-secretors of CA19-9. The rate of non-secretors in the African American population is significantly higher.

Rare types of pancreatic tumors, i.e., Neuroendocrine (PNET) and Acinar Cell Carcinoma (PACC) tumors do not secrete CA19.9 and would never be detected if relying on this biomarker. The Gold Standard for detection when someone is exhibiting multiple symptoms consistent with neoplasms of the pancreas is to have an EUS performed.