Post Whipple Treatment for Stage 1A adenocarcinoma

Sounds like you caught the cancer very early. That’s great news. I was diagnosed with the same cancer in stage 1b. My treatment was 6 rounds of chemo and then the Whipple surgery followed with another 6 rounds of chemo. During my surgery, 28 lymph nodes were extracted and they all were clean. I still followed the surgery with 6 rounds of chemo to hit any lingering cancer that may still exists that the scans may have missed.

Thank you, Montyd for sharing your experience. I did not have any chemo prior to my Whipple as the doctors did not know if there were any cancer cells in the cyst. The oncologist board will be getting back to me next week regarding further treatment with MEK inhibitors to target the BRAF mutation that was found in my cancer. How did you tolerate the chemo? Thank you again!

I was pretty blessed in that the chemo didn’t impact me physically much. I never got ill with the chemo. I did experience some fatigue but it was very minimal. I was concerned that my body might struggle with the chemo after the surgery due to my body being weak but I was able to have positive experiences even after the surgery.

Very encouraging to hear you when through chemo with minimal side effects. I am so grateful and blessed that my pancreatic cancer was caught early and really by accident. Sending many blessing your way!

May I ask what your chemo regimen was? Will just start a work up in two days for 4.4 cm tumor in tail of my pancreas with no liver involvement, reactive lymph nodes or bony mets showing on CT. I’m hoping for the best and look forward to surgery but would love input on the usual adjuvant chemos used and quality of life while on them. Start of a long (hopefully) journey.

Prior to my Whipple surgery, I had a 3 cm cyst on the head of my pancreas with worrisome features. Per my surgeon, 50/50 chance the cyst contain cancerous cell "in situ", but all my markers were negative and so was my biopsy. My cyst had septations, whereas the biopsy is one point on the cyst.. So, no chemo prior to my Whipple surgery.

The cyst biopsy after Whipple did confirm that I had a 0.8 cm adenocarcinoma in the cyst (Stage 1A). No lymph nodes involvement, cancer markers all negative, no observable cancer on any of the other organs.

Presently, my oncologist doctor is looking at micro-metastasis in the blood stream via blood biopsies. Two of the Tempus blood biopsies have come back negative and waiting results of a ctDNA from Signatera. I am also awaiting a response from my oncologist on what their recommendations on further treatment.

During my last doctor appointment, the doctor mentioned MEK inhibitors for the gene mutation found in my cancer (B-RAF). This should be confirmed this week, so I have not started on any adjuvant treatment yet.

Having the Whipple saved my life! Take it one step at a time, we are stronger than we think we are.

I was on 5FU (Fluorouracil) for both of my pre and post Whipple chemo treatments. 6 pre surgery rounds and 6 post surgery rounds (50 hours each round).

Thanks so much. I have an EUS/Bx this week and will know more about “the plan”. I’m so hesitant about any kind of chemo though, quality-of-life wise. Quantity vs quality. Thoughts anyone? I’m also 75.
Sounds as though you were very fortunate in your body’s response to it. Congrats and good luck.

Thank you, newby2. I will be getting the results of my liquid biopsy next week. In my prior visit with my oncologist gene inhibitors were suggested depending on the biopsy and the oncology board results. I am a person that doesn't take medication lightly, so I totally understand how scary it is to think of chemo or strong meds. The way I have always phrased it to my doctors is understanding "risks versus benefits" when facing a choice on a procedure or medication regiment. I also know that the use of chemo drugs have come a long way and are dialed in to the patients situation. Definitely, a discussing worth having with your oncologist. I hope all goes well with your EUS.

So many new avenues for defeating pancreatic cancer are emerging. With the profile that is determined by all of the work up you are getting, the precision treatment can surprise you with the increase in quality of life from what it might have been on chemo. PC is a very difficult cancer to project about. My husband clearly found when switched from the traditional chemo for metastasis to the adrenals from PC to precision treatment afforded by the analysis of the DNA and mutations of the tumor, his quality of life improved and the tumors disappeared. And he had treatment for 2 years, would have longer but at that point had developed a side effect of immnotherapy. but for the last 1.5 years with no treatment, we of course we wonder what the next CT scan could show, but are thankful for each day we have together.