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chemo round 2 or radiation after aborted Whipple

Posted by steveron @steveron, Aug 23 3:58pm

My wife was diagnosed borderline resectable PDAC in Oct 2023. Her 13 cycle Folfirinox chemo ended 5/31/24. CT suggested surgery. Her Whipple was aborted 7/22/24 due to SMV involvement and difficulty reconnecting to small intestine micro vessels. Her oncologist now recommends resuming chemo with gemcitabine and abraxane. He does not recommend radiation as it does not address mets. We are waiting on as yet unscheduled PET. She is scheduled for SMART radiation therapy next month. Radiation will attack tumor, but not mets. Chemo will attack mets and maybe tumor. Radiation takes 2 weeks, chemo could then follow. Chemo another 6 months. Appreciate pros/cons of radiation first, chemo second, vs. chemo first, radiation second. PET results might make the decision for us. Thanks all.

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angeleji2 | @angeleji2 | Aug 24 10:15am

Perhaps, your wife should see another Surgeon? I just met with my surgeon after Cycle 4 chemo (folfirinox), suggested 2 more cycles of chemo before whipple surgery as the tumor responded to the treatment. He will also use a procedure called, Nanoknife, then whipple surgery.

My treatment plan is with my (was borderline resectable and as of Aug 2024, it's resectable, localized)Neoadjuvant Chemotherapy, Whipple Surgery and Adjuvant Chemotherapy. No radiation.

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1 reply
steveron | @steveron | Aug 25 5:59pm
In reply to @angeleji2 "Perhaps, your wife should see another Surgeon? I just met with my surgeon after Cycle 4..." + (show)
@angeleji2

Perhaps, your wife should see another Surgeon? I just met with my surgeon after Cycle 4 chemo (folfirinox), suggested 2 more cycles of chemo before whipple surgery as the tumor responded to the treatment. He will also use a procedure called, Nanoknife, then whipple surgery.

My treatment plan is with my (was borderline resectable and as of Aug 2024, it's resectable, localized)Neoadjuvant Chemotherapy, Whipple Surgery and Adjuvant Chemotherapy. No radiation.

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thanks for the info and best wishes for successful treatment

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silver182 | @silver182 | Aug 26 8:48am

Please find another surgeon more experience and have it done right. If you can find a surgeon that does it the old-fashioned way all my hand go for him. He’s got more than 30 years experience.!!

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steveron | @steveron | Aug 28 5:12pm

update:
we are looking into other surgeons.
we are also considering radiation during chemo since the type of radiation we are considering would only be 5 days of treatments instead of the 5 weeks needed for conventional radiation. Again, we'll ask the doctors, but has anyone had radiation during chemo? How long did you wait between chemo and radiation, and then how long after radiation before resuming chemo? Thanks.

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1 reply
silver182 | @silver182 | Aug 29 8:52am

I had my Whipple and I never needed radiation or chemo thereafter. I guess it was lucky. I never had it before the Whipple for sure cause it would’ve made me weak as I said before get you get a second surgeons opinion.

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Moderator
Colleen Young, Connect Director | @colleenyoung | Sep 6 4:38pm
In reply to @steveron "update: we are looking into other surgeons. we are also considering radiation during chemo since the..." + (show)
@steveron

update:
we are looking into other surgeons.
we are also considering radiation during chemo since the type of radiation we are considering would only be 5 days of treatments instead of the 5 weeks needed for conventional radiation. Again, we'll ask the doctors, but has anyone had radiation during chemo? How long did you wait between chemo and radiation, and then how long after radiation before resuming chemo? Thanks.

Jump to this post

@steveron, you might be interested in this discussion started by @ncteacher
- Switching to chemoradiation (Xeloda + radiation): What to expect?
https://connect.mayoclinic.org/discussion/questions-about-chemo-radiation/
Have you and your wife along with the team decided on a treatment plan going forward? How are YOU doing?

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