Surgery Follow-up and pathology report

Posted by happyjack @happyjack, Aug 1 7:03pm

Had my follow-up with my surgeon today. He had said over a month ago that I was stage 2 or 3 and could not give me a size on the tumor. 3 weeks ago I had Whipple surgery and the pathology report states I have stage 3 pancan. That 9 of 28 lymph nodes taken had cancer cells. Another lymph node, hepatic artery, resection: was negative for carcinoma. This is the info listed on the Tumor:

Tumor Site: Pancreatic head
Histologic Type: Ductal adenocarcinoma (NOS)
Histologic Grade: G2, moderately differentiated
Tumor Size: 4.9x4.1x3.9 cm
Site(s) Involved by Direct Tumor Extension: Ampulla of Vater or sphincter of Oddi, Duodenal wall, Peripancreatic soft tissues

I do not know if any of that is important or not. Or what it means but I thought I would add it for those who know a lot more than I do. I have not had imaging done for over 2 months and am still concerned I am stage 4 with a very small tumor(s) somewhere that has not been detected yet. I am still waiting to get an appointment with an Oncologist. That will be my first question for him.

Is there any other information that I should look for and be concerned about in the pathology report?

Best of luck to everyone with your fight against cancer.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

crawford | @crawford | Oct 20 2:36am

In reply to @happyjack "Thank you for that. And thank you to everyone who has helped me on this site...." + (show)

I am praying and rooting for you Jack to kick this cancer out forever. My sister passed when she was 50 of this insidious cancer. She discovered it and it was stage 4. She passed 3 months later. My father died at 48 of stomach cancer. Now my mom is 80 and diagnosed with pancan. I hate cancer so much, I have no words to describe it. I am 57 and already had a TBI-8 hour brain surgery and a heart attack. WTF!! I carry the diagnosis of pancan like a sack of rocks on my back. I looked in to genomic testing (I am Canadian), and it said that they may find the messed up genetic gene but I may or may not get cancer, so there seems to be no point. Walking the dog never sounded so good, even if it is hammering rain. Stay strong my man.
Regards, Buffie Vancouver, BC

happyjack | @happyjack | Oct 20 11:43pm

In reply to @crawford "I am praying and rooting for you Jack to kick this cancer out forever. My sister..." + (show)

Thank you so much. More good wishes going out to your mom and you.

stageivsurvivor | @stageivsurvivor | Oct 21 7:17am

In reply to @crawford "I am praying and rooting for you Jack to kick this cancer out forever. My sister..." + (show)

The point to your question is that by having genetic testing done and learning of an inherited (germline) mutation, a surveillance type and frequency will be recommended. Pancreatic cancer has much better outcomes when detected earlier so the appropriate treatment can be started. The cure rate for pancreatic cancer is statistically higher in all phases below IV.

happyjack | @happyjack | Oct 21 9:09am

In reply to @stageivsurvivor "The point to your question is that by having genetic testing done and learning of an..." + (show)

That is my understanding as well. Not that there are not exceptions and a few that have had success fighting stage IV. My tumor was large and I have read of people with a tumor 1/2 the size of mine with stage IV. That and the part in my report that found live cancer cells in 9 lymph nodes I think that it is most likely that my cancer is stage IV. They just did not look really hard enough, or the cancer is so small it was not showing up yet on the test I have had.

I think age and health has a lot to do with things also. Someone younger and in really good health can tolerate stronger chemo. Older and people with poor health that cannot tolerate chemo strong enough to affect the cancer nor be able to get trial medication are at lower cure rates also.

This is an older thread, and I have learned a bit since I started it. All that I have written above is about me. My cancer tumor being so large and the 9 lymph nodes with live cancer cells indicate to me my cancer has spread. And my poor health and chronic pain make it really impossible for me to tolerate chemo strong enough to be effective. That is why I have decided on palliative care.

I am feeling pretty good for now. I do not know how long it will last. It hurts so much I just cannot do treatment. I am headed to the dog park and out to run errands as soon as I meet with the Palliative care people. We are different and I am not recommending anyone do the same as me. It is just what I need to do for me.

Best of luck to everyone.

carrie40 | @carrie40 | Oct 21 9:29am

Happyjack,
You sound so good to me...you are not sitting around but out and active. I have found that is difficult to do, but the very best thing for your life. You will enjoy the life you have left--and I bet increase it with your positive life style. Please keep in touch with us all--I know we have all appreciated your posts.

crawford | @crawford | Oct 21 9:17pm

In reply to @stageivsurvivor "The point to your question is that by having genetic testing done and learning of an..." + (show)

I live below the poverty level because I am on Disability from TBI. I had a heart attack last year. I also have epilepsy and vision impairment. In Canada, genetic testing costs $$$. It is only for the privileged. I get 1500/month to live on from the gov. ie Canadian dollars. The Canadian gov wants the Disabled to die because they don't pay tax and the gov doesn't want to pay for them. Some live on the street and die on the street (I am not talking about drug addicts).

happyjack | @happyjack | Oct 21 10:58pm

In reply to @carrie40 "Happyjack, You sound so good to me...you are not sitting around but out and active. I..." + (show)

Thank you for the reply. Yes, it is not easy. To be able to do it I have had to increase my pain meds for my chronic pain and that makes it very difficult to think and reason. I am not as strong as I was before the Whipple surgery and need some help with items over 20lbs. Yes, it is not easy but for me it is easier than the intense pain of treatment. I really admire those who are suffering through chemo. I have reached the point in my life that I have had enough of that already. My health was bad enough before the cancer was found that I had already made arrangements for cremation and paid for that. And I had put my son's names on anything I owned. My house and cars. I was waiting for something from my chronic illness, but thing do not happen that way sometimes. And the increased confusion makes it more difficult to manage my chronic illness. Life has been difficult for a long time.

I do plan to stick around while I am able. Palliative care came out today and it seems there is not much for them to do until my cancer causes me trouble. Then they can increase my pain meds and transfer me to Hospice care.

You take care and wishing only good thing for you and all of us dealing with cancer.

crawford | @crawford | Oct 21 11:25pm

In reply to @happyjack "Thank you for the reply. Yes, it is not easy. To be able to do it..." + (show)

is there a way to reply to you (anybody) without the entire world seeing what I said, swear words and all?

happyjack | @happyjack | Oct 21 11:38pm

In reply to @crawford "is there a way to reply to you (anybody) without the entire world seeing what I..." + (show)

I am saddened to read about your troubles. I wish only the best for you and yours. I did send you a private message so you can reply with a message that only I will see. I have also had a brain injury, and it is the cause of my vertigo. Take care and I look forward to a reply from my PM.