Concerned: I'm beginning to suspect I have pancreatic cancer

I just wish I didn't have to advocate for myself so much; it would be nice if the doctors had more concern on their end, or more of a desire to help me get to the bottom of this. I've developed a pulsating sensation under my ribs. I'm trying to tell myself it's the Zenpep I started taking, but of course my anxiety says that this is yet another symptom of pancreatic cancer 🙁 I'm just feeling so frustrated and lost. I'm going to advocate for myself as much as I can at my appointment with Roswell on Tuesday, but depending upon the outcome, I'm contemplating reaching out to UPMC and/or the Cleveland Clinic.

I just wish I didn't have to advocate for myself so much; it would be nice if the doctors had more concern on their end, or more of a desire to help me get to the bottom of this. I've developed a pulsating sensation under my ribs. I'm trying to tell myself it's the Zenpep I started taking, but of course my anxiety says that this is yet another symptom of pancreatic cancer 🙁 I'm just feeling so frustrated and lost. I'm going to advocate for myself as much as I can at my appointment with Roswell on Tuesday, but depending upon the outcome, I'm contemplating reaching out to UPMC and/or the Cleveland Clinic.

What is UPMC?

Hello @rexsan20

As Colleen, @colleenyoung, said it all depends on the location and type of cysts. Have you read the scan report to see where they are located and the size? About 10 years ago, I was diagnosed with pancreatic cysts (there are four cysts as I recall). I certainly panicked when I learned of them.

I had an ultrasound endoscopy and they were determined to be IPMN, (which can be cancerous or benign), but nothing that looked terribly serious. As I have a history of carcinoid cancer of the upper digestive tract, my GI doctor follows up every two years with an MRI of the liver, pancreas, etc. So far no major changes in size or type.

Talk with your doctor and see what follow up is best for you. How are you feeling? Any digestive tract symptoms?

This is how it is stated on the MRI: Pancreas: The pancreas has normal intrinsic T1 hyperintensity in its parcenchyma. A cystic lesion in th epancreatic tail on series 7 image 9 measures 0.9 x 0.9cm. It has not significantly changed, when remeasured in the same plane on prior exam from 6/02/2021. There is not enhancement within this structure. No main ductal dilation or pancreatic parenchymal atrophy.

Not sure what this means?

The chest CT ordered by Roswell showed 2 lung nodules, but they did not believe any follow up is needed regarding these or anything else. They recommended a local GI, but it’s uncertain whether they will take on my case, as they need to review my records first. They also recommended a rheumatologist in light of my joint and muscle pain and weakness. I’m still not sure what to do. Roswell has essentially washed their hands of me since they’ve found no evidence of malignancy thus far. They agreed to see me again in 4 months, but that seems like a long time to wait when I fear that I’m in a state of cancer cachexia. I know Roswell believes they have ruled out malignancy, but I'm not reassured. They refused to do a biopsy because they didn't see a mass on the EUS, but from the literature I've come across, there are cases of diffuse pancreatic carcinomas that don't form a distinct tumor. I had reached out to the Cleveland Clinic in desperation and now have an appointment with one of their GI surgeons, which I hope means they are in agreement that a biopsy is the only way to definitively rule out cancer.

I know that there are many causes of pancreatic insufficiency, but blood work and imaging ruled out chronic and autoimmune pancreatitis, and cystic fibrosis would've been diagnosed at birth. At this point, to me, it seems like an Occam's razor situation; I'm also reminded of the phrase "if it looks like a duck, swims like a duck, and quack likes a duck, it probably is a duck." I have so many clinical signs and symptoms of pancreatic cancer and it's just terrifying.

Hello @rexsan20

As I'm not a medical professional, I can't explain the results to you. I do recommend that you contact your doctor's office and ask if a nurse or a PA can sit down with you and answer your questions.

Always remember that you can get a second opinion if you don't feel that your concerns are being addressed.

How are you feeling, @rexsan20? Any new symptoms?

No symptoms I do t think just stool is oily: greasy

The chest CT ordered by Roswell showed 2 lung nodules, but they did not believe any follow up is needed regarding these or anything else. They recommended a local GI, but it’s uncertain whether they will take on my case, as they need to review my records first. They also recommended a rheumatologist in light of my joint and muscle pain and weakness. I’m still not sure what to do. Roswell has essentially washed their hands of me since they’ve found no evidence of malignancy thus far. They agreed to see me again in 4 months, but that seems like a long time to wait when I fear that I’m in a state of cancer cachexia. I know Roswell believes they have ruled out malignancy, but I'm not reassured. They refused to do a biopsy because they didn't see a mass on the EUS, but from the literature I've come across, there are cases of diffuse pancreatic carcinomas that don't form a distinct tumor. I had reached out to the Cleveland Clinic in desperation and now have an appointment with one of their GI surgeons, which I hope means they are in agreement that a biopsy is the only way to definitively rule out cancer.

I know that there are many causes of pancreatic insufficiency, but blood work and imaging ruled out chronic and autoimmune pancreatitis, and cystic fibrosis would've been diagnosed at birth. At this point, to me, it seems like an Occam's razor situation; I'm also reminded of the phrase "if it looks like a duck, swims like a duck, and quack likes a duck, it probably is a duck." I have so many clinical signs and symptoms of pancreatic cancer and it's just terrifying.