Treatment options for pancreatic cancer stage 4?

Posted by nunz12 @nunz12, Nov 14, 2022

Hi I joined on behalf of my beautiful sister in law to seek information on her behalf. It’s been a nightmare she just turned 40 and had back pain went to er and they did ct scan they said she has vessels wrapped in pancreas cancer and vessels of liver too. She has a mass behind her stomach leaning on her spine too. They said not operable. Her pain is unbearable on morphine every two hours. After 3 weeks in hospital and biopsy done confirmed pancreas was primary source. Just did 5 days of radiation pain more unbearable due to inflammation. She is very weak and always in pain. One oncologist wants to start chemo right away due to aggressiveness. She has two small children and is feeling desperate for some pain relief so she go home.
Doctors say it’s complicated because pancreas vessels and liver vessels are enveloped in cancer. Can anyone explain or give any advice what to try?
Thank you

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

Agreed.....if she can get to Mayo Clinic, Dr. Truty might be the place for second opinion and possible further treatments.

Absolute best of luck to you. Will definitely send prayers to the family for a good outcome!

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nunz12,

So very sorry to hear of your SIL's circumstances - pancreatic cancer is so devious in the way it grows so silently.

A stage 4 diagnosis, in most cases, does not leave many options. Chemo is usually started with the hope of some additional time.

My general understanding is that in most cases once PC has metastasized resection is no longer a course of action.

Has she had CA 19-9 and CEA blood tests? PET scans?

This is truly a horrible disease.

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@nunz12, I'd like to add my welcome along with @mayoconnectuser1 @tpl and @dubbscopper.

I can see that you are very worried about your sister. This must be so hard to see her in pain and unable to be normal busy mom to her children. It's so unfair.

Sometimes pancreatic cancer is inoperable. I really hope that they can find a way to relieve her pain. I'm sorry to hear that radiation didn't help as it was expected to. Does she have access to a palliative care team? They are the experts in pain management. I would ask if the hospital has a physician or team specializing in palliative care.

As others have mentioned, you may also wish to consider a second opinion at a large cancer center.

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@colleenyoung

@nunz12, I'd like to add my welcome along with @mayoconnectuser1 @tpl and @dubbscopper.

I can see that you are very worried about your sister. This must be so hard to see her in pain and unable to be normal busy mom to her children. It's so unfair.

Sometimes pancreatic cancer is inoperable. I really hope that they can find a way to relieve her pain. I'm sorry to hear that radiation didn't help as it was expected to. Does she have access to a palliative care team? They are the experts in pain management. I would ask if the hospital has a physician or team specializing in palliative care.

As others have mentioned, you may also wish to consider a second opinion at a large cancer center.

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Hi thank you, she does have palliative care team, has only 2 hour window before she needs morphine again.
Today she got nerve block we hope that can give her some relief.
She has been in hospital for one month since her diagnosis wants to get home to her small children.

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My sister had stage 3 PC and Dr Truty is a wonderful dr. He operated on my sister and took out her pancreas, gall bladder, spleen and part intestines last winter. Unfortunately her cancer came back last month and spread to ovaries which was taken out. She is recovering well

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My husband has just recently been diagnosed with pancreatic cancer with metastasis to the liver. Mass is 6 cm × 5 cm and several lesions on both lobes of the liver. What can I expect? He will begin chemo next week.

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@deec2

My husband has just recently been diagnosed with pancreatic cancer with metastasis to the liver. Mass is 6 cm × 5 cm and several lesions on both lobes of the liver. What can I expect? He will begin chemo next week.

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Olease get a second opinion. It's very important. Also always advocate for him!!

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@deec2

My husband has just recently been diagnosed with pancreatic cancer with metastasis to the liver. Mass is 6 cm × 5 cm and several lesions on both lobes of the liver. What can I expect? He will begin chemo next week.

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Hi @deec2, welcome. I've moved your message about your husband's recent diagnosis of pancreatic cancer with liver metastatsis to this existing discussion:
- Just diagnosed pancreatic cancer stage 4 https://connect.mayoclinic.org/discussion/just-diagnosed-pancreatic-cancer-stage-4/

I did this so you can easily connect with other members like @nunz12 @dubbscopper @tpl @mayoconnectuser1 @huilim @helenar @lfitz @susanpmadigan @jessieleigh @mgilson and more who can share their experiences and journey with you and help to shine a light on what to expect.

You may also be interested in these related discussions:
- Radioembolization for pancreatic cancer metastasis to liver? https://connect.mayoclinic.org/discussion/radioembolization/
- Anyone on Gemcitabine with Abraxane? How long? Effective? https://connect.mayoclinic.org/discussion/gemcitabine-and-abraxane/

Dee, you can see, there are treatments options available. Where there are options, there is hope. Do you know what kind of chemotherapy he will be starting?

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deec2,

I am assuming from your specificity of size and locations that your husband has had CT and PET scans?

What is his CA 19-9 tumor marker blood work number?

It sounds as if a neoadjuvant approach with chemo has been decided - I think this means the intent is for the chemo to control and perhaps shrink the cancer.

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