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Surgical options for borderline resectable/locally advanced tumors
My mom was diagnosed with pancreatic cancer in July 2022. She was not eligible for surgery at the time due to SMA encasement, so she was recommended to start chemotherapy. She just had her 12th infusion and will have her 13th and last infusion in about two weeks. Fortunately, her CA 19-9 numbers peaked at around 480 and have since come down to 18. We are heading up to Mayo Clinic in less than a month to see Dr. Truty, but I am super anxious about the consult. I am trying to focus on the fact that her CA 19-9 numbers have come back down to normal and her past two CT scans have shown shrinkage, but there is still SMA encasement, so I'm very worried. What if they tell us she's not eligible for surgery after all planned exploratory surgery? What options do we have after?
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Wonderful to hear that even though she would not benefit from surgery, there are alternate highly effective treatments available. I am on my 6th session of chemo and my CA 19-9 has come down. It is reassuring to me that I might have a good chance of benefit from radiation and chemo even if I am not a candidate from surgery. Blessings to you and your Mom and thank you for sharing your story.
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3 ReactionsJust incredible news!
Will you stay at Mayo for the CRT (chemo radiation treatment)? If I recall their process is three weeks vs five weeks if done most non-center locations?
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1 ReactionThanks everyone! I feel more at ease today, but my mom is still struggling with the situation. Hopefully she will bounce back and realize there’s nothing but positive news.
Dr. Truty said he’s comfortable with us getting chemo radiation done at home, but he set up an appointment with one of the radiation oncologists at Mayo. He said they can provide us with their recommendation so we can get everything done locally!
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1 Reactionwhilted,
The reason I asked about CRT location - my sister returned to our small city to have it done. I don't know whether it really would have mattered, but there were differences in equipment - and timeline.
Mayo, if I recalled was three weeks long - whereas our hospital's oncology department provided five weeks of CRT.
The answer as to why Mayo did it in three weeks vs five was pretty technical and related, I believe, to dosage and accuracy of the equipment. Again, while I don't know if it would have changed the outcome, it was one thing we could have done - stay in Rochester for the three weeks.
That’s what I worried about as well, but because we live in Los Angeles, I don’t think equipment will be too much of an issue. My mom definitely misses being around family and friends, so I have a feeling she will want to stay local. And of course, I’ll miss her too!
Another glimmer of hope: Dr. Truty did a laparoscopy on my mom and I just read the report: On inspection of the peritoneal cavity, there was no evidence of any metastatic disease. He also did a peritoneal washing and the results were just posted as well. CA 19-9 less than 5 and CEA less than 0.7 in the peritoneal fluid! I'm so relieved. I hope our story brings hope to anyone else on this journey.
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1 ReactionI have no doubt you will rock it! It takes some time to let the idea about not being able to physically remove the tumor from your body to sink in, but also bear in mind the extent of the surgery. If eligible, my mom would’ve had to have her pancreas, stomach, and spleen removed. I can’t imagine how her quality of life will be after a surgery that big. I’m going to try to just enjoy the time we have together and be vigilant on routine scans.
Fantastic news. !! What chemo is she doing?
I am in same situation where surgery not an option
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1 ReactionMy mom was on Folfirinox. She did 11 sessions of Folfirinox at full strength and on her 12th session, they discontinued oxaliplatin. She did a 13th session of chemo before her consult at Mayo. We did not want her to have too long of a break before the next step.