Anyone had pancreatic cancer mets to lymph nodes only?

@amchurch, I believe that fellow pancreatic cancer members like @camelbrook @aprilg @elizabethboie @marvinjsturing @raj1979 fall into the category of metastasis to the lymph node only.

I don't know about answering the question "more or less difficult to treat" than metastasis to other parts of the body. Treatment does depend on where the cancer has spread and the extent of that spread.

Do you know if the lymph node affected is close or distant from the pancreas?

Hello, as far as I know, there are two differences. One is in staging and the other is regarding potential treatment. In terms of staging, having spread only to nearby lymph nodes means the stage of the cancer is either II or III, not IV. In terms of treatment, most people discover their nearby lymph nodes were positive after Whipple. As a result, those patients are able to have the surgery, while those with spread already outside of nearby lymph nodes are not eligible to have surgery. Treatment after the surgery is the same for everyone, which is chemotherapy. If the nearby lymph nodes being positive were discovered prior to surgery, which is rare in my experience, I'm not sure if they would do the surgery.

Yes. lymph node involvement seen in pathology report. Two full courses of chemotherapy Treatment (Folfirinox and GemAbx) has failed my spouse over the course of this year. Looking for clinical trials and seeing only phase one available for his Braf type seen in only a low percentage of patients. He swam a mile yesterday. Anyone with STING experience?

@granite how do you know the Chemo has failed? Did other lymph nodes show cancer on scans post surgery? Are you seeing active cancer in lymph system and how do you know?

Thanks.

Yes. Pathology report from Whipple showed 4 /31 lymph nodes involved and no results from full course of Folfirinox. Switched to GemAbrx for full 6 months with scans every 2 months. Last abdominal scan on completion of chemo shows three nodules. Biopsy scheduled very soon for confirmation and analysis. BRAF mutation mismatch repair similar to those seen in pediatric gliomas. Had very complete genomic molecular panel testing and multi detector row scans at top cancer center and also a top surgeon.
But BRAF type cancer cures for pc are in the dark ages. Clinical trials are primarily phase 1 and hard to find. Looking for BRAF targeted therapy. Second choice is STING agonist.

Can they remove the three nodules surgically @granite ?

I'm curious to know about the mets to lymph nodes too. My husband had a distal pancreatectomy/splenectomy two weeks ago for a pancreas adenocarcinoma. Pathology results indicated the tumor measured three centimeters in diameter, the margins were clear. no evidence of cancer at the surgical margins. Out of 37 specimens, there was spread in two of the regional lymph nodes. There's no evidence of cancer that they see on imaging but there could be microscopic disease so the goal is to do chemo for 6 months, 2x a month with fulfirinox.

Did he do chemo prior to the surgery?
Great that he is able to go right to folfurinox afterwards.

No, he didn't have to do chemo before the surgery. The team was quite confident that they could remove it without neoadjuvant therapy. Actually, everything happened so fast, he's just now starting to process the whole situation which the doctor said is what happens sometimes. I took him to the ER on 6/13 and on 7/13 he had the surgery. They moved so quickly which we're so grateful for. The chemo consult is in two weeks.

My situation was similar in that I had a 2.0cm tumor located in the tail of the pancreas. I had a distal panreatectomy/splenectomy (laproscopic/robotic) on May 17. Less than three weeks after consultation with the surgical oncologist. A biopsy done in early April was inconclusive and the recommendation was to proceed with surgery as a second biopsy might also be inconclusive. Patholgy following surgery concluded localized metastatic adenocarcinoma. 6/26 lymph nodes were positive. Four of the six nodes involved via direct extension. Margins were clean. I started my first of 8 cycles of Oxaliplatin/irinotecan/5Fu on June 13. After my first 4 cycles scans and blood work indicate "no evidince of cancer present". My CA19-9 prior to surgery was 53, two weeks post surgery 15, after 4th chemo cycle 7. As you have indicated there is likely microscopic disease somewhere which is why I'll continue with the remaining course of chemo to be followed by 28 days of radiation. Good luck to your husband on his journey. It's a long and challenging road. Four months ago I was feeling bleak. Today I at least feel like there is hope.