1. < Pancreatic Cancer

Are you eligible for surgery with vascular involvement?

Posted by marcia @marciak9, Jun 26, 2023

My Dr wants to remove my entire pancreas spleen and stomach. I’ll be type 1 diabetic and have chronic diarrhea. I’m not sure about life expectancy but it sounds like quality of life will be low. I’ll take insulin every day and with every meal.
The weird part is my previous surgeon said nothing about this. Jus a normal Whipple. Then he tells me he’s passing me off and moving to Canada. I’m at the Mayo in Rochester which is supposed to be the best. I’m not sure what to do. If I have the surgery it can always come back and I’ll never be about to have chemo again. If I don’t have the surgery it’ll show up somewhere and I’ll have to have chemo and radiation again. I’ve already had 12 rounds of chemo and am currently on week two of three of radiation.

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k13 | @k13 | Jun 29, 2023
In reply to @mayoconnectuser1 "k13, I posted this previously - and, it relates not just to Mayo but given any..." + (show)
@mayoconnectuser1

k13,

I posted this previously - and, it relates not just to Mayo but given any center with the same capabilities.

If you have the ability to do so, once you have been accepted and understand the recommended treatment plan, and assuming you are not local to the center, and assuming it is something like the usual neoadjuvant approach ... relocate to that center. Move there and remain until your outcome is known. The lab work is better, the chemotherapy is better, the radiation treatments are better, the turnaround on information and modifications to treater is shorter, the pre/post op surgical care is better - the care is better because the people are better trained, deal specifically in pancreatic cancer. In summary, IMO, is that you have a better chance of survival.

My sister did not do this - and, while I don't know if it made a difference, I would have pushed much harder for this approach. As I noted previously, though, she was adamant about visiting the center, then returning home so she could be with her cats.

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thank you all for responses. I am at a major cancer center- Dana Farber/Boston. And yes, I agree with everything you said--the resources at Dana are way better than what I experienced at the local hospital (during the two stays my husband had there for infection and original stent placement.) We were told surgery was not an option, and he's done chemo (unsuccessful) and now radiation at Dana. I am also going to talk to Sloan Kettering in two weeks about their opinion as well as their clinical trials. We sought a second opinion there in May, at suggestion of Dana Farber Dr, and next week we have follow up call. I guess I always wonder if surgery could be an option, but maybe I am dreaming, and not being a realist.
All the clinical trials seem so specific and there don't seem to be many that he can qualify for. He does not have BRAC gene, but does have the KRAS gene. I've found a few possible trials and will discuss w our Dana Dr tomorrow and then also with Sloan dr. Our dr does not seem to be very helpful on the clinical trials. He has "poohed poohed" most of the ones I show him......

REPLY
wheatley | @wheatley | Oct 6, 2023

<p>I was diagnosed with stage 4 PDAC in Dec 2021. Metastasis to liver. Vascular involvement in/around pancreas. Have done FUFLRORINX(?) and SBRT. Now on 5FU w/o oxiplatin. Scans show minor improvement with vascular situation but have yet to get any specific % changes. Mayo is reevaluating me for surgery. Last Oct they said I was not a candidate. Any one had surgery when vascular involvement was an issue? BTW, my pancreas tumor in concentrated mostly in neck/body, not head/tail. SBRT seems to have taken care of liver lesions.</p>

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2 replies
ashley2235 | @ashley2235 | Oct 7, 2023
In reply to @wheatley "I was diagnosed with stage 4 PDAC in Dec 2021. Metastasis to liver. Vascular involvement in/around..." + (show)
@wheatley

<p>I was diagnosed with stage 4 PDAC in Dec 2021. Metastasis to liver. Vascular involvement in/around pancreas. Have done FUFLRORINX(?) and SBRT. Now on 5FU w/o oxiplatin. Scans show minor improvement with vascular situation but have yet to get any specific % changes. Mayo is reevaluating me for surgery. Last Oct they said I was not a candidate. Any one had surgery when vascular involvement was an issue? BTW, my pancreas tumor in concentrated mostly in neck/body, not head/tail. SBRT seems to have taken care of liver lesions.</p>

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I had surgery with Dr Truty at Mayo in July. He specializes in vascular involvement. If anyone can do it, he can. I had an 8 inch artery harvested from my upper leg, and used to reconstruct my SMA. But I was stage 3. I am not sure about surgery options in stage 4.

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gardenlady1116 | @gardenlady1116 | Oct 8, 2023
In reply to @wheatley "I was diagnosed with stage 4 PDAC in Dec 2021. Metastasis to liver. Vascular involvement in/around..." + (show)
@wheatley

<p>I was diagnosed with stage 4 PDAC in Dec 2021. Metastasis to liver. Vascular involvement in/around pancreas. Have done FUFLRORINX(?) and SBRT. Now on 5FU w/o oxiplatin. Scans show minor improvement with vascular situation but have yet to get any specific % changes. Mayo is reevaluating me for surgery. Last Oct they said I was not a candidate. Any one had surgery when vascular involvement was an issue? BTW, my pancreas tumor in concentrated mostly in neck/body, not head/tail. SBRT seems to have taken care of liver lesions.</p>

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You can search for other responses on this topic. Lots of people have had these experiences, many of the discussion threads.

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