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Adjuvant Chemo
4 months Since Hubby had Whipple. So much has been going on last 2 weeks. 4 scans & 1 MRI. Seen Oncologist yesterday. He's concerned a suspicious area by where the tumer was removed. After the Whipple He had no markers & healed well. Now talking about a biopsy! First due to the Cancer Center taking blood yesterday not having the ( kit) needed to detect cancer cells in his body we have to go back again Friday to have the test. Then it's to be sent out. No results for 2 weeks đŹ. My daughters are very upset he never had Adjuvant Chemo after his Whipple. That is standard protocol? We were never told about it's need by his Oncologist nor the surgeons. Thoughts please.
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Oh update...hubby's Creon just came in nail today so hasn't started it. Just concerned about side effects & if it'll help him gain weight back.
The blood test they're describing sounds like it may be a circulating tumor DNA (ctDNA) test, which requires a special collection kit and is sent to an outside laboratory. If that's what it is, it can provide useful additional information, but I would not let a two-week wait for ctDNA delay a biopsy or other evaluation that the oncologist thinks is necessary.
I would take the daughters' concern seriously and ask the oncologist very specifically:
âWhy was adjuvant chemotherapy not recommended after his Whipple? Was there something in his pathology or medical condition that made you decide against it? And if this biopsy shows recurrent pancreatic cancer, how does that change what you recommend now?â
I'd also ask for copies of the final Whipple pathology report. The most important details are tumor type, tumor size, lymph nodes positive/total examined, margin status (R0 versus R1), grade, lymphovascular invasion and perineural invasion.
And given the circumstances, I would strongly consider having everything reviewed by a high-volume pancreatic cancer center for a second opinion. Four months after Whipple with a new suspicious finding is exactly the kind of situation where I would want another pancreatic specialist looking at the scans, pathology and the decision not to give postoperative chemotherapy.
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4 ReactionsDoubting your husbandâs doctors must give you a sick feeling in your stomach.
I donât know protocol, but my husband could never get a biopsy that said definitely he had cancer. Therefore they would not do chemo first - if there is a protocol, theirs was to do chemo to shrink the tumor prior to the Whipple. So he had surgery first. Because of the location of the tumor, the surgeon couldnât get a clear margin. So next was radiation and a mild chemo.
the oncologist all along had planned on âseriousâ chemo even before surgery. So I guess the long answer must be yes?
Don't be afraid to get a second opinion.
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B had his surgery in May and has been on Creon 36000 almost as soon as he got home. Has your husband been having lower GI issues.? Diarrhea?
Creon has had no Sid effects unless you donât take enough = diarrhea; too much = constipation. Follow the directions. Heâll be fine. 5-6 small meals a day, protein- and calorie-heavy. B loves his ice cream!
B went into surgery weighing 153. Lost down to 137. Currently weighs 141. I canât get him beyond that yet, but his gains are in an ounce or two a week.
Upcoming chemo scares me, tho!
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