I am terrified about my mom MRI MRCP test results

Posted by long72 @long72, Aug 23 8:30pm

My mom just turned 79 last week. In Dec 2020, she had a minor stroke. Late July of 2022, she had another minor stroke. No serious damage. She could walk on her own. However, she lost her appetite and has had fatigue. These are common among stroke survivors.

Last week, she had mild fever and fatigue. So, I took her to the hospital. They first took the CT of her head to make sure no stroke. The doctor then pressed on her tummy and she said she felt pain on the right side. Dr ordered x-ray. Did not see anything. He then ordered ultrasound and it was normal. He then ordered the HIDA cause he suspected that she has gallstone. It came back negative. Yesterday, he ordered the MRI MCRP and this show a mass on the head of her pancreas. Based on his experience, he thinks it's more likely cancer.

I am devastated right now. I took her to the hospital out of concern for her stroke but now facing my worst fear: pancreatic cancer.

I understand that biopsy is the only definite test but the world is crashing down on me. I am hoping either the doctor is wrong or cancer is caught early enough so it's treatable.

She has no symptoms except for the loss of appetite and fatigue, but these are common among stroke survivors like her.

The hospital she is staying is running out of things they could do. So, they suggest my mom to be transferred to USC or the Huntington Memorial. I am guessing the next step will be biopsy. My questions are:
1. can the biopsy be done via EUS or something other tests? I just want her to have the test as soon as possible.
2. Any recommendation on how to get the biopsy done ASAP in Los Angeles metropolitan area?
3. Can the EUS tell if the mass is cancerous right away or we still have to wait for a few weeks?
4. Since my mom is 79 and just 2 minor stroke, will she be a candidate for Whipple? Is there any one in this forum who had Whipple at age closer to hers?

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

Hello @long72 and welcome to Mayo Clinic Connect. I can certainly understand your concern for your mom. It's just great that you are advocating for her during this obviously stressful time.

Since the current hospital is suggesting that she be moved to another facility where she can get better care, this probably indicates the need for a second opinion or at least some further diagnostic work up. It might be wise to follow this suggestion. The National Pancreas Foundation might be able to give you some further insight into the best doctors or hospital to treat your mom. Here is a link to their website. If you call them, perhaps they can help you with more specific information about the best treatment center in your area.
https://pancreasfoundation.org
Have blood tests been done to indicate pancreas functioning?

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The biopsy from my wife's eus was available the next day. Might vary elsewhere but shouldn't be weeks. Assuming that the biopsy sample is taken accurately from the tumor site, yes, it will be used to diagnose pancreatic cancer.

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@hopeful33250

Hello @long72 and welcome to Mayo Clinic Connect. I can certainly understand your concern for your mom. It's just great that you are advocating for her during this obviously stressful time.

Since the current hospital is suggesting that she be moved to another facility where she can get better care, this probably indicates the need for a second opinion or at least some further diagnostic work up. It might be wise to follow this suggestion. The National Pancreas Foundation might be able to give you some further insight into the best doctors or hospital to treat your mom. Here is a link to their website. If you call them, perhaps they can help you with more specific information about the best treatment center in your area.
https://pancreasfoundation.org
Have blood tests been done to indicate pancreas functioning?

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@terease
after telling us the MRI MRCP test results, the Dr. told my brother who was there with my mom that he would put in an order for blood test for pancreatic cancer. Since I was not there, I am guessing the Dr, order CA-19 and CEA blood tests. The conversation happened 4 hours ago so no results for the blood tests yet

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@beachdog

The biopsy from my wife's eus was available the next day. Might vary elsewhere but shouldn't be weeks. Assuming that the biopsy sample is taken accurately from the tumor site, yes, it will be used to diagnose pancreatic cancer.

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thank you for the information.

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I am very frustrated with the current hospital. We like to transfer my mom to City Of Hope hospital which is ranked higher than USC and more importantly closer to home, but the current hospital (which is also part of USC) does not want to do that. He tried to convince us to transfer my mom to USC.

What is more frustrating is that after doing X-ray, ultrasound and MRI MCRP (which shows a mass on my mom pancreas), today the doctor order the CT. If I am not mistaken, MRI MRCP is better at visualizing the pancreas than CT. I believe that if MRI MRCP or CT shows a mass, the next step would be EUS FNA to take the sample issue for biopsy. I don't understand why a CT is needed today. It won't tell anything that the MRI MRCP already did. I was not there when they did the CT so I could not stop them. My brother asked the nurse, she did not know why the Dr ordered the CT. She tried to call him twice but he never returned the calls.

We really want my mom to have the EUS / biopsy ASAP but it seems like this Dr/hospital don't want to help because we are not moving my mom to the hospital they suggested.

I searched around and it takes weeks before we can make appointment with offices who can do EUS in Los Angeles area. The Dr said if we transfer my mom to USC, she can have the EUS within a day or two. However, since we want to move her to City of Hope instead, he first use insurance as a reason why we should think it over. I told him that I call my mom's insurance and they said if the current hospital initiate the transfer request, the insurance will approve the it within 24 hours. However, the Dr. insisted that since City Of Hope does not have contract with my mom's insurance, we could end up with large bills. He seems to want to keep my mom with USC for money/political/business reason. When you have loved one with suspected cancer, you just want to get things done quickly, but I feel this Dr and hospital care more about money/business than my mom's health.

Can someone recommend a good doctor who can perform EUS FNA in Los Angeles area that has open spot not too far out?

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@beachdog

The biopsy from my wife's eus was available the next day. Might vary elsewhere but shouldn't be weeks. Assuming that the biopsy sample is taken accurately from the tumor site, yes, it will be used to diagnose pancreatic cancer.

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@beachdog , may i ask where your wife's eus was done (state, hospital)?

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@long72

@beachdog , may i ask where your wife's eus was done (state, hospital)?

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@long72 My wife had the eus at the main campus of Orlando Health, Orlando,FL. luckily for us, our gastroenterologist is the best known doc in the area and he was able to make the arrangements stat.
It sounds like you may need a referral to make things happen. Do you have a family Dr or specialist to ask for assistance? Even your insurance company might have a patient advocate to call for assistance. Good luck getting scheduled ASAP.

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Just wanted to share my mom latest results. The hospital did the EUS FNA on my mom last Thr. The GI told us right after the procedure that it was just a cyst but he would send the sample tissue to the lab anyway. He said my mom would need a yearly MRI to monitor the cyst. The result from the lab came today and it's not malignant. What a relief. My mom is home and feeling better. She can eat now. I am not sure if it's because she does not want to be hospitalized or her appetite actually improves. Regardless, we are happy that the biopsy test is favorable. She looks better now.

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