Recent diagnosis of pancreatic cancerous tumor - awaiting PET

Posted by minimia @minimia, Jan 9, 2020

My 70 yr old father in law became ill around thanksgiving with chronic diarrhea; thought it was the flu, started to loose lots of weight, tired, became jaundice; finally got appt at GP and they did MRI that showed “tumor” in pancreas; GP referred to Mayo took a few weeks to get appt over Holidays; loosing more weight; sleeping all the time; more jaundice; gets consult, take him off blood thinners; then put stent in to open duct to liver to liver; find cancerous tumor; xray chest – looks clear; schedule for PET next week to see if cancer has spread anywhere; if all clear then he has to gain weight, have chemo to shrink tumor, and then surgery to remove. Any insights on how family can support him through this process and what to ask Dr’s and look out for. Thanks in advance

@minimia

Update – Went in for chemo port placement, sent home first time because had not gone off blood thinners. Anyway, went to Mayo Rochester and had port put in and first round of chemo cocktail; Dr wanted three chemo drugs (Fluorouracil, Oxaliplatin, Irinotecan) however since bilirubin number was still a bit high they did not give him the Fluorouracil. Was sent home with pump to pump more chemo for 48 hrs. Has not had any bad reactions to chemo so far – its has only been 24 hrs. He will do this for 2 times per month for 2-3 months in hopes to shrink tumor and kill any cancer cells prior to surgery. Not sure if I mentioned he is a type 2 diabetic, so struggling a bit with blood sugar control versus eating for strength. He does not have much of an appetite. Any suggestions on how to get through the chemo and what to eat… ? Thanks

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@minimia, I'm not an oncologist or nurse, so I'm only sharing my dad's experience. Some of these chemo drugs (oxaliplatin) can cause peripheral neuropathy (numbness or loss of feeling in the extremities, like feet and finger tips). This can also be a side effect of type 2 diabetes, so his cancer team will ask about the feeling in his hands and feet before every treatment. The side effects are cumulative. My dad had to be careful to use a glove when holding a glass of ice water. He liked to drink really cold water. And he always wore good soled slippers or sneakers even around the house for better stability.

The drugs do affect sugar levels too. You can ask to have a consult with a diabetes educator who specializes in cancer. She/he could provide counsel on what the "new normal" is for his sugar levels while on chemo. An oncology nutritionist can also help with recommendations for eating. Did you know that these services exist? Are you still in Rochester?

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Before each of my chemo treatments I was given steroids. Steroids increase your blood sugars. After my chemo was done, they "forgot" to tell me to watch how much insulin I was taking. Without the steroids, my blood sugars went back down but my insulin had not been adjusted. I had some severe lows because I was taking too much insulin.

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Well things seem to just get worse before they get better ; Is this the new normal? Father in law had first round of chemo last Thursday and then on Sunday wound up in ICU, Dehydration, blood infection , LOW blood pressure, heart in AFIB, they think metal stent may have pierced has gall bladder; he is losing hope; they want to re-do the ERCP AGAIN – 3rd time .. I have to ask , Why don't they just do the surgery…. (whipple) all these other procedures seems to be making everything worse ….

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I had one half of my pancreas removed 9 years ago. And one lobe of my liver.
I also had an embolism when the pancreatic duct did not close. The biggest concern.
I highly suggest not getting chemo .
It weakens one.
Im a type 2 diabetic. I inject insulin .
And its OK.
im ok.
Im also on lanreotide ever 28 days.
Ive been in remission 9 years.
Im 62 now.
I also had alot of abdominal plastic surgery after my whipple.
I am very active.
Make sure u go to a tertiary hospital.
And make sure they have a tumor board.
Get the best surgeon with the most experience.
By prepared to go back to the ER at a moments notice after because of complications. I.e. infections.
Stay Strong.

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Thank you for the information and support. When asked about just cutting out the tumor, the Dr State, if he does not have chemo, the cancer will spread out of the tumor. They are now saying the latest issue was they think the stent moved somehow punctured the gall bladder so had to do surgery on that and he has a bag draining the infection. He is at Rochester Mayo so supposedly they have the best surgeons for this.

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@minimia

Thank you for the information and support. When asked about just cutting out the tumor, the Dr State, if he does not have chemo, the cancer will spread out of the tumor. They are now saying the latest issue was they think the stent moved somehow punctured the gall bladder so had to do surgery on that and he has a bag draining the infection. He is at Rochester Mayo so supposedly they have the best surgeons for this.

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Hello @minimia
I appreciate the update. It sounds like your father-in-law has been through a lot of procedures.

How is he doing with all of this? How about your family? Do you have enough support from friends to help you all?

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Yes thank you he is surrounded by 3 of the 4 kids that live near by and a devoted wife ; Hopefully they have figured out why he had no desire to still eat after the stent and perhaps the gall bladder puncture was the problem all along… This morning he says he is having his first meal in days so lets hope for the best this time… around and he stabilizes then I think he will be more willing to fight this…

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@minimia

Yes thank you he is surrounded by 3 of the 4 kids that live near by and a devoted wife ; Hopefully they have figured out why he had no desire to still eat after the stent and perhaps the gall bladder puncture was the problem all along… This morning he says he is having his first meal in days so lets hope for the best this time… around and he stabilizes then I think he will be more willing to fight this…

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I'm glad to hear that he has a lot of support, @minimia. I hope, as you do, that if he begins to eat and feel somewhat better he will be able to better tolerate the treatment that will be necessary.

Will you post again and let us know how he is doing?

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Need a hail Mary – blood infection so bad – they can not fight it – sending him home till his time comes

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I'm so sorry. Hoping you receive a miracle.

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@minimia

Need a hail Mary – blood infection so bad – they can not fight it – sending him home till his time comes

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Dear @minimia, this must be tough to accept. It would seem with modern medicine that it would not be a "mere" blood infection that would be insurmountable. But infections are insidious. What instructions and/or medications did they offer to get him comfortable? Comfort care is so import. Do you have access to palliative care or hospice?

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Agree, I feel like modern medicine is a joke… How can they not have an antibiotic or something like a blood transfusion, dialysis, etc.. to fix this… How come they sent home last time for I suspect this may have been the cause of the last collapse… I am not sure about comfort – he is at peace with it, its hard on the family, especially since they have been saying this was curable… Booked a flight for my husband

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