Surgical options for borderline resectable/locally advanced tumors
My mom was diagnosed with pancreatic cancer in July 2022. She was not eligible for surgery at the time due to SMA encasement, so she was recommended to start chemotherapy. She just had her 12th infusion and will have her 13th and last infusion in about two weeks. Fortunately, her CA 19-9 numbers peaked at around 480 and have since come down to 18. We are heading up to Mayo Clinic in less than a month to see Dr. Truty, but I am super anxious about the consult. I am trying to focus on the fact that her CA 19-9 numbers have come back down to normal and her past two CT scans have shown shrinkage, but there is still SMA encasement, so I'm very worried. What if they tell us she's not eligible for surgery after all planned exploratory surgery? What options do we have after?
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Thank you for sharing your story. How is the high dose MRI guided radiation going? This could be one of my options as I have involvement of the superior mesenteric vein and am currently inoperable. I am interested in your experiences if you are willing to share. Hope your scans go well. The anxiety about results seems difficult to manage at times. My heart rate went up when I logged on to Quest to see how the results of my CA 19-9 were, fortunately better.
Oh thank goodness on your c19-9
My last scan was same and markers were good
Ive been having some bathroom issues the last few weeks off and on
not sure if its not enough enzymes, my stents or. What …
So Ill 🙏🏻and update after my next scans in 2 weeks
Which hospitals have you been in touch with so far? How many sessions of chemo have you done? I’m glad to hear your CA 19-9 numbers are coming down!
This is so great to hear. Did your previous scans show no evidence of cancer? I think what gives most people a sense of security is knowing that the tumor is no longer in their bodies, so I’m really glad to know you are doing well after getting high-dose radiation. This gives me so much hope.
I am being seen at Sloan Kettering Memorial Cancer Center in NYC. My CA 19-9 numbers have been falling, the most recent of 200 was after 5 sessions of chemo, I started at 1750. I know many things can happen and the CA 19-9 doesn't tell about the state of the blood vessels but it seemed encouraging to me that I seemed to be pointed in the right direction anyway. I will see the surgeon at MSKCC again after the 8th chemo.
I think you're in good shape. Have you considered going to see Dr. Truty? He wants CA 19-9 numbers to be in normal range before any surgery. The fact that they've already come down to 200 for you after 5 sessions is really promising.
I am seeing Dr. William Jarnigan at MSKCC. He is the head of hepatobiliary surgery at MSKCC. He seems really great to me. I will keep the advice about the numbers in mind. I live about an hour and a half from MSKCC. I have a friend who went to Johns Hopkins for surgery, the surgeon does 8 Whipples procedures a week. I think I should do well with staying on the East Coast for treatment. Hopkins would not be too difficult if I am in need of a second opinion about surgery.
You can also try to get a consult with Dr. Wolfgang at NYU Langone. He also specializes in cases involving veins/arteries.
The thing is. They cant be sure. The mass per say was still there which could have been alot of scar tissue , however my c19-9 went down to 7 so they were extremely encouraged that it killed cells
Im hoping thats still the case. As the radiation apparently still works doing its job for a few months after treatment
the above was after 2 months and my next scan in 2 weeks will be 5 months
I originally was stage 3
With vein involvement The surgeons …I had 2 opinions gave me @ a year / 2 years maybe after surgery before mets occurred and told me most likely Id have complications. Which is why I went with radiation that hopefully can give me more time Without being layed up
Its not a cure and in my opinion either is the surgery unless they catch it stage 1 or 2
The oncological world consider s living 5 years curable. But most have recurrences
And Dr Chuong the radiation Dr and my almost surgeon Dr Asbun , told me this mri proton rad has been in use @6 years so its not fully vilified yet so they cant out right say its as good as surgery until more studies are done @10 yrs) but they have high hopes with what they are seeing …
And I read an article about athe anderson foundation that donated a $100 million to Mayo to build more of these proton machines so they must have faith its a good option
MCI has @6 or 8
I'd be interested in hearing more about your MRI guided radiation. My husband was hoping to receive SBRT radiation but due to the size and location with vein involvement it wasn't recommended. We too had a John Hopkins 2nd opinion but no mention of the MRI guided radiation. We are currently scheduled for a Moffit consultation too. Currently chemoradiation is scheduled in the next two weeks. Prayers for good results with your scans!