MRI Sensitivity

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

Hello everyone, I am new to this forum and I really think you're all doing a wonderful job sharing info and providing strength to one another.
My mother sadly passed away in January 2005, she had a tumor that lined the entire outside of the pancreas when detected and still no clear symptoms until the last months of her life.
I have had some during the last 2-3 years though, including a strange rash, back pain, neurological symptoms and dyspepsia, all still undiagnosed.
I have finally persuaded my Doctor to let me have an MRI-scan of my pancreas, but I'm still nervous about the possibility that they're only doing it to make me feel better and thus won't check the images properly.
Is there anyone who knows how good these machines are?
Will they detect even a very small tumor in the pancreas, no matter where it is situated? Any info on this is most appreciated.
Best Regards and Thank you all for a very good forum.
I wish you all the best.

kmeshelper · Posted: Sun Apr 29, 2007 9:12 am Post subject: MRI sensitivity

Your concern is certainly understandable given your experience with this devious disease. Have any of your doctors done the CN19-9 blood test for you? This is relatively cheap and non invasive. As I understand it, it shows whether there is any measurable PC activity. Visual diagnostics can then attempt to find where the activity is .

Keep researching and stay proactive on your own behalf.
_________________
stage 4 unresectible pancreatic diagnosed
2/23/06 at age 44
Gemzar/Tarceva til 4/24/07

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

Thank you very much for your answer kmeshelper, I will keep researching and annoying my doctors.
No, I have not had the test you mention (didn't know about it), but I am meeting with a private physician this week or next and I will ask him if he can do it. Thanks again.

Still though, I am wondering about the preciness of MRI-imaging.
My suspicion is that I might be in the early stages of an endocrine hormone-secreting tumor, will it be seen on MRI if small?
Anyone with any knowledge of these machines and their reliability is most welcome to write a line or two in response.

In the meantime, let's hope for better diagnostic methods and more knowledge about this disease among medical professionals.
After all, one of the strongest reasons for the high mortality rate in PC is clearly that it is almost never diagnosed at early stages.

Big Sister · Experienced user Joined: 02 Nov 2006 Posts: 68

You asked about the efficiency and reliability of an MRI scan as you fear you are a target for pancreaticc cancer.

I am the Big Sister of a fine man who was diagnosed with PC last October, 2006 and died 8 weeks later. He had just turned 61. No symptoms, no indicators that anything was amiss except annoying digestive problems through the years and a mild back pain, both of which could mean a thousand things, serious and not.

Because we shared a common gene pool, I have subsequently had an abdominal CT scan although I have none of the symptoms he experienced. There was no noticeable problem and I was pronounced "unremarkable."

If I could offer any advice to you it would be to get an MRI, get a CT scan, have the blood test, do any and all things to keep this bear at bay. If you read the posts on this forum, you know that the only chance of life after diagnosis is a surgical operation called a "Whipple Procedure." There are people who regularly write on the forum who have had Whipples and who remain alive with strong medication and equally strong hope for the future, however bleak the data. The Whipple can only be done when the cancer is new and hasn't invaded other neighboring organs like the liver, stomach and bowel. The rest of the writers are family members of loved ones who are struggling to stay alive or who have already passed.

I wish you well with your tests and urge you to take full control of your own life. Respect and regard the doctors, as they have the tools to help, but remain in charge of your case, should it turn out to be suspicious. Don't wait for the recommended 6 months or a year; it may be too late if the cancer is hiding.

And this one hides.

Respectfully, Big Sister

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

Thanks for your reply, Big Sister.
I will try to stay on top of this situation, but it certainly isn't easy.
The bad news is my Dr seems to have changed his mind and is not willing to offer me an MRI.
His reasoning behing this is downright scary:

"Pancreatic cancer is very violent, and your symptoms are mild."
"MRI:s can sometimes miss a tumor anyway."
"You should think positive, and say to yourself that this is probably nothing."

Does anyone have any idea what I could possibly say to make him realise that I'm serious about this?

Again, Best Regards and my best wishes to you all.

Vee Smith · Moderator Joined: 12 Feb 2006 Posts: 1003 Location: UK

Ask to be referred for a second opinion. A scan seems to me to be a sensible precaution.

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

Thank you for that comment Vee Smith, I have been seeing an endocrine specialist earlier because of the dyspepsia.
Perhaps I should tell her about all the symptoms, especially the rash which is still undiagnosed and spreading, and ask for an MRI.

Whenever I mention my mother and her passing to a doctor, it's like they think that I am overly nervous about any small symptom and don't take me seriously.

None of the dermatologists I have met with have ever seen a rash like mine, but I have. My mother had the same untreatabe, undiagnosed migratory rash and it was later (after diagnosis) found to be NME, wich is common when the tumor produces excessive amounts of glucagone.

I have asked the same Dr who denied me an MRI to at least measure my plasma glucagone level, but No.
Meanwhile, the rash and other symptoms are accelerating at alarming speed.
I'm beginning to realise that if this is PC, it will certainly be too late when they find it. Unless I am able to convine the endocrine specialist otherwise of course, I reckon that's my last chance of having an MRI done.
I hate Swedish healthcare.
It's only good for mainstream problems, other than that it's useless.
We have exported our best specialists to England and Norway because of our progressive taxation system, and it looks like I'll have to travel to one of those countries in the near future.
My Best to you all.

rlee · Site Admin Joined: 15 Jan 2006 Posts: 245

OLIVER LARSON,
Consider looking at pubmed for articles regarding the sensitivity of MRI to detect pancreatic cancer. Depending on the MRI machine you are using and technique, around 90% or higher is possible. However, remember MRI or any imaging doesn't diagnose cancer, rather a tissue biopsy diagnose people. Imaging detects abnormal tissue. Other imaging includes CT and endoscopic ultrasound. Work with your team of doctors to figure out what is most appropriate for you. Good luck.
_________________
RLee, MD

Any information provided is NOT intended to provide specific medical advice to users but rather to provide users with information to help them better understand their health condition and related care. All readers are strongly encouraged to consult with a qualified physician for answers to their personal medical questions.

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

Thank you Rlee, hadn't thought about pubmed. I'll be looking into it.
Yes, I am aware that an MRI can not actually diagnose anything, but if it has an accuracy of up to 90% then I reckon there's a fair chance that it could detect any alien tissue in my pancreas.
Having it done, however, that's another story altogether.
But I'll keep on trying because I believe time is running out.
Thanks again.

philplop · New User Joined: 04 May 2007 Posts: 2

Oliver,

Firstly, sorry about the loss of your mother.

About your worries... what tests has the doctor actually done so far if any? you only say it has as yet not been dignosed. I am assuming they are ruling things out? you must appreciate that it is a process of illimination and CT and MRI scans are costly time consuming procedures. sorry to sound brutal but there are bound to be hundreds of people in far worse a position than you in need of a CT or MRI scan for their diagnosis.

You say that these symptoms have gone on for a matter of years. I 100% agree with the comment your doctor made about this been a violent disease. Pancreatic cancer is one of the most aggresive cancers and if your symtoms really are originating for PC i would say you should be dead by now. If not... surely suffering some major fatigue and weight loss. I think you need to let this one go. In all honesty if you a deflecting the problem to pancreatic cancer your doctor maybe overlooking another sinister condition... i hope not. it could otherwise be blindingly obvious.

If you are still worried, try a process of imination. ask instead to see a dermatoligist say.. to establish what the rash is. Endoscopy for the dypepsia. Sputum sample.. illiminate H pylori say. Chiropracter for the back pain. I am sure they are all unlinked.

Good luck, but try stop worrying.

OLIVER LARSON · New User Joined: 28 Apr 2007 Posts: 6

The dermatologists have lookad at my rash many times, they don't know what it is.
My chiropractor has no clue what my back problem originates from.
Neurologists have checked my nervesignals, nothing wrong.
Specialists in stomach -and colon problems have checked my stomach and colon, nothing wrong.
But the symptoms persist.

I dare to say almost everything but the pancreas is ruled out.
PC is violent, yes. But only in the very late stages. Before that, it produces only mild symptoms common for many disorders. I don't often say a Dr is wrong, but this one clearly was. In fact, PC can even be silent for years and most endocrine specialists will tell you this. It's not like it starts to produce violent pain or something right from the start, it usually takes quite some growth for that to happen. This is not to say that everyone who experiences a little rashes and dyspepsia should assume PC, but when most other problems are ruled out I believe the pancreas should be examined. When that is done
I shall gladly follow your advise and let this go. Better wrong than sorry.

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