Relative with pancreatic cancer after whipple procedure.

bs3ac · Regular Joined: 27 Aug 2009 Posts: 11

Hi guys this is my first post to the forum and i would like to firstly say that i am very greatful for the advice and stories people have written involving there loved ones as it really does help people like my family who are going through a hard emotinal time at the moment.

I have a relative aged 57 who was diagnoised with pancreatic cancer a year ago. After diagnosis the decision was made to undergo the whipple procedure as the cancer was caught just before spreading to the main artery in that area.

After the surgery she gained strengh although experiencing diabetic symtomps which have recentley stabalised as they managed to save over 50% of the pancreaus.

At a later scan they discoverd that the pancreatic area was clear of cancer but there we innormalities on the liver (4 spots to be precise). She has since gone through chemopherapy procedures and is coming to the end of her 3rd dose soon.

At present she has lost alot of weight as she seems to have diarohea and vomits after most meals as food unsettles her stomach. We fear that if she dosent keep her food down she will just end up wasteing away as she already looks like skin and bones. She is also constantly tired which we belive is down to both the chemopherapy and the lack of nutrients. She also is now very depsressed.

We was enquiring about cyber knife but the current oncologist dosent belive she will be eligable as the liver abnormalities are scattered (or somthing like that).

We are lost in what to do. We cannot force her to eat and keep the food down and we cannot seem to keep her stomach settled even after diffrent medications are used (gaviscon etc).

Would a feeding tube in hospital help her keep food in? As she is still losing weight as her daily calorie count must be <700. She needs the energy to be able to cope with the chemo but is unable to get that energy from consuming food.

Any help however small will be greatly appreciated. Thanks for your time.

brainman

Hi bs3ac,

I am truly sorry about your relative's Pancreatic Cancer. It is one of the worse cancers a person can have because it is so hard to treat and so hard on a person's quality of life.

How long is she able to keep her food down? I cannot remember the exact figures, but a significant amount of nutrition is absorbed in just a few minutes. Is she taking any Ensure or product like that? That too is easily absorbed and will make sure she is getting the right amount of nutrients.

The idea to use a cyber knife or other steriotacting radiation procedure will probably not happen. Any of those procedures are best if the organ is fixed in one place.... brain and bones, for examples. Even the lungs. But the liver, pancreas and other abdominal organs are basically just floating and can move around too much for the been of radiation to be correctly aimed. In addition, they are best when their is only one, relatively small tumor to aim at. This does not mean that they will rule out other forms of radiation. I am not sure about that.

The question about using a feeding tube really is up to her. It will help her get the nutrition she needs but it will put her in the hospital for a long time... a very long time. Other than her nutrition, the only thing that is worrisome is her mental status. I would hate it of her depression was so bad that it is affecting her judgement.

Finally, her weakness... That is a very common thing for people on chemotherapy. It tends to destroy blood cells, especially red blood cells that carry oxygen to the rest of the body. Do you know if she is anemic?

You, your family, and your relative are in my thoughts and prayers.
_________________
Jim
Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405
My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Twitter: @JimHawkins54

bs3ac · Regular Joined: 27 Aug 2009 Posts: 11

Dear Jim

Thanks for your kind reply,

The amount of time she can keep the food inside her varies day to day. Funnily enougth our doctor gave us Ensure to try two days ago and she has managed to drink over 75% of a bottle without bringing it back up yesterday (im sure you may already be aware, a bottle is 300 calories). We are now trying to give her a bottle in the morning and a bottle at night to see if she can manage those extra calories (even sipping a mouth full every 15mins or so should help her).

My biggest concern is she is still falling far short of the recommended daily calorie intake a female should be recieving and i am afraid that she will continue to lose weight over time making her weaker and weaker.

Its not that she dosent want to eat, as her apetite is still healthy as she fancies cakes and certin meals at times but she has a pain when swallowing in the stomach area and she says it feels very acidy when eating food. We have deciced to try to get her to eat very small meals as alot of her stomach was removed after the whipple operation and the sickness seems to be linked with her trying to eat to much at times or her stomach being upset from foods that induce acid reflux.

She went to see the oncologist yesterday and he didnt seem too suprised with her state and it kind of reassured us that he did not feel the need to take her off the chemo (he must see people like her every day). We really belived that she would be told to come off the chemo as to us it seems she has declined alot from being a healthy looking lady to a fragile old lady in a matter of months.

I think our biggest upset is that after having the whipple procedure the pancreatic area/stomach all came back as clear. It was at a later date (a month or so later) that the doctor spotted abnormailities on the liver which we believed to be a less of a worry as the original cancer was in a very dangerous spot being close to other organs. We unfourtantly was very wrong as the cancer on the liver cannot be operated on (which was a big suprise to us).

Could you be kind enougth to tell me a little about the chemo and what to expect? as she is always wanting to sleep and the depression i belive is sourced from getting tired of the chemopherapy aswell as depression itself induces sleeping. Will she be up and perky again when off the chemo? and is it possible to come off the chemo and put her back on it at a later date when she recovers a little bit from the current side effects?

She just wants to be able to get up and live a normal day again but she always seems to be tired, not able to eat and most importantly losing weight.

Thanks again for the reply Jim it really does mean alot to us.

georgie430 · Regular Joined: 02 Jul 2009 Posts: 44

Hi; I dont know if the following will help but, maybe. You stated that your relative was nauseous and things like gaviscon were tried, what about a perscription for Zofran, this is "the" best for nasuea, best given iv. Also is she on pancreatic enzymes, perscribed like Creon 20, or Viokase, it really does help with digestion, especially that she Does have an appetite.

I really hope she is fo if not, her Dr. in my opinion is lacking, Big Time!!

Also is she on an anti-depressant, depression is common for anyone w/ cancer, but it is known particurly with pancreatic.

Just heard today (did here it vaguely before) that red grapes and grape seed is good for people w/ panc can an on chemo, also good for pancrea in general. I was on the herb myself cant think of name, will get back to you.
Hope this helps

If the Dr. says she doesn't need enzymes because she has 50% of her panc. have her advocate be demanding, evrybody is different, alot of people use it for chronic pancreatitis who have there whole panc. I use it periodically it does work. If it does not make sure she does not have
gastroparesis, whih means stomach is working veryslowly, food is sitting on stomach (creams,cheeses will aggravate).

Please keep us posted on all this.

with the best intention,
Denise
_________________
"going thru these very rough times have made
me WAKE UP, I know this sounds cliche, but
don't want to go back to sleep" !!!

kezza1 · Regular Joined: 12 Jan 2009 Posts: 10

Had my whipple in January, found eating without enzyme supplements almost impossible everything went straight thru never did vomit though. Enzymes have almost made my life normal again, but if i miss any, and i take them with all food even snacks, it can get real bad. Any fat will go straight thru you.Just a point of interest for you to think about but just recently I have had an incisional hernia develope which is no biggy having it repaired in October but to support it till then i bought what you would calla girdle. Made of wetsuit rubber it wraps round my stomach holding the hernia in place,but one of the side benefits is that it has made my whipple area feela whole heap better. Dont know why might be the extra heat might be that it is helping the damaged mussels with support just thought you would like to know.

bs3ac · Regular Joined: 27 Aug 2009 Posts: 11

Thankyou for your kind replies guys,

A quick update: She has had a scan today to see if the chemo is doing its job and unfourtantly the secondary cancer on the liver has grown slightly and new abnormalities have been found on the liver. The consultant who stopped by to quickly review the results has also seen a 'dark area' in the stomach lining which we are waiting more results to see if it is cancer or somthing else.

The chemo has failed and so i think the doctor is going to take her off it to let her regain her strength and to put on some weight (she has been given steriods to help this).

The doctor did however say that he is not going to give up on her and mentioned a gene-therapy form of medication.

Does anyone know what options are avaliable if chemo dosent seem to be controlling the cancer or has anyone been or known someone who has been in a similar situation where the chemo wasnt effective?

Regarding her eating she has gained some weight (before the steriods) and has gained some of her apetite back, we found the Ensure drinks to be very helpful (thanks jim for the recommendation). We have also been told by the macmillan nurse to eat foods with load of calories for example microwave meals (lasagna, cottage pies etc). She hasnt been sick as much anymore as we have given her smaller servings but on regular occasions which seems to be helping.

Referring back to diffrent medications, i have spoken to Doctor George Fisher in America (who treated Patrick Swayze) and he mentioned a form of medication called Abraxine which has been recently tested on pancreatic cancer paitents with results showing a 40% better chance of responce to the cancer. Has anyone heard, used or knows anything about this drug?

Thanks again for your kinds responces guys, they really are helpful and i really appreciate them.

Thankyou.

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