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Thread: Seeking advice for further treatment strategy

  1. #11
    Experienced User
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    Jan 2017
    Thanks for your reply Ddessert

    Quote Originally Posted by ddessert View Post
    The CT scans cannot tell the difference between scar tissue and the tumor. It's likely that there is some scar tissue around the remaining tumor that is slowly being reabsorbed by your body. That also means that the tumor is probably even smaller still.
    The measurement is done based on the MR pictures with primovist contrast liquid. Should you not be able to se the difference between scar and tumor then?

    Quote Originally Posted by ddessert View Post
    Does the initial pathology report (that told you it was an ACC) also state the differentiation type (well, moderately, poorly)? I think it is one of the indicators of aggressiveness.
    Does the CA19-9 reading tell you anything?
    No, both CA 19-9, CA 125 and CEA are normal and have been so all the way. CA 125 is actually a bit high, but this is normal after the surgery. Not sure about the differential type, I know I have MSS.
    December 16 - diagnosed with Acinar Cell Carcinoma w/ metastasis (7) to the liver
    January 17 - started treatment w/FOLFIRINOX
    February 17 - allergic to Neulasta, had to stop taking the shots
    March 17 - 50% reduction of tumor and metastasis after 4 treatments
    May 17 - CT scan after 8 treatments: tumor 17x22 mm and well defined
    May 17 - Stoped FOLFIRINOX after 9 cycles to prepare for surgery
    June 17 - Surgery 22 June, Distal pancreatectomy, removed tail/body, spleen and 6 lymph nodes (all negative)
    August 17 - CT and MR show no new mets, existing reduced compared with pictures from June 17
    Genetic profiling done via PanCan: No BRCA mutations, but SMAD4, CTNNB1 and MLL2
    October 17 - CT show stabile disease - no new or enlarged mets
    November 17 - CT show stabile disease - no new or enlarged mets
    January 18 - CT show stabile disease - no new or enlarged mets
    April 18 - CT show stabile disease - no new or enlarged mets

  2. #12
    Super Moderator Top User ddessert's Avatar
    Join Date
    Oct 2013
    Blog Entries
    I don't know if the MRI can see the difference between the scar tissue and the tumor. When doctors need to know the difference, it seems that a CT/PET combination scan is performed. It's a good question.

    I suspected the CA19-9 would be normal, or close to normal. I was hoping it might provide a separate way to know what's going on.

    I'm not very familiar with the CEA and CA 125 in pancreatic cancer. We don't see a lot of patients having them measured.
    BRCA2 3398del5
    Dec 2010 - back/abd pain
    May 2011 - Unresectable stage III, 2.5cm tumor
    Jun-Aug 2011 - Gem/Cis, 9 rounds
    Oct-Nov 2011 - Radiation+Xeloda, 25 days in 5 weeks
    Oct 2011-Sep 2012 - shrinking tumor
    Feb 2012 - National Familial Pancreatic Study
    Aug 2012 - Downgraded to stage IIA, PGP
    Sep 2012 - Whipple, T3N0M0, 0.5cm tumor, 0/16 lymph nodes
    Dec 2012 - Quebec PanCan Study
    Sep 2012-May 2018 - NED
    Mar 2013-present - NCT01088789


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