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Thread: Creon Use after Surgery

  1. #1
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    Creon Use after Surgery

    My wife, age 77, had a small cancer surgically removed from the body of the tail of the pancreas in early January 2017 and has been on chemo since March. An unrelated nodule in the right lung was surgically removed at the same time. The lung cancer has not reappeared but the pancreatic cancer was metastatic. Creon has been taken with meals since then. She has struggled to keep her weight up and is slowly gaining some weight back now that her chemo regimen (her third) has controlled the cancer progression to some extent (CA 19-9 has dropped from a high of 200 to 40). I am wondering if anyone has experience or knowledge about the continued use of creon. Will she continue this for ever or does the pancreas begin to again produce the necessary enzymes? Thanks in advance.

    P.S. She was initially on cisplatin and gemcitabine. She didn't tolerate this well. She was switched to oxaliaplatin and 5-FU. Again, poor tolerance. She is now on capecitabine (oral pills) which she is tolerating with mild side effects. A small cancer grew while she was taking the first regimen but has disappeared now. We assume that the cancer is still in the lymph nodes.

  2. #2
    Moderator Top User ddessert's Avatar
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    If she's needed since the surgery, then it is likely she will always need it. In fact, the pancreas was pretty damaged by the surgery and, if we live long enough, may eventually fail. Although that could take many years.

    However, if a tumor was blocking the pancreatic duct(s) (less likely after surgery unless there was a recurrence), effective chemotherapy might temporarily clear up that duct and allow more natural enzymes to get through. If the chemo is effective and has cleared a duct, it's also likely that the tumor will eventually start growing again and block the duct again.

    It sounds like her situation may be somewhere between the two described above.

    Personally, if she's eating well, I wouldn't touch a thing. We lose a lot of patients due to extreme weight loss. If Creon's expense is a problem, AbbVie has two programs to help out with the costs, in some cases getting it down to $5.
    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-Dec 2016 - NED
    Mar 2013-present - NCT01088789
    @pancanology

  3. #3
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    Thanks for this great information.

 

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