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Thread: My own father, now diagnosed with stage 4 pancreatic cancer

  1. #11
    Super Moderator Top User ddessert's Avatar
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    Oct 2013
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    Hi onlyif,

    As I understand it, metformin acts by increasing the body's sensitivity to the insulin that is produced. There's only so far that can take you.

    But in pancreatic cancer patients (including resected patients), the problem is too little insulin production. There is less pancreas to produce insulin. So this is a supply problem, not a sensitivity problem.

    Which I think means that insulin is going to be more effective. Perhaps Metformin too, so that less insulin is needed.

    I am in a clinical trial at Johns Hopkins and I think it's (past) time to activate that avenue as well.

    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 - IMRT+Xeloda
    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 2019 - NED
    Mar 2013-present - NCT01088789
    Jun 2019- NCT03805919

  2. #12
    Moderator Senior User BrigitteM's Avatar
    Join Date
    Sep 2016
    My husband has type 1 diabetes, and I worked for years for a non-profit doing fundraising for diabetes research. Among other things, I wrote educational material for patients. I will try to give a few elements to understand diabetes.

    There are many types of diabetes, not only 1, 2 and 3, but no matter the diabetes type, people with diabetes end up with too much glucose in the blood. The goal of the treatment is to decrease glucose levels, not to treat the cause.

    I don't think Metformin is necessarily a bad thing to start as it decreases the production of glucose by the liver and the absorption of glucose by the GI system, which in turn reduces blood glucose levels.

    On the other end, injections of insulin will increase the level of insulin, which in turn will circulate in the body to help cells process the glucose.

    The 2 approaches attack the high blood glucose levels from a different angle. Type 1 diabetes patients often get insulin right away because most of the time their insulin-producing cells are entirely destroyed.

    Type 2 patients start with oral medications, but when patients have difficulty to maintain good blood sugar levels, then oral meds are replaced by insulin.

    In any case, monitoring is key. My husband checks his blood sugar level about 5 or more times a day. It fluctuates with food, exercise, emotions, stress, etc...
    __________________________________________________ ___________________
    1/12/2016 No symptoms except ongoing fatigue; blood test revealed elevated liver enzymes
    1/18/2016 Liver ultrasound, then MRI confirmed enlarged bile duct
    1/21/2016 ERCP and placement of a temporary stent
    1/28/2016 CT-Scan showed a lesion on the head of pancreas
    2/09/2016 2nd ERCP + EUS + FNA
    2/12/2016 DX Borderline resectable pancreas ductal adenocarcinoma - Stage 3 @ 61
    2/24/2016 FOLFIRINOX 3 cycles (6 infusions)
    5/12/2016 CYBER-KNIFE Stereotactic Radiation 3 sessions
    6/16/2016 WHIPPLE + portal vein and right hepatic artery reconstructions - 0/19 nodes pos - no mets. Restaged to 1A
    8/31/2016 FOLFOX for 3 cycles (6 infusions)
    Sept 2016 Know Your Tumor - PANCAN.org
    11/4/2016 CT Scan clear - NED
    May 2017 Liver lesion - DX mild fatty liver disease - NED
    Aug 2017 Several small lung nodules - slow growth - NED until August 2018
    Aug 2018 Pancreatic metastasis confirmed by biopsy.
    Sept 2018 Starting clinical trial with RX-3117 and Abraxane (NCT03189914)
    March 2019 Lung nodules are stable

  3. #13
    Newbie New User
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    May 2018
    I hope your father is just as resilient as yourself in his fight with PC. You spare time for everyone. Rest assured that we will spare a prayer for you in your time of need. Best of luck!

  4. #14
    Experienced User
    Join Date
    Feb 2018
    Hello David,
    Itís totally beyond ďsorryĒ that you have to put up with this and fight again- this time for your dad. It is not fair. Your dad is lucky to have you by his side. At least there is you to guide him through this since even qualified health pros can find it hard.
    I really wonder how many people actually do have the hereditary type of pan can. I bet many more than docs think. Who has a post mortem tumor analysis anyway? Most tumors from unresected patients who die are never analyzed. So how do they know? Your story brings me memories of how my grandma died. Stomach pain and couldínt eat. Widespread cancer of unknown origin and details... then my mum dies of pan can unresected. It just makes you wonder who is next. Regarding the CT scan other members mentioned: In our case this type of scan would not see the problem at all even though it was 3*2 cm. The MRs and CTs never saw her peritoneal metastasis either -never until she died. However the CT with pancreas protocol and the MR spotted the initial mass.
    David, whatís your dadís name to include him in my prayers? I wish you from the bottom of my heart the best. Let us know of your course if action.
    Best Wishes

  5. #15
    Quote Originally Posted by simonedriva View Post
    So how do they know? Your story brings me memories of how my grandma died. Stomach pain and couldínt eat. Widespread cancer of unknown origin.
    Your post raised a question in my mind....when the cancer is so widespread throughout the abdomen and a biopsy is not performed how can the doctor know pancreatic cancer is the primary? is it just an educated guess? or can they actually tell from the CT scan?

  6. #16
    Senior User
    Join Date
    Apr 2016
    Well, thatís a huge disappointment....to put it lightly.

    It sounds like his organ involvement and diabetes is similar to my dadís experience. Although my dad didnít become diabetic until a few months after diagnosis. Metaformin did help regulate it and it helped with the excessive thirst and severity.

    It is good he has you. I pop in to catch up and didnít expect to read this. Iíll be thinking of you and your dad.
    Jan 15, 2016 Father went to the ER with extreme abdominal pain...
    Jan 16, 2016 unofficially diagnosed with pancreatic cancer stage IV in the tail, too many mets in his liver to count, spleen and lung.
    Folfirinox-2 doses in February 2016
    March 2016-discont. chemo
    Apr 2016 severe onset of diabetes
    June 15, 2016 Celebrated he/my mom's 47th Wedding Anniversary eating pier fries/fried dough (I think this was his goal...to live to make it 47 years)
    June 15th, 2016 at 11:00 PM experienced sharp abdominal pain not managed with pain meds at home
    June 16th, 2016 at 3am went into the hospice home for pain management (walked into the facility).
    June 16th, 2016 by 11am...we learned this would be where he would spend his last days (shocked because at 9am he took a few sips of coffee)
    June 17th, 2016 at 8:20 pm...sun was setting, windows were open, birds chirping, my mom/me/my brother were all by his side with our hands on his body as he took his last breath at 68 years old.

  7. #17
    Super Moderator Top User ddessert's Avatar
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    Oct 2013
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    Thanks simonedriva. My father Robert Dessert would appreciate your prayers on his behalf.



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