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Thread: seemingly contradictory scan reports

  1. #11
    Super Moderator Top User ddessert's Avatar
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    The endoscopic ultrasound (EUS) procedure can allow them to biopsy the tumor using a fine needle (FNA) through the intestinal wall and across to the pancreas. That may be how they are getting the sample.

    During the same procedure, they could also anesthetize the celiac plexus nerve bundle for the abdomen and pelvis area (CPB), if he’s experiencing pain. If successful, that procedure can reduce the pain for about 6 months which means fewer pain pills, less constipation, and fewer laxatives.

    The EUS will not get a good look at the potential metastases, but the external ultrasound might.
    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
    @pancanology

  2. #12
    My mom just confirmed with me too that the EUS is the biopsy as you mentioned as well. Hopefully that will get them the sample they need.

    Thanks~
    David
    Age 51
    March 1, 2011 - Grade 1 Follicular Lymphoma from node removed from neck.
    2/22 PET/CT scan revealed one additional node in groin - also removed.
    Officially Grade 1 / Stage 3 due to second node.
    No Other Evidence of Disease.
    7/8 PET/CT shows two new small nodes - opposite sides, neck and groin.
    1/06/12 Completed Rituxan x 4 Monotherapy. 2/29/12 NED! Completed 4 additional maintenance doses of Rituxan. 12/12 NED! 6/14 NED! 2/15 NED! 2/16 NED!
    6/17 CT shows 2 small nodes, neck and groin. 7/17 doing Rituximab monotherapy, x 8 this time. All is good again!

  3. #13
    Cytology confirmed today, malignancy, adenocarcinoma on head of pancreas. Results from ultrasound of liver expected tomorrow. I'm not sure what to advise my dad to do. He isn't scheduled to meet with the oncologist until March 18th, which is a long time to have to wait considering patients can read their test results immediately.
    David
    Age 51
    March 1, 2011 - Grade 1 Follicular Lymphoma from node removed from neck.
    2/22 PET/CT scan revealed one additional node in groin - also removed.
    Officially Grade 1 / Stage 3 due to second node.
    No Other Evidence of Disease.
    7/8 PET/CT shows two new small nodes - opposite sides, neck and groin.
    1/06/12 Completed Rituxan x 4 Monotherapy. 2/29/12 NED! Completed 4 additional maintenance doses of Rituxan. 12/12 NED! 6/14 NED! 2/15 NED! 2/16 NED!
    6/17 CT shows 2 small nodes, neck and groin. 7/17 doing Rituximab monotherapy, x 8 this time. All is good again!

  4. #14
    Super Moderator Top User ddessert's Avatar
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    I am going through the same things with my father right now. After our initial meeting with the oncologist, it is still 30+ days from our initial meeting until the first chemo treatment and we’re not there yet.

    I would ask the oncologist about everything that needs to be in place before treatment can start with them. Stents, ports, chemo selection, weight, blood counts, clearance from other doctors, insurance, whatever!

    Note that when doctors tell you that some needed procedure is easy, that is from their perspective. I have seen a “5-minute procedure” from the doctor’s perspective turn into a 3-week scheduling nightmare for us. First there is the pre-surgical appointment, then the surgical appointment, and then 5-day review until you can start treatment - just for a stent insertion or port placement.

    If you have a chance to schedule something that might be needed, do it! schedule early and often. If you don’t need it, call back and tell them. But trying to schedule it later seems to only result in more delays. Don’t let on that you might not need it!

    I’m coming to believe that when the word gets out that you’re a PanCan patient (especially stage 4), your scheduling priority may go down to zero as they don’t think you’re savable compared to others. That seems to be our (perceived) experience. Hard to know why we’ve been back-burnered so often.
    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
    @pancanology

  5. #15
    Thanks for all of your advice here. They posted results from the ultrasound of the liver, and it said, "Marked pneumobilia obscures detail of the hepatic parenchyma. The previously visualized hyperechoic presumed benign cavernous hemangiomas are not visualized." This basically says there was too much gas in his system for them to see anything. Argh.

    The doctor tried to call yesterday afternoon and my parents missed the call. Double-argh. He said he would call back this morning, but never did. Mom called the office and Dr. Kendrick was in surgery all morning. I am becoming far less impressed with the Mayo Clinic by the day. My mom asked what I thought she should do (tell dad the report or not), and I told her that she should probably go ahead and read dad the biopsy report. She and I have known it for over a week now, and I think it would be really hard for her to feign surprise when the doctor actually does call to give the report. All it says is "positive for malignancy, adenocarcinoma." There is nothing beyond that, minus the suspicious spots on the liver from the PET/CT.

    My dad of course is devastated. And now he has to wait through yet another weekend for further information. They did talk initially about putting in a port, and he already has a stent in place for the duct blockage. Last I spoke with him about it, he was absolutely terrified of possible chemo, and wasn't sure he could even endure it. I don't know what to tell him there, having never had anything beyond Rituximab myself. And that was nothing.

    I do know that in Oklahoma where he had the stent done, the oncologist there talked about doing "mild" chemo on him first to try to shrink the mass. I think this probably means Gemcitabine, though I'm not certain. I doubt he would handle anything much stronger. He is not in the best of health, and is almost 80 years old, on constant pain meds for chronic back and bladder pain (he had carcinoma in situ in his bladder and gets biopsies bi-annually), and has severe scoliosis. He's a mess, and I don't know how to advise him. Part of me wants to tell mom to take him home and do palliative care, but we just don't have enough information yet to make an informed decision.

    David
    David
    Age 51
    March 1, 2011 - Grade 1 Follicular Lymphoma from node removed from neck.
    2/22 PET/CT scan revealed one additional node in groin - also removed.
    Officially Grade 1 / Stage 3 due to second node.
    No Other Evidence of Disease.
    7/8 PET/CT shows two new small nodes - opposite sides, neck and groin.
    1/06/12 Completed Rituxan x 4 Monotherapy. 2/29/12 NED! Completed 4 additional maintenance doses of Rituxan. 12/12 NED! 6/14 NED! 2/15 NED! 2/16 NED!
    6/17 CT shows 2 small nodes, neck and groin. 7/17 doing Rituximab monotherapy, x 8 this time. All is good again!

 

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