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Thread: tumor growth and increasing fatigue

  1. #1
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    tumor growth and increasing fatigue

    My husband had a CT in November 8, 2018 that showed a 2.5 cm tumor in his pancreas, partially encapsulating the splenic artery. There were small tumors too numerous to count in his liver.

    He was told his prognosis was not good that he wouldn't make it until Chrismas, and they set up a CT guided needle biopsy. He declined the biopsy and has been taking 10 mg Percocet every 5 hours since then, a sleeping pill, Boost, and TUMS for indigestion. He has not seen an oncologist as he would refuse chemotherapy anyway. He is 74.


    He had an ultrasound yesterday (unofficial) and the tumor is 7cm now and totally encapsulating the splenic artery (blood flow is still excellent), but he doesn't feel much different than he has all along, with the exception of increasing fatigue. His liver is not engorged or enlarged.

    Is a tumor growth from 2.5-7cm fast or slow for 4 1/2 months? Any speculations on prognosis? Also, what helps with the fatigue? Will prednisone help?
    Last edited by kathydiane; 04-16-2019 at 07:56 PM.

  2. #2
    Moderator Senior User BrigitteM's Avatar
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    Personally, I find it very hard to say. Would your husband consider a second opinion in a major pancreatic cancer center? And then he could make his own decision better informed.
    __________________________________________________ ___________________
    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. #3
    Super Moderator Top User ddessert's Avatar
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    Tail tumors can progress significantly without major complications for quite some time. just for reference, the pancreas is about 15cm long, so this one is now covering half his pancreas.

    Soon, look for diabetes, appetite, and weight loss to happen. Diabetes just because the pancreas is being overwhelmed by a tumor. If jaundice starts, you’ll know it’s almost covering the entire pancreas.

    I will also state that since he did not have a biopsy, there is always the chance that this is a pNET tumor, not adenocarcinoma. In that case, it would be much less aggressive and the prognosis and treatment are very different. While there is only a 5% chance of being a pNET type of cancer, if he does not progress significantly in the next 6 months, you may want to check into that.
    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

  4. #4
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    He won't. His decision is made. I'm asking on this for my own mind, not his. He has put it in the Lords hands and not man's. I would like to know if anything will help the fatigue though.

  5. #5
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    He had a CT in February last year of his lungs, back and abdomen and there was no trace of a tumor then so it's doubtful it's pNET, right?

  6. #6
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    When I was first diagnosed, I cut out tea and coffee. Later I found out both of these are beneficial for cancer patients especially for extra energy and adding fluids. There must be one of two that he will like.
    Mar. '18 - Diagnosed Stage IV with liver mets CA-19 124,000
    Apr. '18 - Started chemo - Gem, Abrx, Cis
    July and Sept '18 - Ct scan - all tumors shrinking
    Oct. '18 - CA-19 - 1,495
    Oct. '18 - Started Gem, Abrx 1/2 dose

  7. #7
    Super Moderator Top User ddessert's Avatar
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    Quote Originally Posted by kathydiane View Post
    He had a CT in February last year of his lungs, back and abdomen and there was no trace of a tumor then so it's doubtful it's pNET, right?
    I really don’t have enough experience with pNET to make such a call. It’s just unlikely based on the statistics, but then this story about Wilko Johnson always sticks in the back of my head.
    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

  8. #8
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    thank you! I'll check out the story!

  9. #9
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    He cut out coffee at first because it bothered his stomach but now he loves it mixed with Boost! Glad to hear it's beneficial.

 

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