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Thread: ascites

  1. #1

    ascites

    Hi, what can people here tell me about ascites? I know d dessert has corresponded with many patients over the years, so hoping for an answer from him or anyone. Is it true that it usually means the end is not far off? Is there a permanent method of dealing with it, or just continual draining ? I guess the question here is, if you get it, can you get rid of it? What are the symptoms? Is this something that would be obvious to a doctor, that would show up somehow in bloodwork?
    Thanks so much.
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.
    January 2019 Tried FOLFIRINOX after G/A became ineffective. FFX doesn't work. CA 19-9 rising
    February 2019 two small tumors appear on liver
    May 2019 - CA 19-9 skyrocketing. Started IMRT radiation treatment.
    August 2019 MRI done. No Evidence of Disease (NED). CA 19-9 dropped significantly. Still not normal range.

  2. #2
    Experienced User
    Join Date
    Feb 2018
    Posts
    75
    Hello Jackie

    Ascites is most of times no good news I am afraid. However, you must know if you are dealing with it in the first place and if it is certainly attributed to cancer. For starts, a physical abdominal exam should take place to check how tight belly is. Some people are bloated with gas. You might need differential diagnosis. Accumulation of liquid within the peritoneal cavity may or may not be noticed especially in the beginning. Or, it can be accompanied with unexplained weight gain/ fullness. My mum developed ascites two months prior her passing. At first we thought ( wishful thinking ) that it was due to the pressure the tumor was putting against the portal vein. After she had surgery to relieve the pressure with a stent ( which in retrospect I find it was completely unnecessary) I realized that it was not because of the pressure but probably due to numerous micro metastases within the peritoneal cavity unseen by mri and other scans. Pet scan should be better at seeing that but she never had one. There is medication to treat it such as diuretics, egg whites in the diet. I believe it depends how bad ascites is. Mum had 3-4 litters a day and she needed a permanent drain. It was not painful though. Please take into account I am not medical professional and I talk only by experience. Seek pro advice. There might be some introperitoneal chemo treatment available now that delivers drugs into the peritoneal cavity directly. That would give a chance to get rid of it since the blood supply there is indirect and systemic chemo does not kill cancer there very well. Also, mind that if ascites develops medication needs to be adjusted to keep the body in balance. Our doctors were confused at the end- they were recommending different medication. I do not mean to discourage you Jackie. Please do not forget everybody is different and same responses are not always anticipated. I wish you good strength in your journey and a good outcome promptly. I hope I helped.

    Take care

    Simone

  3. #3
    Senior User
    Join Date
    Mar 2018
    Posts
    155
    I thought at the beginning of my treatment that l was experiencing ascites, but it turned out to be side effects of the chemo causing bloated stomach. Don't panic. Also wasn't there a post not too far back where someone's ascites disappeared after starting treatment or a different treatment?
    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
    - Ca-19 up to over 6,000
    April '19 - Started 5-fu, Abraxane, Oxaliplatin
    Ca-19 down to 600, missing many doses due to
    low platelets
    Aug '19 - Started Irrinotecan, abraxane, cysplatin
    missing doses, low platelets
    Sept '19 - Ca-19 holding steady, ct scan shows 2 small
    lung nodules - 3mm, 5mm, blood clot in pulmonary
    vein, primary and liver mets stable started blood thinner
    Oct. '19 Switched back to POLF treatment - Paclitaxel,Oxaliplatin,
    Leucovorin, 5FU

  4. #4
    Hi Jackie,

    As other's have said - please consult your doctor, it sounds like it truly varies by person. I believe they were able to confirm my mom's ascites via CT scan, but there may be other imaging/examinations to confirm or deny.

    Unfortunately, in my mom's case, it was not good news as she began to rapidly decline after she developed ascites and passed about 3 weeks later. She had two procedures to manually drain the fluid which did help her become comfortable temporarily.

  5. #5
    I'm sorry for your loss. I'm feeling relaxed and not in a panic, just want to learn more about it, as this seems to be a common cause of death among PC patients. I'll be consulting with my doctor in a couple of days.
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.
    January 2019 Tried FOLFIRINOX after G/A became ineffective. FFX doesn't work. CA 19-9 rising
    February 2019 two small tumors appear on liver
    May 2019 - CA 19-9 skyrocketing. Started IMRT radiation treatment.
    August 2019 MRI done. No Evidence of Disease (NED). CA 19-9 dropped significantly. Still not normal range.

  6. #6
    Experienced User
    Join Date
    Aug 2017
    Posts
    53
    ascites develop after the cancer itself moves to the peritoneum area.
    my dad developed ascites after the cancer returned back agressively from 8 months ago, but we were able to control it and stop it.
    first two times it needed to be drained, 4l and 3,5 l were drained, than his doctor put my dad on lazyx or what's called water pill.
    after the comeback of the cancer we changed his chemo protocol to gemzar abraxane and cisplatin, and since he had a great response on this combo ascites stopped, because the mets on his peritoneum disappeared.
    24-06-17 : Dad Dx Stage 4 mass on tail of pancreas , mets on liver.lungs
    06-07-17 :PET :mets to lungs , 4.6 x 3 cm mass on pancreas tail SUV max = 4.2 , innumerable mets on liver SUV max = 6.3
    21-09-17 :CT scan :stable tumor, significant shrinkage of mets on liver
    03-11-17 :CT scan :stable tumor, shrinkage liver mets
    04-01-18 :PET/CT mets in lungs (Scar tissue) ,3.3 cm Calcified tumor showing Faint FDG SUV max = 2.2 ,Necrotic liver mets SUV max = 3.7
    26-04-18 :chemo stop,18 cycles of full Ffx, no active Cancer cells
    19-06-18 :PET scan:NED
    03-09-18 :MRI scan:still NED
    09-10-18 :PET scan:no activity on pancreas, liver,increased activity on lungs SUV max =2.72 .back on FFX 2 Cycles
    12-12-18 :PET scan:increased activity on liver,lungs,peritoneum and pancreas+ascites.Time to switch chemo: gem+abrx+cispl
    22-02-19 :CT shows stability on pancreas,liver,peritoneum shrinkage on lungs mets
    07-10-19 :PET/CT shows :Tumor disappeared ,Shrinkage on liver,lungs mets

  7. #7
    @Jackie - that is the right attitude - consult your doctor. I think it really varies so much from person to person (i.e., some folks develop ascites and it subsides with draining and chemo) so please don't take it as a bad sign (even if it wasn't great for my mom).

    Keep us posted on how you are doing and hang in there!

  8. #8
    Thanks so much for the replies. I'm really encouraged to read that there is a possibility to combat ascites. I doubt I have it, but my strategy for survival is to always stay a few steps ahead so that I'm ready for anything. I had been feeling a bloating or tightness below my ribs, and I will check with my doctor about it tomorrow.
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.
    January 2019 Tried FOLFIRINOX after G/A became ineffective. FFX doesn't work. CA 19-9 rising
    February 2019 two small tumors appear on liver
    May 2019 - CA 19-9 skyrocketing. Started IMRT radiation treatment.
    August 2019 MRI done. No Evidence of Disease (NED). CA 19-9 dropped significantly. Still not normal range.

  9. #9
    Experienced User
    Join Date
    Dec 2017
    Posts
    88
    Quote Originally Posted by jackieb501 View Post
    Thanks so much for the replies. I'm really encouraged to read that there is a possibility to combat ascites. I doubt I have it, but my strategy for survival is to always stay a few steps ahead so that I'm ready for anything. I had been feeling a bloating or tightness below my ribs, and I will check with my doctor about it tomorrow.

    Hi Jackie,

    My mom has similar complaints: bloating, especially after meals, and tightness in lower rib area. She's having it checked these days. If you don't mind, could you please share with me how your doctor thinks about your situation? Really appreciate it.
    Oct 2017 - Mom's annual checkup found elevated CA19-9 (280 kU/L)
    Nov 2017 - Diagnosed. Pancreatic Adenocarcinoma on body/tail of pancreas, ~3cm mass
    Dec 2017 - Distal pancreatectomy, 3.5*3*2 mass removed, 2/17 lymph nodes.
    Jan 2018 - CA19-9 dropped to 30 kU/L 4 weeks after surgery.
    Feb 2018 - 3 rounds of S1
    June 2018 - CA 19-9 from 50 to 170 KU/L. CT + PET confirmed recurrence at remainder of pancreas + peritoneal mets.
    July 2018 - Started Gem/Abraxane
    Sep 2018 - Peritoneal mets disappeared on CT. CA 19-9 dropped to 35.
    Nov 2018 - Finished 4th round of Gem/Abraxane. Clear CT. CA19-9 dropped to 22.

  10. #10
    Hello, Mel, and everyone here. I have good news to report. The doctor did a quick ultrasound and found no fluid. There was gas, and I'm guessing this was the culprit. I'm so relieved. I didn't strongly feel that I had it, but I did want to learn more about it. I was also relieved to learn from my doctor that ascites is not as common as I thought it was.
    February 2016- diagnosed with PC
    March 2016- inoperable due to arteries, also liver mets suspected
    March 2016-January 2017 -Gemzar/Abraxane
    February 2017 surgery-PC tumour and liver mets removed at same time
    July 2018 Back on Gemzar/Abraxane due to rising CA 19-9. Scans were clear.
    January 2019 Tried FOLFIRINOX after G/A became ineffective. FFX doesn't work. CA 19-9 rising
    February 2019 two small tumors appear on liver
    May 2019 - CA 19-9 skyrocketing. Started IMRT radiation treatment.
    August 2019 MRI done. No Evidence of Disease (NED). CA 19-9 dropped significantly. Still not normal range.

 

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