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Thread: My dad might have Pancreatic cancer.

  1. #1

    My dad might have Pancreatic cancer.

    My dad is 62. Healthy. No major diseases in the family. No history of cancer in the extended family either.

    Fit, works out regularly, works 50-60 hours a week, very active, has never had alcohol or smoked.

    He wanted to get a CT scan done to make sure everything was alright, he doesn't have any symptoms, all of his vitals are normal, LFTs, Blood glucose and he asked his primary care to order a CT for him who surprisingly did.

    The CT scan mentions this,

    There is mildly prominent mucosal enhancement in the proximal duodenum.

    Along the anterior surface of the pancreas, just to the left of the pancreatic
    head, there is a focal convexity which measures 2 cm in AP diameter. This demonstrates the same density and enhancement as pancreatic tissue prior to and during infusion. No discrete mass, abnormal fluid collection, or inflammation is demonstrated. Pancreas is otherwise normal in appearance.

    No hepatic or splenic abnormalities are demonstrated . No calcified gallstones are present. No intrahepatic biliary ductal dilatation is demonstrated. Configuration of both adrenal glands is normal.


    and

    Anterior surface of the pancreatic neck demonstrates a focal 2 cm convexity. Although the density of this structure is identical to that of the pancreas, the possibility of a pancreatic mass cannot be excluded.

    Mildly prominent mucosal enhancement in the proximal duodenum raises the possibility of mild duodenitis
    Everything else is normal. No liver/spleen abnormalities. No lymphadenopathy. But it was not a pancreatic scan just a contrast CT so here I am shitting bricks. My dad doesn't seem to phased by it for some reason and we haven't told my mom. I haven't been able to get any sleep in last few days.

    The primary care provider said "there are some irregularity on the CT , we can order another CT in a couple of months to make sure everything is okay" which I honestly found odd. I hope my dad's not lying to me. I mean I went to med school(haven't started residency) and he won't lie about that to me but idk.

    Is this how it starts?

    He has an appointment with Primary care provider on Thursday that he took to tell him to order a MRI of the pancreas. I hope he is okay and it's just something benign or an anatomical variant. This is so scary.

  2. #2
    Super Moderator Top User po18guy's Avatar
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    Sorry to hear of this. Very curious as to why a CT was ordered out of the blue. Also huge leap from likely duodenitis to cancer. What must be understood is that radiologists might be described as alarmists and must mention every single thing they see in a CT that does not exactly match the "perfect human" chart on doctor's wall.

    The take home here is what we all should have known all along: enjoy every moment with your dad. I say this not because he might die, but because you might! 103 people die suddenly and unexpectedly each day in traffic collisions. If you are in med school, this is going to be your life.

    Wait for him to do follow ups and if the anxiety is tearing you up (it must be, because you are fearing cancer), then deal with the anxiety - either short or long term.
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    Both lymphoid and myeloid malignancies lend a certain symmetry to the hematological journey.

    Believing in the redemptive value of suffering makes all the difference.

  3. #3
    Quote Originally Posted by po18guy View Post
    Sorry to hear of this. Very curious as to why a CT was ordered out of the blue. Also huge leap from likely duodenitis to cancer. What must be understood is that radiologists might be described as alarmists and must mention every single thing they see in a CT that does not exactly match the "perfect human" chart on doctor's wall.

    The take home here is what we all should have known all along: enjoy every moment with your dad. I say this not because he might die, but because you might! 103 people die suddenly and unexpectedly each day in traffic collisions. If you are in med school, this is going to be your life.

    Wait for him to do follow ups and if the anxiety is tearing you up (it must be, because you are fearing cancer), then deal with the anxiety - either short or long term.
    My dad used to be a surgeon in his country and so he is extremely proactive about screening and all that. He has been talking about getting a CT done for quite a while now because of his age just as a tentative screening of sorts.

    If he was back in his home country, he could just walk in to his friend's radiology centre and get a MRI/CT done whenever he liked or get one of his friends to order one for him, of course he can't always do that in America but he has found a PCP who is very chilled and listens to him. He just requested one and the doctor agreed for whatever reason, he probably said epigastric pain after eating spicy food because I have heard him complain about it once a month if I cook something that's kinda spicy but that's not pathological per se, I don't know how true that is because my dad can just be shielding us from the truth. He also works with surgeons and he is supposed to be a first assist with an oncosurgeon tomorrow and is planning to talk to him about it.




    Of course the 2cm convexity be just variant anatomy, apparently my anatomy textbook says ~30% of people have contour variants. What's "good" here is that it shows the same density as rest of the pancreas and that the CT doesn't seem to talk about any invasion in neighboring blood vessels, what's bad is 10% of Pancreatic adenocarcinomas are isoattenuating ie show similar density as the normal pancreatic tissue and that this is was just a "normal" Contrast CT with not a pancreatic protocol but it's still not normal so that's eating me away.

    I don't know how things will go. I am planning on driving up to Mayo Clinic if the diagnosis is confirmed in coming days. We live in Chicago and I want him to get the best care possible. I just wish there was a way to speed up the process of diagnosis.



    Thank you so much!

    If you are in med school, this is going to be your life.
    The sad part is I see death everyday, the suffering but you get a bit numb when you see it everyday but then you are suddenly on the other side and you understand how bad it can be for people on receiving end.
    Last edited by somewhere_suspicious; 10-07-2019 at 07:26 AM.

 

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