My Brother first complained of Abdominal pain in Feb. of 2007. In May of that year he waqs diagnosed with pancreatic cancer. He enrolled in a study where he received presurgical treatment of chemo (Gemzar and Avastin) and radiation. Unfortunately, when he went into have a Whipple procedure, they found he already had metastatic disease (it had spread to his liver) and they were unable to do the cancer. His chemotherapy was changes (Gemzar and Xeloda). The doctors found a pain dose that worked for him and until January of 2008 he was doing quite well considering he was living with Stage IV pancreatic cancer: his pain was controlled, he continued to work out, go for long walks, and he continued to ba able to drive and take care of himself totally. The following is his question (posed in his words):
"In late January I was about to take a 3 week solo road trip to Florida, a trip that was approved of by my doctors. Just before that I developed an obstruction in my bile duct that necessitated the placing of a plastic stent in my bile duct. That operation was successful and I was given permission to hit the road to Florida. At that time, late January, I was practically the poster boy for living with pancreatic cancer. My pain was entirely under control, I was as regular as is possible for someone on a large dose of continuous release morphine, and anybody would be hard-pressed to say that could see anything wrong with me. I was feeling good. On practically the day the stent was put in, I began having pain in my upper stomach. I even have an email dated from that time to my medical oncologist complaining of this pain and saying that it needed to be dealt with before I left on my road trip. I was told by the gastroenterologist that this was pain associated with the stent and that it would go away and I was cleared for my road trip. Initially, once I left, I dealt with the pain through rather large doses of my “breakthrough” medication, dialudid. When, 10 days into the vacation, I ran out of Dilaudid, I was forced to deal with the pain which had become considerable. I went to Emergency a few times on the way back home and went to Emergency two days after I returned home; this resulted in a 2 ½ week hospital stay. They could not find out what was causing the increased pain, because they said there is no medical precedent for a stent in the bile duct which was performing the function for which it was installed, to cause this kind of pain: and CAT scans showed no evidence of any problems. They insisted my cancer was spreading rapidly and that the cancer was causing the pain. However, I had a CAT scan on January 25th, just before the stent was installed, which actually showed that my tumor was shrinking. It seems unnatural, even given the aggressive nature of pancreatic cancer to go from being an individual who was virtually pain-free to being a pain-wracked basket case virtually overnight. My question (finally) to anyone out there is this: have any of you experienced anything remotely similar where the placement of a plastic stent in the bile duct has wrought this kind of havoc. And, if so, how was the problem resolved?"