My brother has pancreatic cancer

Hello everyone. I came here searching for some hope and insight. On the 7th of this month, my 36-year-old brother went to see our primary-care physician thinking he had a stomach flu or food poisoning. Over the previous week or so, he had been suffering from a range of symptoms that included nausea, poor appetite, mild abdominal discomfort, generalized itching, dark-yellow urine, and diarrhea with pale-colored stool. He was checked into a local hospital that same day, and following blood tests, ultrasound, CT scan, and ERCP with stent placement and biopsy, my brother was diagnosed on the 11th with pancreatic ductal adenocarcinoma. The attending physician referred him to an oncologist who specializes in pancreatic cancer at a comprehensive cancer center. Prior to his appointment with the oncologist, which was arranged for the 17th, my brother was sent for a PET scan to determine the initial staging of the cancer and appropriate treatment recommendations.

On the day of the appointment, my brother and I were informed by the oncologist that the tumor was classified as Stage IIA with no lymph node involvement or venous/large vessel invasion. Furthermore, we were told that pancreatic cancer can be controlled only if it is detected early enough before it has spread to other organs, when it can be removed by surgery. Unfortunately, both the oncologist and the surgeon that he consulted could not recommend my brother as a candidate for surgery because the tumor had almost completely encased the superior mesenteric vein, making resection too problematic with significant risk of a fatal outcome. We were also told that the only viable treatment option for now would be neoadjuvant combination chemotherapy to down-stage the tumor by shrinking its volume to the extent that resection eventually becomes possible.

In preparation for the chemotherapy, my brother had a venous port implanted beneath the skin via the subclavian vein last week on the 24th, which, incidentally, was my birthday, and he began the very first round of chemo on, of all days, Halloween. Currently, he will be on a 28-day cycle – once a week (Mondays) for three weeks, with the fourth week off – of chemo infusions (Gemzar and Abraxane) for a total of 3 rounds (3 months).

What has me absolutely confused about this entire situation is that my brother was in a car accident back in May of this year, barely 5 months ago. He was given a detailed clinical examination including CT scan and MRI to rule out internal injuries. The radiologist did not report detecting any suspicious lesions or masses in my brother's abdominal cavity. Did she make a mistake? How could someone develop pancreatic cancer in such a short period of time?

Sorry to hear about your brother.This is a great sight for people to try and anwser your questions.I BELIEVE some cancer moves quickly.I had a whipple in july 2010 and was considered clean,by nov it was in my liver...also it is hard ti detect,you'd haft to be looking for it.

Good family support is important now.

God Bless

Rick

Tumors can be difficult to see in the pancreas, especially if they are small. When they found my husband's tumor, it was small, but had already spread to liver.

Good luck and blessings to you.

Gretchen

hi there my sister had, had all sorts of tests & symptoms, theraputic removal of gallbladder, scans, ercp & more tests, what we do know is that there deff wasnt anything there 3 months prior to her being diagnosed that could be seen on any scan or test, suposedly it is so hard to spot with other organs being in the way (she had been overweight too), but after 3 months it was the loss of appitite, loose stools then turning bright yellow that they then put a stent in her bile duct and took a scrapping while they were there, then diagnosed and had her whipple surgery within the week, she had her portal vein resected as it had been involved, her age went for her only being 41 the surgen was sure her body could cope, she bled out 3 times, and the surgery took 12 hours. After the surgery she had been told she wouldnt have made it to the following xmas with the rate of growth, 10 months!!

Alot of people say surgery is the way forward but i have read alot of other people getting chemo 1st to make surgery possible

its so shocking how fast the treatment and surgery all happen we are still trying to catch up 22 months later

am sure others will be of help to you, but your brother is on the right track now, thats the problem with pc, early detection

GB Clare

I became sick with diarhea last March and had tests and blood work and nothing showed.  Early April I became jaundiced, had dark urine, clay colored stools and ithcing within 1 week. I had blood work done again and it was really abnormal. Within a week I had a CT scan and MRI when the cancer showed on the head of  my pancreas.

This is a very deadly cancer and if found early can have a better prognosis. I had the whipple on April 27 and was told it was stage 2a with negative nodes and  margins.

I hope your brother can get the best care and have the surgery. Best of luck to him.

I was treated at a NCI comprehensive center in July 2010 for related ampullary cancer, often referred to as pancreatic, but always listed under it.  As a result, I have friends who are and others that are pancreatic cancer survivors and read/hear a lot.  My center does neoadjuvant treatment, presuming chemo (and chemo-radiation).  You might want to try and ask by calls or visit if a second center would advise same cocktail of meds, gemzar is common and if some do radiation at same time.  Sloan-Kettering in NY, MD Anderson Texas, Norris Cotton in NH, often do neoadjuvant and possibly Dr. Doug Evans who trained my surgeon (used to be at MD Anderson and can google him) may do surgery when artery involved as might some other docs.  The goal would be to asap compare options to increase surgical candidacy but I am presuming the neoadjuvant route is a good choice.  My oncologist helped pioneer that concept and I am seeing really amazing things.  I am not sure if radiation is often done as well, so my two cents make some calls... fast while following protocol.  My radiation oncologist (I had adjuvant treatment after) suspects dietary factors like animal proteins/fats as seeing pancreatic cancer in younger, and for ampullary cancer which is average age 70 yr old man, I was relatively young (and female).  I think one type of pancreatic more common in younger but adenocarcinoma in younger patients is often but not always associated with genetic disorders that increase tendency---FAP, Lynch/HNPCC, BRAC genes...  Can be tested, I was.  Different centers follow different protocol and only some surgeons have expertise to consider dealing with artery.  I  was not feeling right, vague symptoms, jogging 2 miles/day, acute pancreatitis, then got very ill very suddenly with 104.2 temp,  ... no jaundice but liver enzymes high too and CAT scan/MRI/Ultrasound all showed no mass, MRCP was normal, EUS showed some sign ducts dilated and possible bile duct obstruction but they kept saying gallstones.  In my case the ampulla the valve in or next to pancreas due to density can hide a mass, and too often 1 cm or smaller can be hidden on any scan.  I finally was so sick and not getting well after gallbladder removed, I was in very big trouble if crisis not resolved so went with ERCP which was in my case was pretty risky, but it diagnosed me and led me to surgery,...  Forget egos even my top oncologist asked if I wanted a second opinion and set it up. 

On Nov 01, 2011 8:16 PM squand wrote:

Sorry to hear about your brother.This "" target="_blank" rel="nofollow">http://brother.This " target="_blank" rel="nofollow">brother.This is a great sight for people to try and anwser your questions.I BELIEVE some cancer moves quickly.I had a whipple in july 2010 and was considered clean,by nov it was in my liver...also it is hard ti detect,you'd haft to be looking for it.

Good family support is important now.

God Bless

Rick

Thank you for your support, Rick. I hope you are doing better. To be honest, I'm still coping with the shock of my brother's diagnosis. Those were words neither of us ever expected to hear, especially since he has never touched alcohol or tobacco and has always led a healthy lifestyle. In fact, I had always assumed that pancreatic cancer was a disease of mid-to-late adulthood. At the moment, even though the tumor is currently unresectable, the oncologist is cautiously optimistic about my brother’s prognosis since the cancer was discovered fairly early and is almost certain he will respond well to the chemo. Although I’ve read that there’s a relatively high rate of recurrence concerning pancreatic cancer, I’ve come across several stories in this community and beyond about other patients in my brother’s situation who have lived several years (a few nearly 10+) past such a diagnosis.

By the way, if it's not too much trouble, would you mind reposting that link? I keep going to a dead page every time I click it. I would really appreciate it.

On Nov 01, 2011 8:52 PM Gretchenmarie wrote:

Tumors can be difficult to see in the pancreas, especially if they are small. When they found my husband's tumor, it was small, but had already spread to liver.

Good luck and blessings to you.

Gretchen

I truly hope that your husband is doing much better nowadays. Given the rather aggressive nature of pancreatic cancer, the oncologist told my brother that he was fortunate (well, as fortunate as one can be under the circumstances) that the tumor had been discovered while still at Stage II since early pancreatic cancer detection only accounts for a minority of newly diagnosed cases.As it stands, because the tumor has only spread locally without invading any regional lymph nodes and cannot be detected in other locations in the body, my brother’s chances for a successful outcome are better than naught for now. I hope things stay that way for a long time to come.

On Nov 02, 2011 1:36 AM janet10 wrote:

I became sick with diarhea last March and had tests and blood work and nothing showed.  Early April I became jaundiced, had dark urine, clay colored stools and ithcing within 1 week. I had blood work done again and it was really abnormal. Within a week I had a CT scan and MRI when the cancer showed on the head of  my pancreas.

This is a very deadly cancer and if found early can have a better prognosis. I had the whipple on April 27 and was told it was stage 2a with negative nodes and  margins.

I hope your brother can get the best care and have the surgery. Best of luck to him.

 

 

I'm so glad that you're back to good health. If my brother ends up responding effectively to the chemo and the tumor shrinks down to the point that it can be surgically removed without any adverse consequences, he should be eligible for pancreatic resection sometime in late January or early February of next year according to the oncologist. Knock on wood.

Your brother and my sister seem to have similar diagnosis and both are on the same gemzar/abraxene regimen.  Did they tell you that he was participating in a clinical trial?  As I understand it, there are only 25 people in this Stage 3 clinical trial across the country.  My sister will have her 3rd treatment tomorrow.  We too are hoping for the Whipple in late Jan or Feb, depending on the results of the chemo.  I will pray for you.