Whipple / Infection / Liver Lesion

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Whipple / Infection / Liver Lesion

by Strong4dad on Wed Aug 23, 2006 12:00 AM

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My dad is 58 yrs old. He was dx with PC in May 06 and had the whipple in July 06, where a 3.4 cm tumor was removed from the head of the pancreas, the duodenum and the gallbladder removed, 3 out of the 11 lymph nodes removed were positive, liver intact and all margins negative. During the surgery it was discovered that the tumor was growing on the base of pancreas and on the superior mesenteric artery. The surgeon cleaned out as much as he could on the MSA, but he felt there were microscopic cells left behind. Pathology report, confirmed those findings. Four weeks post whipple he developed an infection on the surgical incision and was put on oral antibiotics for ten days. Two days ago he went in for a follow-up and the surgeon felt he needed to be hospitalized for a few days to do IV antibiotics. They did a CT scan this morning and discovered that the infection was superficial and not too deep, which is good news. Unfortunately, they found a small lesion in his liver. (This is what has me more concerned) Does that mean that cancer has spread to the liver? Can someone please inform me. He will be starting chemo/radiation (that was the plan prior to the infection) with standard treatment for PC and also participating in a clinical trial. It will all take 6 months. It has been 7 wks since surgery and he is slowly recovering. He is eating small frequent meals, with tons of protein, on insulin (he has been diabetic for 5 yrs and oral meds, but his MD feels he will not be on insulin for too long), takes enzymes to help with digestion, also down to two vicodin a day for the pain on his back. Up to this point, I had been very optimistic, but now I am scared. Please, any advice, comments, questions are appreciated. Silvia


by Jroge on Wed Aug 23, 2006 12:00 AM

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My 74 yr. old mother had the whipple,(April '06) and you know it is a major surgery. Recovery takes a long time. She was lucky to have no infection, but she lost 45 lbs from April to the present. The chemo/radiation started out easy, got more difficult, and the recovery isn't quick. So, you may face a rocky road ahead, but for a good outcome, it is worth it. Yes, the cancer can definitely spread, but the treatment will deal with that, too. I hope your father isn't alone. Good luck.


by Amnia on Fri Aug 25, 2006 12:00 AM

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You asked "Does that mean that cancer has spread to the liver?" Sadly, almost certainly the answer to that question is yes. The liver is usually the second place pancreatic cancer spreads to (the first is the local lymph nodes surrounding the pancreas). The only way to know for sure would be to biopsy the liver. This is a slightly dangerous procedure, due to the risk of bleeding. Given that 3 lymph nodes were positive and that the margins were positive ("they left microscopic amounts of cancer behind"), I doubt they will do a biopsy of the liver. I think they will repeat the scan in a month or so. If it is cancer, the mass in the liver will get larger and more liver masses may turn up. Let's hope I am wrong, it wouldn't be the first time, -Amnia

Strong Dad

by Dave_b on Sat Aug 26, 2006 12:00 AM

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Silvia, I'm 52. I had a Whipple 06/01/06. The PC was detected in my liver 8/01/06. I am currently enrolled in a Clinical Trail at the University of Chicago which is sponsored by the American Cancer Assoc. I just began Chemo 8/22/06, 11 weeks post op. There is a three drug regimen that I am receiving, Gemzar, Tarceva and Avastin. I am psyched about the clincal trial but the disease is a nasty one. I'm stage 4 and am looking to gain every day possible that I can, in that, each day is a day closer to a cure. Lot's of good things on the horizon, for me, I wish the horizon was a little closer. God Bless You and Strong Dad. Let me know if you need any phone numbers.

Thank You Dave b.

by Strong4dad on Mon Aug 28, 2006 12:00 AM

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I sincerely appreciate your reply. My dad was going to participate in a clinical trial, but due to his infection, he is no longer eligible. (My understanding is that he needed to begin therapy 8 wks post-op). Could there be other clinical trials out there for him that his oncologist has not told us about? He is now 8 wks post op and his wound needs to heal completely before he can begin therapy, so we are looking at another 4 weeks or so. And I believe he will only be on Gemzar once he can begin treatment. How do you feel now that you have started your treatment? Do you have any advice for my dad? You are so right about this nasty disease. It has changed our lives forever. God Bless you too. I would also appreciate phone numbers.

Stay Hopeful!

by Oliver4222001 on Fri Oct 13, 2006 12:00 AM

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Hi, I just came across your question and it's almost 2 months from the date of posting. I hope your dad is recovering. If the dr did not say it's cancer, don't assume the worst. Similar situation with my mom who is 59, stage 3. turned out the "cloudy" spots on her liver were puss pockets from a bacterial infection. this was confirmed with a biopsy from the spots. it wasn't too complicated though they did hospitalize my mom 3 weeks for observation. she was on IV antibiotics the whole time. Stay hopeful! Prayers and positive thoughts to you.
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