Pancreatic Cancer W/ Metastasis To The Liver

My father was diagnosed with PC in June 2006. he has recently taken FU-5 Chemo and radiation. he went back for another CT scan and it has now spread to the liver. The Doctor would not tell us the size or the stage. We are now seeking a second and third opinion. The answers we were given are not good enough. I know that there are other options out there. I have been doing a lot of research since we found out it had spread. We have a Cancer Center a few hour away that we are setting up an appointment with. This may be our only hope in getting him the proper help he needs. If you have any information for me please help.

Pancreatic Cancer that has spread to the liver is Stage 4B. Staging goes from 1 to 4B with 1 being the best and 4B being the worst. The size of the mass in the liver does not matter.

Pancreatic cancer used to be treated with 5-FU. Now it is usually treated with Gemzar. Here is an excerpt from a Univ of FL website:
"The standard chemotherapy drug for the treatment of advanced pancreatic cancer is Gemzar®, which has been shown to improve response to treatment, time to cancer progression, and survival duration when compared with the older chemotherapy drug 5-fluorouracil.[1] In a clinical trial comparing Gemzar® and 5-FU, Gemzar® produced significant improvement in disease-related symptoms, as well as prolonging survival. The number of patients surviving one year after treatment with Gemzar® was 18%, compared to only 2% with 5-FU."
Excerpt taken from: http://www.ufscc.ufl.edu/patient/content.aspx?section=ufscc&

Radiation can also help, except in the liver. Pancreatic mets in the liver cannot be radiated without destroying the liver, so radiation to the liver is not an option.

Stage 1 pancreatic cancer has the potential for being cured with a Whipple procedure (big surgery). Stages 2-4 are generally considered to be incurable. Sadly, most pancreatic cancers at the time of diagnosis are stage 2-4.

I agree that getting a second opinion is a good idea, given that your dad got 5-FU, not Gemzar. If it were my father, and his life was on the line, I would go to the ends of the earth for the best second opinion out there. In this case, the ends of the earth are located at MD Anderson in Texas, and Sloan-Kettering in New York. You can google them and even make an appointment for your dad (both sites have phone numbers to call and make appointments).

I am not an oncologist. Does anyone out there know more about 5-FU and Gemzar? Is there a good reason to still use 5-FU for PC? If you get a second opinion and they answer that question please post the answer. Thank you.

Just my two cents,
-Amnia

in metastatic disease with a good performance status there are several options. clinical trials, Gemzar + RT, Gemzar alone or Gemzar combos. With poor performance status its Gemzar or supportive care. So I dont think there is a spot for 5FU alone under current practice guidelines.

I'm sorry to hear about your Dad. I'm in the exact same position. I'm 52. I was dianosed 5/10/06. I had a Whipple surgery 6/01/06. It still spread to my liver. I had undergone surgery at a hospital other than U of C. (for the record). I just enrolled in a clinical study at the University of Chicago hospital with a Dr. Hedy Kindler, pancreatic oncologist. I began treatments one week ago.

Dr Kindler suggested there were two or three other hospitals, nationwide, that recently joined this study. Supposedly there are approximately 95 people in this study nation wide. This is a large number. I interviewed with this team on 8/14/06 and began treatment the following week. My original oncologist, who is well known and respected, suggested that I join the U of C program if I could get in. Once you begin treatment at any center you cannot switch protocals.

Do your research. I've met other people in the program and I am encouraged. The prognosis sucks, but theoretically, they are showing positive results from their work. Their goal is to extend life. My goal is to let them and hopefully someone finds a cure in the mean time.

I am receiving a three drug mixture of the drugs Gemzar, Tarceva and Avastin. You can't get this combo just anywhere. This study is being sponsored by the American Cancer Society, rather than a drug company. Good luck in your hunt. I was prepared to go anywhere in the country for care and U of C kept coming up for excellence. Other standouts are MD Anderson in Houston, and Mayo in Rochester MN, Johns Hopkins. God Bless you and your dad. If you need phone numbers, let me know.

I'm a 67 yr. old active female who has been seeing Dr's and having every test, c.t. scan, etc. I have been experiences severe abdominal distress with unbearable back pain the last six months. At my appt. this last Tuesday, my internist told me that all my organ were free of cancer. Three months later, this last Wed., I was in such distress that I was taken to hospital by ambulance. More tests and now the pancreas/liver is stage 4 cancer. It evidently came on very quick or somehow was missed. I'm still reeling and I see an oncologist next Thursday to discuss what they call, what's next. I'm on alot of pain meds and need to hear from those of U who have this disease and what hope you've found. My prayers to all of U and your families. Leta

My father has PCw/liver mets and it is in a stage 4. Back in July he was given 5FU and radiation. It did not help very much because he was only given very small doses. I took him to the H. Lee Moffitt cancer Center in Tampa Florida. He was started on a combination of three types of Chemo called GTX. It is Gemzar, Taxatere, And Xeloda. he has only had one 14 day cycle of this and from 9/5 to 9/21 his tumor marker had dropped from 9.2 to 8.6. I had to do all of the research and made him the appointment. None of his Doctors had reccommened him go to a cancer center. But now I am glad we did what we did for him. Miracles happen every day. Don't give up hope.

Although my wife is only in the early stages of chemotherapy for Stage IV disease her response to GTX therapy has been excelent. I urge all patietns to explore this treatment with their oncologists. From our perspective it is a significant leap forwards for the management of theis disease.

my mother went to the hospital ic Oct. this year she thought she was having a gall bladder attack and so did the doctors at first till they did an xray, they saw spots on her liver and they did a biopsie and came back and said every thing was ok , the next day they did another biopsie they took samples from all 4 sides of the pancrease they then told us they found cancer and that it had metassified to the liver ,her cancer when found is at a stage 4 it is the size of a small cantaloupe this is what we were told then they started chemo , now also she had jauandice normal # is 1 and hers was 15 she started taking a chemo called xeloda this is a pill form she took 2 a day for 10 days and an iv chemo twiced called gazmer after her first found her jauandice went down to 2 she is able to get up eat move around some she did not get ill from the chemo , but she was ill from the weaking state she was in prior to them diagnosing the cancer. My mother has been crippled since birth so she has always doctored at least every 3 months how does someone get cancer to a stage4 and a doctor not tell this was my question and make the doctors tell you what you want to know it is your right to know GOD BLESS YOU AND YOUR FAMILY
VICKIE

my mother went to the hospital ic Oct. this year she thought she was having a gall bladder attack and so did the doctors at first till they did an xray, they saw spots on her liver and they did a biopsie and came back and said every thing was ok , the next day they did another biopsie they took samples from all 4 sides of the pancrease they then told us they found cancer and that it had metassified to the liver ,her cancer when found is at a stage 4 it is the size of a small cantaloupe this is what we were told then they started chemo , now also she had jauandice normal # is 1 and hers was 15 she started taking a chemo called xeloda this is a pill form she took 2 a day for 10 days and an iv chemo twiced called gazmer after her first found her jauandice went down to 2 she is able to get up eat move around some she did not get ill from the chemo , but she was ill from the weaking state she was in prior to them diagnosing the cancer. My mother has been crippled since birth so she has always doctored at least every 3 months how does someone get cancer to a stage4 and a doctor not tell this was my question and make the doctors tell you what you want to know it is your right to know GOD BLESS YOU AND YOUR FAMILY
VICKIE

Leta,
Happy thanksgiving, my dad's happened just as your's. Although luckly he is painfree so far. I hope all is good with you..
Carolyn