Pancreatic Cancer - localized inoperable

My brother in law was operated on by Dr. Watkins this past Tuesday, October 16, 2012. He had a nanoknife procedure. He is in a tremendous amount of pain, but since the whipple was not a possibility because the tumor had extended into the main blood vessels, this was the only option. My sister, who is his wife, and the children are very worried. I just hope all this suffering is worth it, but Dr. Watkins told my sister that in 1/3 of the cases the tumor comes back. He also said that he has  only one patient who is still alive after having the nano knife surgery perfomred six years ago, but this is an "enigma." That sounds pretty depressing. I mean calling it an "enigma," basically means that the doctor does not know how he could still be alive; it's a puzzlement to him. Anyway, that's the way I interpret it. 

I was rather let down because before my brother in law had the nanoknife surgery, his oncologist said that his cancer markers came down 75%. However, when they did the CT scan, the tumor had not shrunk. It had not grown, but it had not shrunk either.

Does anyone know why the markers would have gone down 75% but the tumor not shrunk?

I am just hoping with all my heart that this nanoknife procedure keeps him alive until they come up with something else. I believe that John Hopkins is having success with a certain vaccine for pancreatic cancer, but I do not know for what stage. Does anyone out there know anything else about it?

Heartfelt regards for everyone who has this terrible cancer, or loves someone who has it!

Lucilliana

My husband had the Nanoknife  by Watkins last year. Six months after chemo stopped it came back somewhere else.I think the original tumor is dead. The vaccine at Hopkins and other places is for resected or whipple patients within 8 weeks of  the operation. Look up GVAX clinical trial on NCI website. You can get in touch with Hopkins or other places that are doing the trial. The NCI site lists all the other places.  (National Cancer Institute) How many and how lond are Watkins other patients still here?. We are still here at 18 months anyway.

I'm by no means an expert in nanoknife. All I know is from what I've read online. However, it looks like nanoknife is a procedure that zaps the tumor with electricity to try and kill the tumor. I'm guessing that the tumor can still remain after the procedure and would simply be a 'dead mass?'  If cancer markers are down, this could mean that the tumor is not as active as it was before?

But regarding the inoperable nature of your brother-in-law's tumor, I have read about some cases of borderline resectable patients that are put into the resectable category by receiving chemo/radiation prior to surgery. The chemo/radiation can sometimes shrink the tumor away from blood vessels that initially classified a patient as unresectable. I have even read about some cases where the doctors can do vascular surgery for cases where tumors have grown into blood vessels. I don't want to give false hope, however. These cases were all in the borderline resectable category. 

I'm so sorry your family has been affected by pancreatic cancer. In the mess of all of the doctors, knives, and needles, I hope your family is able to make it through the ordeal.

Best of luck.

Regarding Nanoknife surgery.  I had this operation performed by Dr. Robert Martin at the U. of Louisville on 1/16/12.  My tumor was "inoperable", with by initial diagnosis being done on 2/16/10.  The surgery also removed several metastisis.  There was no other option for me.

Prior to the nanoknife surgery I had the standard 5-fu and radiation treatment which did not shrink the tumor at all.  In fact it grew.  I followed this up with two different clinical trials which basically kept the cancer in check, except for developing a metastisis on my omentum.

Getting the results of the first CT scan after the surgery Dr. Martin declared the tumor dead.  He was unable to remove it and said it would show up as a mass in future CT scans and that if would take years to dissolve naturally.  Yes, I had lots of pain initially but after two weeks was in little pain.  My cancer markers went from above 400 to less than 20 two months after the surgery.  I had six months of follow-up chemo (Gemzar) starting 1  month after the surgery.  My latest PET scan done in Sept. shows no sign of active cancer.

There is hope!! Just keep praying!

Bill

Lucilliana- You need to check out the Johns Hopkins pancreatic discussion site.  There you can find people that have had their tumors shrunk away from the arteries, who have had the nano knife surgery and is still alive, and some are even being considered for whipples where they were given no hope for one.  We all know the statistics but someone has to fall in the success percentage, right?  Praying for you and your family

http://pds17.pathology.jhmi.edu/N/n.web?EP=N&URL=/MCGI/SEND1^WEBUTLTY(199,8)/1499542478

On Oct 20, 2012 8:10 PM Lucillina wrote:

My brother in law was operated on by Dr. Watkins this past Tuesday, October 16, 2012. He had a nanoknife procedure. He is in a tremendous amount of pain, but since the whipple was not a possibility because the tumor had extended into the main blood vessels, this was the only option. My sister, who is his wife, and the children are very worried. I just hope all this suffering is worth it, but Dr. Watkins told my sister that in 1/3 of the cases the tumor comes back. He also said that he has  only one patient who is still alive after having the nano knife surgery perfomred six years ago, but this is an "enigma." That sounds pretty depressing. I mean calling it an "enigma," basically means that the doctor does not know how he could still be alive; it's a puzzlement to him. Anyway, that's the way I interpret it. 

I was rather let down because before my brother in law had the nanoknife surgery, his oncologist said that his cancer markers came down 75%. However, when they did the CT scan, the tumor had not shrunk. It had not grown, but it had not shrunk either.

Does anyone know why the markers would have gone down 75% but the tumor not shrunk?

I am just hoping with all my heart that this nanoknife procedure keeps him alive until they come up with something else. I believe that John Hopkins is having success with a certain vaccine for pancreatic cancer, but I do not know for what stage. Does anyone out there know anything else about it?

Heartfelt regards for everyone who has this terrible cancer, or loves someone who has it!

Lucilliana

This is from AngioDynamics website, "A medical device called the NanoKnife by AngioDynamics, an innovator in the medical device field, is being questioned by members of the medical community because the device was fast-tracked by the Food and Drug Administration (FDA), and was approved without clinical studies in 2008. Essentially, the device went from animal testing straight to the market of hospital interventional radiologists and oncologists." - I don't think many nanoknife procedures were done 6 years or more ago thus the long-term success is actually unable to be determined at this time.  My husband had the nanoknife in December 2011 and is doing great!  I hope to have him a long time!  Your brother-in-law did not have the whipple?  Dr. Martin performed the Nanoknife on the part of the tumor which involved the artery and the whipple on the rest of the tumor removing 1/2 of the pancreas, some of the stomach, etc.  Pancreatic cancer has some bleak statistics, but there is hope due to the nanoknife.  I am grateful for it and for Dr. Robert Martin. Praise the Lord for Dr. Martin for trying what other Doctors said was not possible.

On Oct 20, 2012 8:10 PM Lucillina wrote:

My brother in law was operated on by Dr. Watkins this past Tuesday, October 16, 2012. He had a nanoknife procedure. He is in a tremendous amount of pain, but since the whipple was not a possibility because the tumor had extended into the main blood vessels, this was the only option. My sister, who is his wife, and the children are very worried. I just hope all this suffering is worth it, but Dr. Watkins told my sister that in 1/3 of the cases the tumor comes back. He also said that he has  only one patient who is still alive after having the nano knife surgery perfomred six years ago, but this is an "enigma." That sounds pretty depressing. I mean calling it an "enigma," basically means that the doctor does not know how he could still be alive; it's a puzzlement to him. Anyway, that's the way I interpret it. 

I was rather let down because before my brother in law had the nanoknife surgery, his oncologist said that his cancer markers came down 75%. However, when they did the CT scan, the tumor had not shrunk. It had not grown, but it had not shrunk either.

Does anyone know why the markers would have gone down 75% but the tumor not shrunk?

I am just hoping with all my heart that this nanoknife procedure keeps him alive until they come up with something else. I believe that John Hopkins is having success with a certain vaccine for pancreatic cancer, but I do not know for what stage. Does anyone out there know anything else about it?

Heartfelt regards for everyone who has this terrible cancer, or loves someone who has it!

Lucilliana

My husband's cancer markers fell from 2507 down to less than 3!  Dr. Martin told us the tumor is dead, but it doesn't necessarily disappear after the Nanoknife.  The body absorbs some of it, but the rest is just scar tissue and will always show up on the CT scan.  Local doctors think this is a reoccurence when they see it, but an experienced radiologist knows what to expect.   The vaccine is not available yet unless you are within 8 weeks of having the nanoknife. 

On Oct 22, 2012 8:02 PM wcroeh wrote:

Regarding Nanoknife surgery.  I had this operation performed by Dr. Robert Martin at the U. of Louisville on 1/16/12.  My tumor was "inoperable", with by initial diagnosis being done on 2/16/10.  The surgery also removed several metastisis.  There was no other option for me.

Prior to the nanoknife surgery I had the standard 5-fu and radiation treatment which did not shrink the tumor at all.  In fact it grew.  I followed this up with two different clinical trials which basically kept the cancer in check, except for developing a metastisis on my omentum.

Getting the results of the first CT scan after the surgery Dr. Martin declared the tumor dead.  He was unable to remove it and said it would show up as a mass in future CT scans and that if would take years to dissolve naturally.  Yes, I had lots of pain initially but after two weeks was in little pain.  My cancer markers went from above 400 to less than 20 two months after the surgery.  I had six months of follow-up chemo (Gemzar) starting 1  month after the surgery.  My latest PET scan done in Sept. shows no sign of active cancer.

There is hope!! Just keep praying!

Bill

Hello wcroeh: I was hoping you could tell me more about your condition, the pancreatic cancer with metastisis...my father has stage 4 pancreatic cancer which has spread to his liver. We contact Dr. Martin in Louisville just this Monday about possibly doing the Nano-Knife IRE procedure & he said he doesn't recommend it for patients with metastasis. I've read several stories however of individuals with mets to the liver who had the procedure done successfully so I'm not understanding why Dr. Martin won't help my father. I've even read stories of Dr. Martin performing the procedure on people with metastasis so I'm quite confused why my father was rejected so quickly. Can you tell me more about your case? I would desperately appreciate it. God Bless Ashley

We are contemplating having the nanoknife. My husband is not able to have surgery and the surgeon suggested the nanoknife.  The tumor has not gone to other organs as this time and he has had folfirinoz, gemzar, and radiation. He was diagnosed July 2011. Any information on the nanoknife would be gratefully appreciated.

I just read your message and wish your brother in law all the best. May God Bless him a full and speedy recovery. 

Nutrition plays an important role in cancer prevention and treament. Good nutrion helps to boos immune system and detoxify our body. Please don't discount nutrion as a part of recovery.

Another important part is exercise. I know while a person is sick, it is difficult to do exercise. However; 5-10 ten minute walk two to three times a day will help to maintain physical and mental heealth. Exercise also boosts immune system.

Another suggestion is to read about alternative and complimentary treatments. Read about Dr. Bruzynski in Houston. Dr. Ralph in New York. There are numerous videos on YouTube. Please watch them. Watch a video on YouTube about Angiogenesis.

I am not an MD or Microbiologist or Biochemist. I am an ordinary human being and one of my brother was diagnosed with Pancreatic Cancer two years ago.

Good Luck and please keep us posted.