Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

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Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Wed May 01, 2013 12:45 PM

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Is there any treatment that can help?

I've been reading several success stories, but few include which type of pancreatic cancer it is that was 'cured'. Also when mentioning chemo it would be helpful to know which exact drugs.

Thank you,

EM

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by aus6321 on Wed May 01, 2013 04:34 PM

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It's kind of hard to say what is 'cured' with pancreas cancer. Some people are in the 'No Evidence of Disease' category.  If they are fortunate, they stay in that category for the rest of their lives... the span of which is not dictated by cancer.

Some people have tumors that stop growing/shrink in the presence of chemo.  If they can continue to tolerate the chemo, they too are fortunate in that their cancer is controlled and not causing any more damage.  Of course, NED is is still better, but I think this is probably the best some can ask for.

I've read of FOLFIRINOX chemo treatments and ABRAXANE/Gemcitabine chemo treatments used to treat adenocarcinoma.  However, you have to realize that everyone's case is unique.  Some tumors respond well, some do not.  Some people tolerate some chemo's well, some people do not. 

I think the key is to understand what works best and working with the doctor to make sure he/she is doing the same. Understanding how the doctors use the indicators and scans to determine the progress of your cancer is always good in this regard.

Lastly, is there any option for surgery?  Is there any vascular involvement that prohibits surgery?  How about the liver mets?  Is there only one tumor in the liver?  Or are they too numerous to remove?

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by maxxschiken on Wed May 01, 2013 04:42 PM

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My wife, age 57 weighing 125 pounds and 5'0" at diagnosis with Inoperable Stage 4 Adenocarcinoma Pancreatic Cancer with metastasis to her liver in July 2011 went with a new standard treatment called folfirinox developed in France with clinical trials completed here in the U.S. and published in the New England Journal of Medicine in May 2011.  Her very first four hour infusion began in August 2011 and did not include irinotecan to see how well she tollerated the other drugs in this combo. Since she tolerated them well, irinotecan was introduced on her 2nd treatment to complete the first cycle and all four drugs (fluorouracil, leucovorin, irinotecan, and oxaliplatin) were infused throughout the 10 month duration of treatment. No breaks from treatment, from August 2011 through February 2012 she received a 48 hour infusion evey other week. Beginning in March 2012 through June 2012 it was modified to a 48 hour infusion every three weeks. 

The 5cm tumor on the body of her pancreas didn't just shrink after 19 sessions of Folfirinox it became a scar tissue with no metabolic activity. The two spots on her liver measuring 1cm each did not merely shrink either, they disappeared and never returned after her 12 session of treatment. And, since June 2012 she has not had any cancer treatments, no chemotherapy only quarterly CTscan whivh haver revealed NO evidence of new or progressive metastatic disease and No tumor recurrence.     

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Wed May 01, 2013 05:12 PM

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On May 01, 2013 4:34 PM aus6321 wrote:

It's kind of hard to say what is 'cured' with pancreas cancer. Some people are in the 'No Evidence of Disease' category.  If they are fortunate, they stay in that category for the rest of their lives... the span of which is not dictated by cancer.

Some people have tumors that stop growing/shrink in the presence of chemo.  If they can continue to tolerate the chemo, they too are fortunate in that their cancer is controlled and not causing any more damage.  Of course, NED is is still better, but I think this is probably the best some can ask for.

I've read of FOLFIRINOX chemo treatments and ABRAXANE/Gemcitabine chemo treatments used to treat adenocarcinoma.  However, you have to realize that everyone's case is unique.  Some tumors respond well, some do not.  Some people tolerate some chemo's well, some people do not. 

I think the key is to understand what works best and working with the doctor to make sure he/she is doing the same. Understanding how the doctors use the indicators and scans to determine the progress of your cancer is always good in this regard.

Lastly, is there any option for surgery?  Is there any vascular involvement that prohibits surgery?  How about the liver mets?  Is there only one tumor in the liver?  Or are they too numerous to remove?

I am inquiring on behalf of my mom. She is 74 years old. On 2/23 she was diagnosed with pancreatic cancer. On 3/13 she had the Whipple Procedure done laproscopically at the Mayo Clinic. They successfully removed the tumor from her pancreas, as well as a spot on her liver which they did not think was cancerous, but later found out it was. She is recovering nicely from surgery, but on her follow up visit to Mayo on 4/25 her CT scan revealed several new 'spots' on her liver. The cancer is adenocarcinoma. They estimated she has 4 months to live without further treatment or 6 months if she has chemotherapy using gemcitabine. Gemcitabine is the only chemotherapy the Mayo oncologist recomended for her. Further surgery is not an option they said.

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Wed May 01, 2013 05:17 PM

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On May 01, 2013 4:42 PM maxxschiken wrote:

My wife, age 57 weighing 125 pounds and 5'0" at diagnosis with Inoperable Stage 4 Adenocarcinoma Pancreatic Cancer with metastasis to her liver in July 2011 went with a new standard treatment called folfirinox developed in France with clinical trials completed here in the U.S. and published in the New England Journal of Medicine in May 2011.  Her very first four hour infusion began in August 2011 and did not include irinotecan to see how well she tollerated the other drugs in this combo. Since she tolerated them well, irinotecan was introduced on her 2nd treatment to complete the first cycle and all four drugs (fluorouracil, leucovorin, irinotecan, and oxaliplatin) were infused throughout the 10 month duration of treatment. No breaks from treatment, from August 2011 through February 2012 she received a 48 hour infusion evey other week. Beginning in March 2012 through June 2012 it was modified to a 48 hour infusion every three weeks. 

The 5cm tumor on the body of her pancreas didn't just shrink after 19 sessions of Folfirinox it became a scar tissue with no metabolic activity. The two spots on her liver measuring 1cm each did not merely shrink either, they disappeared and never returned after her 12 session of treatment. And, since June 2012 she has not had any cancer treatments, no chemotherapy only quarterly CTscan whivh haver revealed NO evidence of new or progressive metastatic disease and No tumor recurrence.     

I am very happy for your wife, and take some encouragement from her successful treatment.

When you said she tolerated them well, what does well mean? Did she have no ill effects from treatment, or were they just tolerable?

Thank you for responding to my inquiry. I've been becoming more and more discouraged.

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by maxxschiken on Wed May 01, 2013 06:15 PM

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She tolerated 19 sessions of folfirinox without a break from treatment.  Her WBC's never dropped to levels requiring a break to give the bone marrow a chance to recover.  She's somewhat of a medical anamoly as most people can only tolerate 6-7 treatments at which time the patient's white blood cells become dangerously low. 

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Thu May 02, 2013 01:03 AM

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Thank you for the information. I am so frustrated trying to figure this all out. You've been very helpful and I appreciate it. I will ask the new oncologist about this therapy when we see him on Monday.

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Fri May 03, 2013 03:10 AM

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Did your wife do anything in conjunction with the chemo such as modified diet or supplements?

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by taylors13 on Fri May 03, 2013 03:52 AM

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This story is amazing. Would love to know where and who her doctor is for future reference. God Bless your wife! I know it hasn't been easy. I lost my 70 year old mother one month ago after an eight month battle. She had successful and non complicating whipple surgery. She did 5 weeks radiation and 5 weeks xeloda. Cancer came back strong and fast. I am extremely saddened and wonder why her cancer was so fierce. Adenosquamous stage 2b at diagnosis. Good luck to your wife. Take care of yourself as a caregiver. I am a five year caregiver for my husband with brain cancer. I am extremely stressed and exhausted.

RE: Stage IV Pancreatic Cancer Adenocarcinoma Spread to Liver

by EMartin on Fri May 03, 2013 09:47 AM

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I am so sorry for your loss of you mother, and to deal with that while taking care of your husband. All I can think is you poor, poor thing.

May I ask how the radiation and chemo effected her? What her quality of life was during those 8 months?

I really don't know if we just give up, or if we keep fighting. My mom is feeling pretty well now, and I don't want to plunge her back into feeling miserable if she won't have a reasonable chance at meaningful life extension.

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