Adjuvant therapy for resected stage IA adenocarcinoma

CT scans revealed I had a 3cm mass in the neck of my pancreas.  I had a distal pancreatectomy in late December.  The very good news came in the postoperative pathology report.  The adenocarcinoma was only 4mm in size.  The remainder of the mass was pancreatitis.  Surgical margins were clear.  22 lymph nodes removed showed no malignancy.  No other metastasies were detected.  This resulted in the cancer being staged pT1,pN0,pM0, or stage IA.

The only seeming negative item on the pathology was that the tumor abutted, but did not surround, the superior mesenteric artery.

I feel very fortunate and blessed to have caught this early and received a hopeful report.

My first recommendation from an oncologist was for radiation plus 5FU chemotherapy.  He did not think Gemzar was appropriate.

I will get a second opinion from another oncologist this week.  Any thoughts from any of you here?

The "vaccine" being tested now seems like a very good idea to me, but I had a prior splenectomy, so it seems I would be excluded from that test, which is very disappointing.

Thank you for any advice and God bless all of you involved in fighting this disease.

On 1/29/2007 Amanal wrote:

CT scans revealed I had a 3cm mass in the neck of my pancreas.  I had a distal pancreatectomy in late December.  The very good news came in the postoperative pathology report.  The adenocarcinoma was only 4mm in size.  The remainder of the mass was pancreatitis.  Surgical margins were clear.  22 lymph nodes removed showed no malignancy.  No other metastasies were detected.  This resulted in the cancer being staged pT1,pN0,pM0, or stage IA.

The only seeming negative item on the pathology was that the tumor abutted, but did not surround, the superior mesenteric artery.

I feel very fortunate and blessed to have caught this early and received a hopeful report.

My first recommendation from an oncologist was for radiation plus 5FU chemotherapy.  He did not think Gemzar was appropriate.

I will get a second opinion from another oncologist this week.  Any thoughts from any of you here?

The "vaccine" being tested now seems like a very good idea to me, but I had a prior splenectomy, so it seems I would be excluded from that test, which is very disappointing.

Thank you for any advice and God bless all of you involved in fighting this disease.

You are indeed luck to have caught this so early.  You would be a candidate for some type of chemo or chemo + radiation.  There are choices which dont really impact survival much, so its up to the ONC or you, if you have a preference.  I think radiation + 5FU would be fine.  The vaccine is still in clinical trials and has shown about a 6 month survival advantage.  The only exclusion criteria which may apply to you is any type of immune supression which may include splenectomy.  You might check with the trials to see if that is indeed the case.