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Pancreatic Cancer

What Should I Expect In Stage IV Cancer?

01/10/2008

Question:

This may be a difficult question to answer, but please give it a try! My husband was diagnosed in 4/07 with stage IV pancreatic cancer (mets to liver). He was started immediately on Gemzar and Tarceva. His tumor markers dropped considerably over the first 6 months of treatment, but then they steadily rose. His CT scans over the course of the treatment were stable (no shrinkage of tumors). As the tumor markers kept rising, my husband was having difficult time tolerating the chemo. It was decided that the chemo was no longer working. He is now taking Xeloda and seems to be tolerating it fairly well. He does not want any real aggressive treatmet due to the quality of life vs. quantity. If the Xeloda doesn`t work, what can we expect as far as the progression of the disease? He is not due for another tumor marker for 2 more weeks, and the next CT scan will be in Feb. Is it pancreatic failure or the liver failure that usually causes death? Despite two large tumors in the liver, his LFT`s are normal, exept for the LD. The only pain he has is new. It seems to be on his LEFT side. I'm not sure what that could be; any thoughts? Thank you for your time.

Answer:

People with pancreas cancer will usually die from malnutrition complicated by infections like pneumonia etc... Other causes include bowel obstruction or liver failure. His pain should be able to be controlled with oral medications. Talk to your treating physician regarding optimizing his medications. Also have him concentrate on his nutritional status. Good Luck.

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Response by:

Syed A Ahmad, MD Syed A Ahmad, MD
Associate Professor of Surgery
College of Medicine
University of Cincinnati