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What Causes Recurrence Of Lesions In Head Of Pancreas?
Question: Age=52 Years.
Male.
Sir,
Diagnosed Jaundice.
On 25th January,2014 undergone CT Scan.Diagnosed Pancreatic Cancer.
Ca 19.9= 117.
Undergone Whipple's Procedure on 30th January,2014.
Histopathology Report-Moderately Differentiated Andenocaricoma of Pancreas with involvement of surrounding Fat and reactive hyperplasia of nodes( 0/15 ).
T1N0M0. Tumor Size=1.5 cm.
Discharged on 19th February,2014.
Patient Stable. Hickman's Port Inserted.
Then underwent Adjunct Chemotherapy -Gemzar.
6 Cycles.
Chemo Completed in August,2014.
Ca 19.9 =Post Chemo=16.41.
1 st CT Scan in September,2014.
Ct Scan Result=
Pneumobillia is noted.
No Definite Enhancing Mass is seen in head of Pancreas.
Sub Centimeter Peri-Pancreatic Lymph nodes are seen.
Same are seen in the Messentry and Retro peritoneum.
Soft Tissue Density Omental Nodules are seen.
Ct in January,2015.
There is no definite enhancing mass see in the head of the pancreas.
Sub Centimeter PeriPancreatic Lymph Nodes are seen-probably clinically not significant.
There has been some regression in the omental nodules.
Sub Centimeter Retro-peritoneal Lymph Nodes are seen
On 1st April ,2015.
Ca 19.9 =15.43.
CBC,Liver Function Test Normal.
No Diabetes.
Kindly Advice.
Hickman's Port Still There.
When can port be removed.
Report Suggests ?
14 Months are over from Day Of Surgery.
What are Chances Of Relapse.
Male.
Sir,
Diagnosed Jaundice.
On 25th January,2014 undergone CT Scan.Diagnosed Pancreatic Cancer.
Ca 19.9= 117.
Undergone Whipple's Procedure on 30th January,2014.
Histopathology Report-Moderately Differentiated Andenocaricoma of Pancreas with involvement of surrounding Fat and reactive hyperplasia of nodes( 0/15 ).
T1N0M0. Tumor Size=1.5 cm.
Discharged on 19th February,2014.
Patient Stable. Hickman's Port Inserted.
Then underwent Adjunct Chemotherapy -Gemzar.
6 Cycles.
Chemo Completed in August,2014.
Ca 19.9 =Post Chemo=16.41.
1 st CT Scan in September,2014.
Ct Scan Result=
Pneumobillia is noted.
No Definite Enhancing Mass is seen in head of Pancreas.
Sub Centimeter Peri-Pancreatic Lymph nodes are seen.
Same are seen in the Messentry and Retro peritoneum.
Soft Tissue Density Omental Nodules are seen.
Ct in January,2015.
There is no definite enhancing mass see in the head of the pancreas.
Sub Centimeter PeriPancreatic Lymph Nodes are seen-probably clinically not significant.
There has been some regression in the omental nodules.
Sub Centimeter Retro-peritoneal Lymph Nodes are seen
On 1st April ,2015.
Ca 19.9 =15.43.
CBC,Liver Function Test Normal.
No Diabetes.
Kindly Advice.
Hickman's Port Still There.
When can port be removed.
Report Suggests ?
14 Months are over from Day Of Surgery.
What are Chances Of Relapse.
Brief Answer:
Blood test for Ca 19.9 and CT scan of whole abdomen after 3 months.
Detailed Answer:
Hi
The normal level of Ca 19.9 in the blood of a healthy individual is 0-37 U/mL.
As your pancreatic tumour marker test Ca 19.9 is 15.43 you do not need to worry and the tumour is under control.
Sub centimeter peripancreatic lymph nodes and retro peritoneal lymph nodes are very small in size in the latest january 2015 CT scan report and the previous omental nodules has decreased in size and there is no lesion seen in the head of pancreas now and your disease is under stable condition now and you are absolutely fine.
Hickmans port can be removed after 18 months of surgery.
Chances of relapse is only 25% after 1 year and i would advise you to repeat a Ca 19.9 pancreatic tumour marker blood test and CT scan of whole abdomen after 3 months.
Wishing you good health.
Regards
DR DE
Blood test for Ca 19.9 and CT scan of whole abdomen after 3 months.
Detailed Answer:
Hi
The normal level of Ca 19.9 in the blood of a healthy individual is 0-37 U/mL.
As your pancreatic tumour marker test Ca 19.9 is 15.43 you do not need to worry and the tumour is under control.
Sub centimeter peripancreatic lymph nodes and retro peritoneal lymph nodes are very small in size in the latest january 2015 CT scan report and the previous omental nodules has decreased in size and there is no lesion seen in the head of pancreas now and your disease is under stable condition now and you are absolutely fine.
Hickmans port can be removed after 18 months of surgery.
Chances of relapse is only 25% after 1 year and i would advise you to repeat a Ca 19.9 pancreatic tumour marker blood test and CT scan of whole abdomen after 3 months.
Wishing you good health.
Regards
DR DE
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Sir
Today repeated ca 19 9 levels
Ca 19 9 are 50.
Ultrasound shows recurrence in head ofpancreas.
Local recurrence -further treatment.
Survival time.
Today repeated ca 19 9 levels
Ca 19 9 are 50.
Ultrasound shows recurrence in head ofpancreas.
Local recurrence -further treatment.
Survival time.
Brief Answer:
Second line chemotherapy with FOLFIRINOX
Detailed Answer:
Hi
Since your ca 19.9 has increased and ultrsound shows recurrence in head of pancreas i would advise you to undergo second line chemotherapy with FOLFIRINOX.
In this regimen the drugs folinic acid, irinotecan, oxaliplatin and fluorouracil is used.
The median overall survival after this therapy is 11.1 months.
FOLFIRINOX is given at every 2 week interval and atleast 6 cycles needs to be given followed by reasessment with blood test for Ca 19.9 and CT scan of whole abdomen.
Major side effects of FOLFIRINOX are that it can reduce the number of white blood cells in your blood which can cause infection, bruising and bleeding, anaemia, diarrhoea and tiredness.
Discuss FOLFIRINOX regimen this with your treating physician.
If you have no more clarifications then please rate the answer close the thread.
Regards
DR DE
Second line chemotherapy with FOLFIRINOX
Detailed Answer:
Hi
Since your ca 19.9 has increased and ultrsound shows recurrence in head of pancreas i would advise you to undergo second line chemotherapy with FOLFIRINOX.
In this regimen the drugs folinic acid, irinotecan, oxaliplatin and fluorouracil is used.
The median overall survival after this therapy is 11.1 months.
FOLFIRINOX is given at every 2 week interval and atleast 6 cycles needs to be given followed by reasessment with blood test for Ca 19.9 and CT scan of whole abdomen.
Major side effects of FOLFIRINOX are that it can reduce the number of white blood cells in your blood which can cause infection, bruising and bleeding, anaemia, diarrhoea and tiredness.
Discuss FOLFIRINOX regimen this with your treating physician.
If you have no more clarifications then please rate the answer close the thread.
Regards
DR DE
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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