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What Causes Severe Vomiting When Diagnosed With Pancreatic Cancer?
Question: Hello. My name is XXXXXXX My wife was diagnosed in XXXXXXX with pancreatic cancer? According to our cancer doctor, the cancer progressed and within just a couple of weeks to where she could eat or drink nothing without vomiting. To this date we are waiting bedside for her to pass. She has not eaten for 5 weeks and not drank water for 4 days. She is mostly incoherent. My question is this. If it was determined that something other than the cancer caused her vomiting, such as a large hiatal hernia, which she has, is it too late for her body to recover from the long lack of food and water? If the cause of the vomiting could be repaired, could she recover?
To continue, the cancer dr. told us that it would do no harm to wait for a month to begin chemo to shrink the tumor and do whipple surgery. However, within 2 weeks, my wife began vomiting violently. Several trips to Dr and ER gave her medication with no reason for the episodes except the cancer. What I cannot figure is this, how did she go from being able to wait a month to start treatment to being too sick to eat or drink in less than 2 weeks? She was told she had a large hiatal hernia. Could the hernia have caused the symptoms that were being attributed to the cancer? If she now as able to repair the hernia, could she recover from lack of food and water or is it too late? Please Help!!
To continue, the cancer dr. told us that it would do no harm to wait for a month to begin chemo to shrink the tumor and do whipple surgery. However, within 2 weeks, my wife began vomiting violently. Several trips to Dr and ER gave her medication with no reason for the episodes except the cancer. What I cannot figure is this, how did she go from being able to wait a month to start treatment to being too sick to eat or drink in less than 2 weeks? She was told she had a large hiatal hernia. Could the hernia have caused the symptoms that were being attributed to the cancer? If she now as able to repair the hernia, could she recover from lack of food and water or is it too late? Please Help!!
Brief Answer:
PANCREATIC CANCER
Detailed Answer:
DEAR JPHILLIPS,
I AM SORRY THAT YOUR WIFE HAS THIS PROBLEM. HIATUS HERNIA WILL MOSTLY CAUSE REGURGITATION OF FOOD AND NOT REALLY VOMITING. IN HIATUS HERNIA IF PATIENT IS SITTING UPRIGHT AND STAYS SO AFTER FOOD IT WILL NOT REGURGITATE BUT WILL PASS DOWN. FOR THIS PATIENT HAS TO SIT FOR 3 TO 4 HOURS TILL THE FOOD GOES OUT OF STOMACH AND THERE WILL BE NO VOMITING. BUT IF SHE HAS PROJECTILE VOMITING POSSIBLY THE PANCREATIC CANCER INVOLVING ITS HEAD WILL CAUSE BILE DUCT OBSTRUCTION LEADING TO THE EPIGASTRIC PAIN, VOMITING OF ACIDIC FLUID EVEN WITHOUT EATING FOOD. THIS CAN BE DETERMINED BY ONE TEST CALLED ERCP DONE BY A GASTRO ENTEROLOGIST.
SINCE SHE IS A PROVEN CASE OF CANCER OF PANCREATIC HEAD, THERE IS NO POINT WAITING FOR TREATMENT AND CHEMOTHERAPY IS NOT THAT SUCCESSFUL. WHENEVER POSSIBLE SHE NEEDS TO UNDERGO SURGERY (WHIPPLES) FOLLOWED BY STERIOTACTIC RADIOTHERAPY AND ADJUVANT CHEMOTHERAPY WHICH WILL GIVE HER LEASE OF LIFE .
FAILING TO DO SO SHE WILL GET MALNOURISHED AND EMACIATED WHICH WILL FURTHER INCAPACITATE HER FOR UNDERGOING SURGERY OR CHEMOTHERAPY.
PROPER CONSULTATION WITH GASTRO ONCOSURGEON IS ADVISABLE TO GET THE CLEAR CUT DIRECTION. IF SHE IS NOT ABLE TO EAT ORALLY PARENTRAL NUTRITION THERAPY IS RECOMMENDED TO MAKE HER SUITABLE TO STAND THE ACTUAL TREATMENT.
I HOPE I MADE THE THINGS CLEAR TO YOU.
TRULY,
DR. J. TICKU
PANCREATIC CANCER
Detailed Answer:
DEAR JPHILLIPS,
I AM SORRY THAT YOUR WIFE HAS THIS PROBLEM. HIATUS HERNIA WILL MOSTLY CAUSE REGURGITATION OF FOOD AND NOT REALLY VOMITING. IN HIATUS HERNIA IF PATIENT IS SITTING UPRIGHT AND STAYS SO AFTER FOOD IT WILL NOT REGURGITATE BUT WILL PASS DOWN. FOR THIS PATIENT HAS TO SIT FOR 3 TO 4 HOURS TILL THE FOOD GOES OUT OF STOMACH AND THERE WILL BE NO VOMITING. BUT IF SHE HAS PROJECTILE VOMITING POSSIBLY THE PANCREATIC CANCER INVOLVING ITS HEAD WILL CAUSE BILE DUCT OBSTRUCTION LEADING TO THE EPIGASTRIC PAIN, VOMITING OF ACIDIC FLUID EVEN WITHOUT EATING FOOD. THIS CAN BE DETERMINED BY ONE TEST CALLED ERCP DONE BY A GASTRO ENTEROLOGIST.
SINCE SHE IS A PROVEN CASE OF CANCER OF PANCREATIC HEAD, THERE IS NO POINT WAITING FOR TREATMENT AND CHEMOTHERAPY IS NOT THAT SUCCESSFUL. WHENEVER POSSIBLE SHE NEEDS TO UNDERGO SURGERY (WHIPPLES) FOLLOWED BY STERIOTACTIC RADIOTHERAPY AND ADJUVANT CHEMOTHERAPY WHICH WILL GIVE HER LEASE OF LIFE .
FAILING TO DO SO SHE WILL GET MALNOURISHED AND EMACIATED WHICH WILL FURTHER INCAPACITATE HER FOR UNDERGOING SURGERY OR CHEMOTHERAPY.
PROPER CONSULTATION WITH GASTRO ONCOSURGEON IS ADVISABLE TO GET THE CLEAR CUT DIRECTION. IF SHE IS NOT ABLE TO EAT ORALLY PARENTRAL NUTRITION THERAPY IS RECOMMENDED TO MAKE HER SUITABLE TO STAND THE ACTUAL TREATMENT.
I HOPE I MADE THE THINGS CLEAR TO YOU.
TRULY,
DR. J. TICKU
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
so you r saying that a 3 centimeter tumor could progress to the point of starvation in less than 3 months? She had the liver tree stint placed twice, the last one metal the week of July 4th. I asked the cancer Doctor several times about some type of feeding regimen. Her dismissed it as not possible. had that been done, perhaps she would have been able to endure chemo and radiation. Am I thinking incorrectly? I appreciate your honest and helpful answer.
I tried to ask tell the doctor that the tumor seemed to come quickly from nowhere and was he positive we could wait to begin treatment. Hee told that waiting a month would cause no ill effects.
I tried to ask tell the doctor that the tumor seemed to come quickly from nowhere and was he positive we could wait to begin treatment. Hee told that waiting a month would cause no ill effects.
Brief Answer:
PANCREATIC CANCER
Detailed Answer:
DEAR XXXXXXX
THANKS FOR REVERTING.
IF YOUR PATIENT IS WEEK, INCOHERENT, UNDER NOURISHED HOW CAN SHE TOLERATE ANY TREATMENT. WE HAVE TO MAKE CORRECTIVE MEASURES, IMPROVE HER NUTRITIONAL STATUS SO THAT SHE HAS GOOD STANDING. YOUR DOCTOR IS RIGHT THAT WAITING WILL NOT CAUSE MUCH HARM AS HE KNOWS THAT HE CAN NOT START ANY ACTIVE TREATMENT IN THIS BAD STATE OF HEALTH BUT THERE WILL BE NO BENEFIT UNLESS WE IMPROVE UPON HER PERFORMANCE STATUS. AS YOU SAY THAT STENTS ARE ALREADY PLACED, THIS MEANS THAT THE PATIENT HAS QUITE ADVANCED DISEASE.
YOUR THINKING IS INCORRECT THAT CHEMO AND RADIATION AT THIS STAGE CAN HELP. USING THESE MODALITIES AT THIS TIME WILL DO MORE HARM THAN GOOD. FOR STARTING THIS PATIENTS GENERAL CONDITION SHOULD BE GOOD.
TRULY,
DR. J. TICKU
PANCREATIC CANCER
Detailed Answer:
DEAR XXXXXXX
THANKS FOR REVERTING.
IF YOUR PATIENT IS WEEK, INCOHERENT, UNDER NOURISHED HOW CAN SHE TOLERATE ANY TREATMENT. WE HAVE TO MAKE CORRECTIVE MEASURES, IMPROVE HER NUTRITIONAL STATUS SO THAT SHE HAS GOOD STANDING. YOUR DOCTOR IS RIGHT THAT WAITING WILL NOT CAUSE MUCH HARM AS HE KNOWS THAT HE CAN NOT START ANY ACTIVE TREATMENT IN THIS BAD STATE OF HEALTH BUT THERE WILL BE NO BENEFIT UNLESS WE IMPROVE UPON HER PERFORMANCE STATUS. AS YOU SAY THAT STENTS ARE ALREADY PLACED, THIS MEANS THAT THE PATIENT HAS QUITE ADVANCED DISEASE.
YOUR THINKING IS INCORRECT THAT CHEMO AND RADIATION AT THIS STAGE CAN HELP. USING THESE MODALITIES AT THIS TIME WILL DO MORE HARM THAN GOOD. FOR STARTING THIS PATIENTS GENERAL CONDITION SHOULD BE GOOD.
TRULY,
DR. J. TICKU
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Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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