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What Does A "diffuse Fatty Atrophy Of The Pancreas" In A CAT Scan Report Indicate?
Question: Wife had a CAT scan that revealed a "marked diffuse fatty atrophy of the pancreas. There is a mass adjacent to the head measuring 2.8cm x 2.2cm which is suspicious for a neoplastic process".
What does this mean?
Is this tumor considered large or small?
CA19-9 blood tests were taken but no results yet.
What does this mean?
Is this tumor considered large or small?
CA19-9 blood tests were taken but no results yet.
Brief Answer:
Detailed evaluation is required on the lines of a possible cancer
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
The CAT scan shows the presence of a likely tumor near the head of pancreas that needs to be investigated further. Suspicious for neoplastic process indicates a possible cancer process that has been going on in the area.
Once you get the CA 19-9 tumor marker report then you might require a FNAC needle test or a biopsy to confirm the condition.
A 2.8 x 2.2 cm tumor is a considerable smaller one. A tumor bigger than 3 cm is considered larger. As it is 2.8 cm, it is almost at upper limits of the smaller category.
The marked fatty atrophy of pancreas is an age related finding.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Detailed evaluation is required on the lines of a possible cancer
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
The CAT scan shows the presence of a likely tumor near the head of pancreas that needs to be investigated further. Suspicious for neoplastic process indicates a possible cancer process that has been going on in the area.
Once you get the CA 19-9 tumor marker report then you might require a FNAC needle test or a biopsy to confirm the condition.
A 2.8 x 2.2 cm tumor is a considerable smaller one. A tumor bigger than 3 cm is considered larger. As it is 2.8 cm, it is almost at upper limits of the smaller category.
The marked fatty atrophy of pancreas is an age related finding.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Yogesh D
Thanks for the info. FYI the age of patient is 64.
Still waiting on CA19-9 results & biopsy isn't scheduled yet but have further questions:
-how can the "stage" of the tumor be determined; other than surgery?
-how are the nearby lymph nodes investigated for possible cells?
-can the state of "metastases" be ascertained without surgery?
-would the "whipple procedure still be an option if it has spread?
-is chemo even an option if it has spread?
-we are located in XXXXXXX Canada & our "wait times" are terribly long, like 45 days, on a normal basis, so are there any renowned cancer clinics with know history of " success in Canada, USA or worldwide?
Still waiting on CA19-9 results & biopsy isn't scheduled yet but have further questions:
-how can the "stage" of the tumor be determined; other than surgery?
-how are the nearby lymph nodes investigated for possible cells?
-can the state of "metastases" be ascertained without surgery?
-would the "whipple procedure still be an option if it has spread?
-is chemo even an option if it has spread?
-we are located in XXXXXXX Canada & our "wait times" are terribly long, like 45 days, on a normal basis, so are there any renowned cancer clinics with know history of " success in Canada, USA or worldwide?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
Please find my observations below
1. how can the "stage" of the tumor be determined; other than surgery?
Stage of the cancer is known by the size and extent of the tumor. Techniques like CAT scan and endoscopic ultrasound help a lot in staging of cancers in the panceres. Since your wife has no other features of cancer spread other than the mass in the head of pancreas measuring 2.8 x 2.2 cm hence she might be having Stage Ib disease if cancer is confirmed in the mass. Ultrasound or CT scan guided FNAC or biopsy is a must for making pathological diagnosis.
2. how are the nearby lymph nodes investigated for possible cells?
If the lymphnodes are big then a needle can be placed under ultrasound or CT scan guidance and the cells aspirated or biopsy done. If lymphnodes are small then they are measured in the next scan for any growth.
3. can the state of "metastases" be ascertained without surgery?
Metastasis can be found on imaging studies like CAT scan and PET CT imaging. These are non surgical methods.
4. would the "whipple procedure still be an option if it has spread?
Pancreas cancer is treated by Whipple and modified Whipple techniques when disease is resectable and has not spread. Once disease has spread locally then surgery has got a high risk and might reduce patient survival.
5. is chemo even an option if it has spread?
Chemo can be given to increase survival period in those having disease spread.
6. we are located in XXXXXXX Canada & our "wait times" are terribly long, like 45 days, on a normal basis, so are there any renowned cancer clinics with know history of " success in Canada, USA or worldwide?
In the US, best cancer treatment is offered by MD XXXXXXX cancer center
Please use the following link
http://www.mdanderson.org/locations/index.html
For pancreas cancer support in Canada you can see the following website
http://www.pancreaticcancercanada.ca/site/PageServer?pagename=homepage
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
Please find my observations below
1. how can the "stage" of the tumor be determined; other than surgery?
Stage of the cancer is known by the size and extent of the tumor. Techniques like CAT scan and endoscopic ultrasound help a lot in staging of cancers in the panceres. Since your wife has no other features of cancer spread other than the mass in the head of pancreas measuring 2.8 x 2.2 cm hence she might be having Stage Ib disease if cancer is confirmed in the mass. Ultrasound or CT scan guided FNAC or biopsy is a must for making pathological diagnosis.
2. how are the nearby lymph nodes investigated for possible cells?
If the lymphnodes are big then a needle can be placed under ultrasound or CT scan guidance and the cells aspirated or biopsy done. If lymphnodes are small then they are measured in the next scan for any growth.
3. can the state of "metastases" be ascertained without surgery?
Metastasis can be found on imaging studies like CAT scan and PET CT imaging. These are non surgical methods.
4. would the "whipple procedure still be an option if it has spread?
Pancreas cancer is treated by Whipple and modified Whipple techniques when disease is resectable and has not spread. Once disease has spread locally then surgery has got a high risk and might reduce patient survival.
5. is chemo even an option if it has spread?
Chemo can be given to increase survival period in those having disease spread.
6. we are located in XXXXXXX Canada & our "wait times" are terribly long, like 45 days, on a normal basis, so are there any renowned cancer clinics with know history of " success in Canada, USA or worldwide?
In the US, best cancer treatment is offered by MD XXXXXXX cancer center
Please use the following link
http://www.mdanderson.org/locations/index.html
For pancreas cancer support in Canada you can see the following website
http://www.pancreaticcancercanada.ca/site/PageServer?pagename=homepage
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sorry for any confusion, I renewed to extend our session as I wanted to convey the results of the CA19-9 blood test- it came back with a 9. Our family doctor said under 26 is normal. So what does this mean?
-it isn't a cancerous mass?, as the body system isn't trying to reject it?
-or that the cancer hasn't spread?
We still haven't been assigned a date for the biopsy. But many thanks for the link to the pancreatic center in Canada; they referred us to the XXXXXXX XXXXXXX hospital in Toronto & they claim to only have a 1 week waiting period
-it isn't a cancerous mass?, as the body system isn't trying to reject it?
-or that the cancer hasn't spread?
We still haven't been assigned a date for the biopsy. But many thanks for the link to the pancreatic center in Canada; they referred us to the XXXXXXX XXXXXXX hospital in Toronto & they claim to only have a 1 week waiting period
Brief Answer:
CA 19-9 normal means less likelihood of pancreatic cancer
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
The CA 19-9 level is normal and this means that there is less likelihood of the mass to be a cancer. It is a cancer marker and a high value indicates probability of cancer. However you should discuss the mater with doctors at the cancer hospital and get a biopsy scheduled quickly. This is because a normal CA 19-9 can rarely be a cancer and it must be treated should it be one.
It does not mean anything about system rejecting it.
There are patients who have the CA 19-9 value more than 1000 and they have a higher stage of pancreatic cancer.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
CA 19-9 normal means less likelihood of pancreatic cancer
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
The CA 19-9 level is normal and this means that there is less likelihood of the mass to be a cancer. It is a cancer marker and a high value indicates probability of cancer. However you should discuss the mater with doctors at the cancer hospital and get a biopsy scheduled quickly. This is because a normal CA 19-9 can rarely be a cancer and it must be treated should it be one.
It does not mean anything about system rejecting it.
There are patients who have the CA 19-9 value more than 1000 and they have a higher stage of pancreatic cancer.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok, we met with doctor/ surgeon in Toronto & the CT scan revealed on spot on the pancreas now 3.2cm x 2.6cm, which is 10% larger than 3 weeks ago. The pancreas didn’t look normal itself, was flatter, irregular, surrounded by fatty tissue, could not be certain that it is cancer, is normally more distinct, but radiologist said liver & lungs looked normal, no spreading.
The team decided to operate vie resectioning with the whipple procedure. Said it’s a neoplasm, uncertain if its cancer or not, are not planning to do a biopsy, wouldn’t change the need to operate.
We see the surgeon again on Wed, 1 more blood test to be taken.
Problem is they can’t do the operation sooner than 4 weeks. Dianne is now experiencing constant severe pain, lost appetite etc.
Some questions:
-is there a serious danger in waiting the 4 weeks? Is it normal to wait this long?
-if pancreas is resectioned & tumour removed, does this mean the cancer (if it was cancer) is gone?
-is it normal to follow with chemo or radiation? Or could chemo be done while we wait
Suggestions?
Ken Kropf
21 Lunor Court
Tavistock, ON
N0B 2R0
519-655-2009
Cell 519-301-2510
The team decided to operate vie resectioning with the whipple procedure. Said it’s a neoplasm, uncertain if its cancer or not, are not planning to do a biopsy, wouldn’t change the need to operate.
We see the surgeon again on Wed, 1 more blood test to be taken.
Problem is they can’t do the operation sooner than 4 weeks. Dianne is now experiencing constant severe pain, lost appetite etc.
Some questions:
-is there a serious danger in waiting the 4 weeks? Is it normal to wait this long?
-if pancreas is resectioned & tumour removed, does this mean the cancer (if it was cancer) is gone?
-is it normal to follow with chemo or radiation? Or could chemo be done while we wait
Suggestions?
Ken Kropf
21 Lunor Court
Tavistock, ON
N0B 2R0
519-655-2009
Cell 519-301-2510
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. Cancer of the pancreas is a challenging diagnosis and it is important to confirm that we are dealing with a cancer before starting treatment. In the pancreatic cancer patients I have come across so far, those who have the tumor in the head region have a better chance of cure.
2. In tumor of head region, surgery is the best option. It is to be done in experienced hands and if a 4 week wait is required in a cancer hospital then its worth it. We do not want complications for Dianne and wish that she recovers well after the surgery. I would say 4 weeks doesnt matter as long the surgery is being done by a team experienced in cancer surgery. The whipples surgery requires a period of rest and recovery that can take a few weeks.
3. I can understand the pain that she is in. Dianne is going through a lot of stress at present. She needs to be told that the cancer is still not confirmed and that we will help her fight the condition should cancer be confirmed after surgery. In my own experience, family support and positive thinking is important for any patient who is facing the cancer dilemma.
4. We have to wait for the biopsy results after surgery is done. Though the cancer is removed after doing resection, there can still be microscopic invasion which is invisible to the eye.
5. Ethically chemotherapy or radiation cannot be given to any patient unless a cancer is confirmed. This is the reason aggressive treatment is given after cancer is confirmed. Every cancer patient will have a different treatment course as decided by the treating doctor.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Please find my observations below.
1. Cancer of the pancreas is a challenging diagnosis and it is important to confirm that we are dealing with a cancer before starting treatment. In the pancreatic cancer patients I have come across so far, those who have the tumor in the head region have a better chance of cure.
2. In tumor of head region, surgery is the best option. It is to be done in experienced hands and if a 4 week wait is required in a cancer hospital then its worth it. We do not want complications for Dianne and wish that she recovers well after the surgery. I would say 4 weeks doesnt matter as long the surgery is being done by a team experienced in cancer surgery. The whipples surgery requires a period of rest and recovery that can take a few weeks.
3. I can understand the pain that she is in. Dianne is going through a lot of stress at present. She needs to be told that the cancer is still not confirmed and that we will help her fight the condition should cancer be confirmed after surgery. In my own experience, family support and positive thinking is important for any patient who is facing the cancer dilemma.
4. We have to wait for the biopsy results after surgery is done. Though the cancer is removed after doing resection, there can still be microscopic invasion which is invisible to the eye.
5. Ethically chemotherapy or radiation cannot be given to any patient unless a cancer is confirmed. This is the reason aggressive treatment is given after cancer is confirmed. Every cancer patient will have a different treatment course as decided by the treating doctor.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Many thanks. Just got a call this morning that surgery time became available for this Thursday, will try to keep in touch.
We will learn the extent of the situation & be anxious for follow-up treatment. We may opt for alternate "low dose, multiple chemos but will let the doctors direct us.
We will learn the extent of the situation & be anxious for follow-up treatment. We may opt for alternate "low dose, multiple chemos but will let the doctors direct us.
Brief Answer:
Biopsy report is most important
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Good to know that they have arranged for an early surgery. Hope the surgery goes as planned and that the lesion turns out benign.
Once the surgery is over, the biopsy report is most important as you know this will guide the rest of the treatment. Hoping for the best.
Please do keep in touch.
Regards,
Dr.Vivek
Biopsy report is most important
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
Good to know that they have arranged for an early surgery. Hope the surgery goes as planned and that the lesion turns out benign.
Once the surgery is over, the biopsy report is most important as you know this will guide the rest of the treatment. Hoping for the best.
Please do keep in touch.
Regards,
Dr.Vivek
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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