Sign-in to Ask A Doctor - 24x7
OR
Sign in with GoogleGet your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
What Does This Pathology Report Signify?
Helo dr. I am a 59 year old man who was recently diagnosed with stage 1 pancreas cancer. on april 17 2017 a staging laproscopy and panceaduodectomy (Whipple procedure) were perfomed . I was fortunate enough to have a general practitioner who was on the ball and got me into the correct test asap The procedures were were perfomed in RI by Kevin P Charpentier MD. The final pathology report showed the tumor size 1.6 x1.0 x1.0 confined to the pancreatic head. 35 lymth nodes tested no cancer. the only risky diagnoses from the pathology report according to my hemotologist Howard P Safron, MD. * Invasive ductal adenocarcinoma moderate to poorly differentiated with focal signet ring cell features *Lymphovascular invasion Present *Perineural invasion Present Taking mostly these findings into account Dr saffron recommends that I can elect Kemo therapy with traditional drug gemcitabine. or join in their study with a combonation of drugs called Folfox -A (NCT#:0000) The study drugs are much more toxic but he seems to suggest I am healthy enough and my chances for beating this cancer are better with the study meds. Dr Safron is well respected and took some time making sure me and my wife new what he was seeing. I guess what I am asking is for another opinion. It is the middle of the night and my mind is full of questions, any helpful feedback whould be appreciated Respectfully, William Oneill YYYY@YYYY
Thu, 18 Jan 2018
Hello,
I would also say that you are fortunate enough to be diagnosed in stage I. In my practice i hardly see a stage I pancreatic ca. I agree that you had underwent surgery as per standard recommandations. And your final histopathology report has few advers markers like perineural and lymphovascular invasion.
Coming to adjuvant treatment after surgery every organization recommands some form of treatment even in stage I disease be it single drug, two drugs or chemoradiotherapy. What I would recommand is to get CA19.9 and CT post surgey as they have progmostic importance.
In my practice we usually go ahead with gemcitabine as single agent. Combination therapy is currently used in advanced disease and it is under trial in adjuvant setting. So if you want to go ahead with combination treatment you should take part in a trial.
Lastly what i noticed is you had underwent surgery in april 2017. What is recommanded is to start adjuvant treatment within 8 weeks, maximum upto 12 weeks. So if you are beyond this period then taking treatment now may not change disease process.
I will be happy to answer any of your queries.
Thank you,
I would also say that you are fortunate enough to be diagnosed in stage I. In my practice i hardly see a stage I pancreatic ca. I agree that you had underwent surgery as per standard recommandations. And your final histopathology report has few advers markers like perineural and lymphovascular invasion.
Coming to adjuvant treatment after surgery every organization recommands some form of treatment even in stage I disease be it single drug, two drugs or chemoradiotherapy. What I would recommand is to get CA19.9 and CT post surgey as they have progmostic importance.
In my practice we usually go ahead with gemcitabine as single agent. Combination therapy is currently used in advanced disease and it is under trial in adjuvant setting. So if you want to go ahead with combination treatment you should take part in a trial.
Lastly what i noticed is you had underwent surgery in april 2017. What is recommanded is to start adjuvant treatment within 8 weeks, maximum upto 12 weeks. So if you are beyond this period then taking treatment now may not change disease process.
I will be happy to answer any of your queries.
Thank you,
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer.
For a more detailed, immediate answer, try our premium service
[Sample answer]
Related questions you may be interested in
Loading Online Doctors....