A diagnosis for pancreatic cancer can be a traumatic one but one that also catapults you into (for most of us at least) an unfamiliar world of doctors and hospitals.
You are most likely to have had your diagnosis by way of a CT scan, MRI scan or by EUS or ERCP. (If you are unfamiliar with any of these diagnostic tests, clicking on the links will take you to the relevant information pages).
Your consultant may have told you they have seen a mass on your pancreas and unless a biopsy was performed (as can be done during ERCP & EUS procedures) they may not yet know whether this mass is malignant or benign.
In this blog, I will attempt to provide answers to some of the more common questions patients have at this stage. You may well have others – so do leave them in the reply section below and we will attempt to answer them in a general sense.
Please note we are unable to comment on individual cases. If you have concerns about your own diagnosis or treatment you should always consult your own medical team who will be best placed to answer your questions.
Quite often the surgeon /physician treating you may not insist on obtaining a diagnosis of cancer. If the tumour is resectable (surgically removable) one can proceed with surgery. The resected specimen will then show the tumour histology as well as accurate staging.
It is imperative however to have histological diagnosis (benign or malignant) if the tumour is not resectable as chemotherapy can only be given to malignant tumours. A biopsy is then likely to be performed. The oncologist will not start chemotherapy without adequate histology.
The majority of pancreatic tumours are not resectable due to late presentation. The tumour growth is indeed very silent in the early stage. Quite often the tumour may be small at presentation but if it is firmly attached to important blood vessels, resection (surgery) cannot be carried out. Patient fitness to undergo major surgery is important and can be one of the reasons why surgery cannot be considered.
Surgery for pancreatic cancer can be an intense challenge to the body. One has to be optimised to the best possible condition to face this operation. The liver plays a major role in metabolism and recovery and if one is jaundiced the liver function is not at its best to aid recovery. Hence your doctor may wish to delay surgery until your liver function is optimum.
The stages of pancreatic cancer are mentioned on our web site. To simplify this I would like to state that your doctor will tell you firstly if your tumour is within the pancreas or has spread to other organs. If it’s within the pancreas he will then tell you if it can be removed or if it is locally advanced (cannot be removed). The best case is when the tumour has not spread and can be removed. Advanced tumours are those that have spread to other organs.
The management options for all stages of pancreatic cancer have increased tremendously over the years. One has to hence be optimistic and fight this cancer with the support from your Physician, Surgeon, Oncologist and all allied medical staff who will be always willing to help you.
You will not be the only one to experience this. It happens to all patients when they are given such news. You may recall being introduced to the Cancer Nurse Specialist (CNS) who may have been in the room when your doctor gave you this news. If you have this number , please call her/him and arrange an appointment to see her/him. She/he will be most willing to go through all this with you again. She/he can also arrange another appointment for you with the consultant. If you do not have her/his number please do not hesitate to call your Consultant’s secretary who will arrange another appointment with you.
These are slow growing tumours. It will not change your prognosis. This wait allows your liver function to recover and, if your doctor is building you up nutritionally it will allow you to come through the operation better.
This aspect and nutritional fitness will be covered in another blog. If you have immediate concerns, speak to your Cancer Nurse Specialist, dietitian or medical team.
- Posted by Neville Menezes on January 24, 2012
Hi! I am Neville Menezes, Trustee of Pancreatic Cancer Action.
I am a Hepato-biliary and Pancreatic Consultant Surgeon, based in Surrey, UK. I work at the Royal Surrey County Hospital, Guildford and St.Peter’s Hospital NHS Trust, Chertsey, Surrey.
In this blog, not only will I be writing about pancreatic cancer from my specialist perspective: pancreatic surgery, but I am hoping to invite guest bloggers who are pancreatic cancer specialists including oncologists, gastroenterologists, GP’s, dietitians and cancer nurse specialists to contribute too.
It is important to have a discussion on medical topics on a regular basis related to pancreatic cancer diagnostics and treatment options. This will allow us to keep abreast with concerns raised by patients and clinicians in treating this difficult cancer.
We are planning to dicuss on this blog some topics like , “What to expect after being diagnosed with pancreatic cancer”, “The people who will be looking after you from now on”, “How are patients considered for surgery”, What other options of treatment are available?” and so on.
So do come back to this blog on a regular basis to see whats on it.
Also, we would be very interested to hear what topics you would like discussed on this blog – please leave your comments below.
Yours,
Neville
- Posted by Neville Menezes on October 25, 2011
Mr Neville Menezes, MS FRCS is a Consultant Pancreatico-Biliary Surgeon. Neville is based at the Royal Surrey County Hospital NHS Foundation Trust and Ashford & St.Peter’s NHS Trust, which are both part of the Surrey, West Sussex & Hampshire (SWSH) Cancer Network.Neville is one of the founding trustees of Pancreatic Cancer Action and is the Consultant Pancreatic Surgeon to our founder, Ali Stunt.