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Gastroenterology  (Expert Forum)
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pancreatic cancer, gallstones?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
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MedHelp Member's Question

pancreatic cancer, gallstones?

by joannela, Jul 18, 2005 12:00AM
I am inquiring about my father. He's 63 years old, caucasian, about 5'9' - I am not sure of his weight; he may be just slightly overweight, but not very much. Nonsmoker; though he smoked in the past, he quit more than 15 years ago. He has Type II diabetes, which is managed through oral medication. He had a heart attack 8 years ago and recovered well with a stent.  He had some restenosis 2 years ago and the area was restented and so far is fine.  For about 2 months now, he has been complaining of stomach pains, mainly after larger meals. The pain occurs mostly at night and feels like a cramping and/or burning feeling. The pain tends to wake him up and last anywhere from half and hour to a couple of hours - he rarely has pain during the day.  He had a colonoscopy and endoscopy a few weeks ago, both were negative. His doctor has prescribed Nexium, but it does not seem to have helped. I think he has had some constipation and/or diarrhea, but I'm not sure (he doesn't really talk about that with me, but he has mentioned vague "bathroom" issues). Most recently, he has been complaining of pain in his back, mainly at night along with the stomach pain, in between his shoulder blades; though he said he has had some pain in other areas of his back, he said it's mostly in his shoulder blades. When he saw his doctor last, a few weeks ago, he said to keep trying the Nexium for a few weeks and if the pain persists, they would schedule an MRI. I have done some research on this and the symptoms of pancreatic cancer and gallstone seem very similar. I have tried to reassure him, telling him I think it's his gallbladder, but I myself am very worried it's more serious, such as pancreatic cancer. Are there any symptoms that can differentiate between the two, until we get his tests?
Doctor's Answer

by Kevin Pho, MD, Jul 20, 2005 12:00AM
Gallstones certainly are suspected based on the story.  The MRI is overkill at this point - an ultrasound would be the first reasonable step.  If there is evidence of biliary dilation (which then can point to possible pancreatic diseases), then you can further evaluation with an MRCP or ERCP.  



Pancreatic cancer is manifested by a pain that can be intermittent, radiating to the back, weight loss and possible jaundice.



You can discuss the option of an ultrasound with your personal physician.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

http://www.straightfromthedoc.com
Member Comments (17)

by wassupwassabi, Jul 19, 2005 12:00AM
you can get an abdominal ultrasound to check for gallstones; pancreatic cancer I'm not sure about.  If they find gallstones I know there's a home remedy involving olive oil and lemon juice to move gallstones out of the body (you'd need to ask the doc if he/she thinks it's safe to do that, although it seems to me it would be safer than getting an organ removed)

by astros18, Jul 19, 2005 12:00AM
I have done the liver flush and had wonderful results. I passed hundreds of stones. I did Dr. Hulda Clarks flush. If you believe in chiropractic, I would encorage you to give that a try. Acid reflux can cause terrible pain in your back between the shoulder blades. If he does have "bathroom issues" then a colon cleanse will probably help. If his colon is backed up, that could be the cause of his burning stomach. Digestive food enzymes and a good probiotic won't hurt either.

by surgeon, Jul 19, 2005 12:00AM
two points: first, the symptoms are highly suggestive of gallstones. Pancreatic cancer is much more likely to cause steady pain, and usually there's weight loss. Ultrasound would, for most docs, be the first test, not MRI



Second: the "flush" advice, and the lemon/olive oil thing are totally bogus and useless. Take enough olive oil and lemon, and you'll pass curds of oil that quacks will tell you are stones. It's entirely fake. Want proof? If an ultrasound shows gallstones, try those methods, pass all the weird things you want, and ask for another ultrasound (it's an expensive proof, I'll admit: but I know from experience with thousands of gallstone patients what works, what doesn't, what fools the foolable.

by astros18, Jul 19, 2005 12:00AM
To: surgeon
First of all, I resent being called a fool. People who have closed minds are in my mind the fools. Just because you do one flush doesn't mean that stones are not still present. Stones actually form in the liver. After a flush, more stones work their way down and therefore would be seen on an ultrasound. Once you have stones, you will probably continue to get them even and especially after your gallbladder is removed. One of these days the quacks will be those in the medical profession who think their word is the only word. After years of listening to people like you I was in the worst health of my life and bedridden with 4 kids to take care of and unable to do so. It has been thru the wise counsel of countless people in the natural health profession that I was able to resume my life normally. I no longer rely on a pill to make me better, I rely on myself and what my body tells me. Before you start calling people fools and putting them down as simpletons, look in the mirror.

by surgeon, Jul 20, 2005 12:00AM
Good luck to you. Virtually everything you said in the above post is medically incorrect. Stones RARELY form in the liver; and practically never form again once the gallbladder is removed. Also, I called no one a "fool." I mentioned fooling the foolable. People get fooled all the time: that doesn't make them fools. Some, however, are foolish. Others are gullible. Still others are in need of answers and when they can't get what they want, they turn elsewhere. But I'm well aware that mainstream medicine doesn't have all the answers for all people. Many of the alternative choices are at least benign. I'm not aware of people being harmed by an occasional "liver flush." (there's no such thing as a liver flush, physiologically; but unless it's done over and over, it's harmless enough.) Some choices, unfortunately, are deadly, in that they steer people away from what they need. But I'm