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Post Whipple Procedure
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Post Whipple Procedure

My husband just went through a Whipple Procedure for a tumor located in the duodenum, head of the pancreas and the fatty tissue between them. They only removed 4 lymph nodes during the surgery, and all 4 were negative. 9 days post op, they did a CT Scan, and the report noted 1 enlarged, possibly malignant lymph node located on the lesser curvature of the remaining portion of the stomach. What would normally be the next step for my husband. The surgeon has told us nothing yet, and we have not yet been set up with the cancer clinic in our area. Also what is the life expectancy after a whipple procedure. The surgeon had told me 18 months prior to surgery. They took out a small portion of the lower stomach and the duodenum, and gall bladder, all margins appeared clear on these samples. The tumor it's self measured 3cm X 3cm X 3.5cm.
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Avatar_dr_m_tn
Hi.  Assuming that your husband's tumor is pancreatic cancer, and that the enlarged lymph node near the lesser curvature of the stomach signifies cancer metastases, the options would be either to surgically remove that remaining node or to just do chemotherapy.  I am inclined to go for the second option (chemotherapy), because I have doubts that doing a re-surgery to remove that node will have much of an impact in improving your husband's survival.  Even after surgery, only around 15% of patients survive for five years.  Chemotherapy can help improve the odds a little, but not by much. With chemotherapy, more people with advanced pancreatic cancer survive (around 23%) at 1 year, than if no chemotherapy is given (10-15%).
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