Should I be making travel plans to see my father

[cheryl56833]

A mass about the size of a fist has been noted on my father’s pancreas. There hasn't been a biopsy yet, so I don't really know that it is cancerous, but he was admitted to the hospital on Monday via the emergency room for rapid heart beat, difficulty breathing, continuous coughing, slight jaundice, extremely high white blood cell count, inability to void, weight loss but distended stomach and general fatigue. He is 76 years old without preexisting pancreas problems. Tonight they are going to drain the fluid from his abdomen to help make him more comfortable, biopsy of the mass hasn't been scheduled yet, they are thinking maybe tomorrow. What are we looking at here? I'm in Maine, he and mom are in Ohio. Should I be on a plane there right now?

[iced_yaria]

i am very sorry about your father. my deepest condolences.

[Sunes]

Please accept the most sincere condolences for the loss of your father.
I will pray for you your family  .
Sunes.

[Fernando Roque, MD]

Hi.  I'm really sorry to hear the news about your father.  I will include him in my prayers.

[cheryl56833]

Dad passed at 11 yesterday morning.

[Fernando Roque, MD]

Hi.  I think that it is critical to get a definite diagnosis once your father's condition has been stabilized.  There is a big difference in terms of prognosis if that pancreatic "mass" turns out to be cancer or if it is a case of pancreatitis (this cannot be ruled out at this point).  Although his condition right now is severe, if it is pancreatitis, it's potentially reversible and your father may recover from the illness.  Doing aggressive treatment is justified in this case.  If his diagnosis turns out to be cancer, it's most probably far advanced, and aggressive medical management might not have any effect in improving his survival.

[cheryl56833]

Thank you for your reply.

My daughters and I did go to Ohio and see Dad over the weekend. My oldest daughter (24) has stayed on for a while. Dad's condition continues to deteriorate and she didn't want to leave her grandmother till more was known. My 2 daughters are 13 years apart, so I returned to get the youngest (12) back to school and hockey practice.

I received a call this morning that Dad was non responsive around 6 this morning with a very low heart rate and unable to breathe on his own. They have put him on a respirator and postponed the placement of the shunt that they thought might remove the back up of fluids causing the distention in his stomach and abdomen which would have allowed then to do the biopsy. Within the last hour he has become responsive again and has opened his eyes and blinks or nods when spoken to so there has been some sense of rebound on his part. The doctors are now planning to treat him with dialysis as it appears all kidney functions have ceased.

Since there is so much fluid and infection (based on the very high white blood cell count) present they will not do a lumpectomy of biopsy, they just keep telling us there is an 80-90% chance that cancer has invaded the pancreas, liver, kidney and abdominal cavity. They refer to him as very sick and in grave condition. They are unable to offer a diagnosis or prognosis since they can't verify anything through sample collection. They are offering information based on how he presents, CAT scan results and his having to have been put on the respirator to breathe. Yesterday his blood pressure was very high, today it continues to be very low and dropping. They have told my mom that medical intervention by means of resuscitation or Defibrillation may not be offered due to the state that he is presently in, yet they are willing to do the dialysis.

Is there anything else that could or should be considered at this point?

Cheryl

[Fernando Roque, MD]

Hi.  From your description, your father does seem to have a serious condition.  There is a distinct possibility that the fist sized mass in your father's pancreas is cancer.   Inflammation of the pancreas (pancreatitis) can also mimic a "mass", and this also has to be ruled out.  I think it would really help if you can be at your father's side and provide emotional support during this critical period.