pancreatic cancer stage IIB -preventative treatment

My husband under went the whipple procedure in Aug. 2007.  He has never healed completely maybe due to hep. C.  He takes 200 mg oxycoton 3 times per day with oxy IR as break through.  Vomiting and nausea have also been a consistent problem and he takes reglan and zophran 3 times per day.  My question:  Last Oct he had radiation and chem (gemzar and taxol).  Then for preventative reasons they attempted gemzar alone 3 on and 1 wk off.  This was too much and he ended up in the hospital with fluid around his lungs and infection in lungs.  They reduced his treatment to 2 on 1 off.  He tolerates but with no quality.  Sleeps 20 hrs per day and severely vomits approx 1-2/week.  We were told he was to do this for six months and it was to prolong life.  Now they are cutting that back again and suggesting xeloda for 2 years which has made him sick in the past.  When dx'd they said it metastisized to the lymph nodes.  CA-19-9 has been between 37-60 for past year.  Petscan has been clean.  We are torn if we keep doing treatments that might prolong or wait for the cancer to appear again and then treat.  Any suggestions?

[Fernando Roque, MD]

Hi.  Using Xeloda alone has not been proven in clinical trials to prolong the life of patients with pancreatic cancer after surgery.  The drug combinations which have been tested and proven to prolong survival include Xeloda PLUS Gemzar, Gemzar alone, or Gemzar PLUS Erlotinib.  The decision whether to continue chemotherapy or delay until the appearance of recurrence is a difficult one, with no clear answers, since there is still no satisfactory treatment for pancreatic cancer at  this time.