Post Whipple Cat-Scans

[Ken99]

What is the acceptable frequency (How often) for doing Cat-Scans and blood test (Cancer checks for the first 5 years) for an individual that had Pancreatic Cancer and the Whipple operation? I am referring to an individual that does not have cancer symptoms since the Whipple operation (Carcinoma of the Ampulla of Vater).  I am at 23 months post Whipple. Worded another way, how often should individual that is symptom free have Cat-Scans/Blood tests to check if the Cancer has returned. No Chemo was involved.

[doctorsis]

A related discussion, metaplastic carcinoma was started.

[Ken99]

Thank you for your prompt review.  I provide the following additional information:

Pyloric-preserving Whipple resection performed mid December 2005.
Moderately differentiated invasive Adenocarcinoma of Ampulla of Vater, 3.0 CM Tumor Invading but not through Muscularis Propria.
No evidence of vascular invasion or perineural invasion.
Margins of Excision (Duodenal, Bile Duct, and Pancreatic) Negative for Tumor.
Heteroptopic Pancreas, 0.9 CM. near the proximal Duodenal Resection Margin.
Pancreatic Parenchyma with no significant pathologic changes.
Four peripancreatic Lymph nodes, negative for Metastatic Carinoma.
AJCC Tumor Staging: pT2 pNO pMX
Two Oncologist stated no benefit would be gained with Chemo or Radiation so none was performed.
No study involved. Medicare patient.
First Cat-Scan in August 2006 followed in September 2006 with an MRI and Liver Biospy due to elevevated AlkP (level 389). Second Cat-Scan in March 2007.  Both negative. AlkP at last check, March 2007 was 133.
Thank you for your help.

[Denise L. Johnson, M.D.]

I do not have enough information, what was your stage?  tumor size, lymph node involvment or not?

Were you on a protocol for clinical studiy which will define how often you will need follow up.

Please forward this information for a complete information