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Avatar universal

Stage 4 pancreatic cancer diagnosis, need opinions (CT scan included)

* Age: 53
* Gender: male
* Height: 195cm
* Current weight: 90kg
* Past medical history: None, never visited a doctor

This year symptoms started:
Body weight before any symptoms: 105 kg

May, June, July, August, September, October
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1. Periodic (lasts for 1-3 days on/off, then goes away for 15 to 30 days) numb pain in abdomen in level of diaphragm area to the left - after eating or on random occasions

**August:
Back injury to the right lower back (right where the rib cage ends) - tripped and fell with whole weight on the back on the round metal spike --- treated with pain medication and rest. Area was bruised for few days.

**September and November
Noticeable weight loss

November
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Body weight: 96 kg

29th oct to 3rd november contracted a common cold that lasted for 7 days (was heaviest one ever, usually never gets sick)
and after that starting
4-6th of november - increased fatigue, pain in abdomen and fever 37 to 38 celsius
that lasted for two days:

1. Constant pain in abdomen around diaphragm area, where the ribcage meets the belly the entire width
2. Constant temperature ranging from 37 to 38 celsius, fever
3. Constant bloating that dramatically worsens after eating
4. Pale stool
5. Unable to pass gas regularly
6. No appetite
7. Hard and non frequent stool, usually passes something after 3-4 days
8. Darker urine than usual
9. Jaundice - comes and goes, but when it appears - it's intense

8th of November
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Rushed to emergency due non relieving pain:
Done blood work and urine:
Increased values:

* urobilinogen: 197 µmmol/L (max allowed 17 µmmol/L)

* urine is dark yellow


They gave instructions to visit a doctor and do some screening

9th of november
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Ultrasound of entire abdomen, suspected at hepatitis.
Liver is enlarged and very coarse. The rest of abdomen is fine.
Recommended basic blood tests and markers for hepatitis.

10th of november
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Hepatitis test results are all negative.

Blood work:

*   Leucocytes: 11 / max 9.7

*   MCV: 99 / max 97

*   RDW: 8.1 / min 9

*   MPV: 5.2 / min 6.8

*   Bilirubine: 30 / 5-21 max

*   GGT: 89 / 55 max

Same symptoms start again…


Rushed to emergency and sent to clinic (around 23h)
-------------------------------------------------------------

**Tests:**

Ultrasound - detected enlarged liver and pancreas

**Got medication:**

Infusion: 0.9% NaCI 500ml i.v. + amp controloc i.v, Voltaren 1./2 amp i.m and recommended low food intake

**Recommended:**

CRP test and amylases and also report to gastroenterology and abdominal


11th of november
---------------------------------------------------

**Tests for CRP:**

Bilirubin levels are normal, including: total, direct and indirect

Amylases is normal, 31

However CRP is at 117 / maximum 0.1 to 5.0 mg/L

— started using voltaren suppositories - it dramatically improved the state of health - no fever, less or no pain in abdomen and less bloating

13th of november
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Reported to gastro, they gave opinion:

Probably some infection, start with antibiotics

Given Pantoprazole 40 mg 1x1 4 weeks, RANIBOS 150 mg 1x1 4 weeks


16th of november
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No changes at all with antibiotics, fever and abdominal pain is still present without voltaren suppositories: consulted a diagnostic clinic

recommended: CT scan, color dopler, tumor markers, enzymes of the liver

**TEST RESULTS:**

*  Creatine: 66  / max 105

*  Urea: 3.83 / max 8.10

*  Bilirubine: normal

*  GAMA GT: 166 / max 49

*  AST: 31 / max 40

*  ALT: 51 / max 41


**TUMOR MARKERS:**

*  CEAS: 27.42 / max 5

*  CA19-9: > 500 / max 37


**COLOR DOPLER and CT scan confirmed the following diagnosis:**

Thrombosis venae portae

**Prescribed treatment:**
Clexane 2x5 for 1 week
Xarelto, 2x 15 mg 3 weeks
then 20 mg 1x1 3 weeks
with controloc


17th of november
---------------------------------------------------

CT radiologist finalised the results after tumor marker results:

Focal lessons on liver are vascularised poorly. There are lesions:

1. in left lobe of the liver 17 mm
2. between two lobes size of 26 mm
3. in segment number 5 size of 48 mm
4. in segment number 6 14 mm

Vena portae is expanded about 22 mm. Hypertension. Around it you can see vascularised tortuous blood vessels.

In the tail of pancreas, there is expansive area of dimensions 6x3.5 cm. Which is inhomogeneous, poorly vascularised. Uneven contours.

On left adrenal gland there is area of size 15 mm and in the right adrenal gland you can see similar one with the size of 17 mm.

Kidneys are looking good.

**Summary:**

Tumor process on tail of pancreas which is not separated from left adrenal gland and wall of stomach. Thrombosis vena portae with signs of hypertension, secondary deposits on the liver.

**Recommended:**
Biopsy of the liver or pancreas to confirm CT diagnosis -- this was recommended by the main diagnosis doctor, because he cannot confirm the cancer, mainly because some of the symptoms that he expects are not there.


Current State
---------------

Clexane and Xarelto extremely improved general health:

**Still present symptoms:**

1. Stool is still pale, but less than before
2. Bloating is still present, but less than before
3. Fatigue (this is probably caused by clexane and xarelto due side-effects)
4. Gas passing is improved, but still not that good

**Removed symptoms:**

1. Abdominal pain
2. Bloating reduced significantly  
3. Stopped losing weight (last 3 days of measurement no weight change / 90 kg)
4. Normalised food intake, however larger amounts of food are not possible
5. Stool passing is improved, but not significantly
6. Jaundice (almost gone)

**New symptoms:**

1. Frequent urination at night, usually up to 6 times

**Glucose in blood:**

All nominal

thromb is not completely dissolved, but the blood is passing freely again, but not with same efficiency according to last color doppler done.

DICOM files

https://drive.google.com/file/d/0B4t10gKP0eIoTHhpR3hXb1ZFVjQ/view?usp=sharing

can provide exports in video or images

thanks, any opinion is highly appreciated



history of illness in family:
-------------------------------

* Father died at the age of 38 of a heart attack

* Mother died at the age of 67 of a heart attack

* Brother died of cancer - colon cancer, then after 4 years of struggle metastasized into liver, bones, lungs.

* No records of genetic disorders or other diseases




CT scans in .mp4 https://drive.google.com/folderview?id=0B4t10gKP0eIoNXN3cVpiX3BWdkk&usp=sharing

Videos on youtube (all files that i found in the folder in default orientation):

https://youtu.be/sAM6PjDC6wY

https://youtu.be/4HU5uJfF4Y8

https://youtu.be/7wopiOWP-D4

https://youtu.be/xFkGxJe40hU


Different orientations:

https://youtu.be/115YWOmrHXc

https://youtu.be/FsbfQOp9HMk

Although, the zip file contains all DICOM data for viewing with a program

https://docs.google.com/uc?authuser=0&id=0B4t10gKP0eIoTHhpR3hXb1ZFVjQ&export=download


http://www.osirix-viewer.com/ for mac

http://www.radiantviewer.com/ for windows
5 Responses
Avatar universal
COMMUNITY LEADER
This is very informative data, but unfortunately we are not doctors here in the Communities and cannot diagnose things. But by reviewing your data, it is clear that something needs to be addressed. Hopefully you have a good team of specialists engaged with this, any thing else would be insufficient.

Given the presence of multiple tumors - liver, pancreas and elsewhere - along with the elevated tumor markers - CEA, CA19-9 - there needs to be some aggressive treatment assessments made. The Mayo Clinic will provide consulting without requiring you to make the trip.

Also, I see that there is a great deal of good CT data, but enhanced MRI/MRCP imaging should be used as well. Especially wrt the liver tumors, the MRI imaging uses the dual blood supply to provide unique imaging data and insights.

Let us know how things are going and when the doctors are able to start to finalize the true nature of the tumors and have a working diagnosis.
Avatar universal
Sorry for all your going through. I didn't see that you have gone to an oncologist yet.  Not meaning to scare you more than you probably already are but pancreatic cancer is one of the worst cancers to have. My sister died from it because she waited until she was yellow skin before starting treatment.  Please don't let doctors mess around with you. Go see an oncologist, if not to just rule out cancer. If you have pancreatic cancer the meds you're taking are only masking it, treating symptoms not the cancer.
I hope you go, I wish you the best,please be your own advacent.

1 Comments
I agree with  Penjaz regarding Pancreatic cancer being one of the worst of the cancers to have. Having been a nurse fo 41 years, I have seen many patients diagnosed with pancreatic cancer. Not to scare/worry you any more than you already are, but I would highly recommend that you see an oncologist as soon as possible. Take all tests and labs that you have or can get. Usually by the time the cancer is diagnosed, It is usually too late to do anything.in regards t chemo or radiation. The time frame for life is usually 6 months. My husband was diagnosed in Feb.2013 and died August 29,2013. Being a nurse, when given the diagnosis, I knew the life expectancy would be roughly 6 months. His physician gave him some IV and PO chemo. The intention was not to cure but to give him more quality time with our family. He was  able to attend the weddings of 2 of our sons. One 6/22 and the other n 7/3. We have memories as well as pictures. We lost our oldest son to cancer 1/98. He was diagnosed 7/89 at the age of 7y/o with leukemia. I tell you this because cancer is real. It doesn't discriminate if you are black/white, rich/poor old/young, educated/ non-educated or famous/non-famous. Please make an appointment with an oncologist and whatever the diagnosis is you  can go from there. Praying  it's not cancer but something they can treat and cure. PLEASE keep us informed. Blessings of health ,happiness and prosperity are being sent your way.
May God bless you and your family. Mommy52 (Maddie)
Avatar universal
I agree, you should see oncologist now. In October of 2013 my husband (54) became very sick with the flu. 2 months later again. In March of 2014 he was sick again & was diagnosed with high blood pressure. In June of 2014 he had 2 stints put in his heart. In August he had hernia surgery & in October lost his job. In December of 2014 he had flu again. In March of 2015 he started throwing up & after a week of testing, was sent to larger facility where he was diagnosed with pancreatic cancer. A whipple procedure was done & after many complications was finally able to come home. After lots of healing, prayers & love we thought we had it beat. 2 cts all clear. December brought the news that it has spread to his liver. They had to stint bile duct. He is 90lbs & he takes his pain meds & sleeps. Dr.s see no need in chemo. Pls take care & take charge before it's too late.
Avatar universal
Can you get to a state where Rick Simpson oil is sold?  California, Colorado there are several.  Look at his video called Run from the Cure on Youtube.  You can beat this. I would also be taking an aloe drink called "Alive Again". Order it and plan on drinking a bottle ever 8-10 days. Find  a way to drink Alkaline water, a filter in a pitcher if about $40.  My father passed from this form for cancer and you have to get to a state where all forms of known cures can be used.  Medicine won't cure you.  CBD will help.  Read up on it.
Avatar universal
Can you get to a state where Rick Simpson oil is sold?  California, Colorado there are several.  Look at his video called Run from the Cure on Youtube.  You can beat this. I would also be taking an aloe drink called "Alive Again". Order it and plan on drinking a bottle every 8-10 days. Find  a way to drink Alkaline water, a filter in a pitcher is about $40.  My father passed from this form for cancer and you have to get to a state where all forms of known cures can be used.  Medicine won't cure you.  CBD will help.  Read up on it.
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