Richard Sanders7 said:Did those PhDs actually specify which exact tumor cells we're dealing with? Because if we’re looking at pancreatic adenocarcinoma, then the standard chemo protocols honestly don't make much sense; however, if it turns out to be small cell carcinoma, then the treatment plan makes perfect sense.
Please, get a second opinion as soon as possible and ask specifically about the histological type of the tumor. If it is indeed pancreatic adenocarcinoma, you should definitely ask about therapy involving Sunitinib.
They just performed a biopsy on three pieces of the gastric mucosa when they suspected stomach cancer, and that was it:
Vial 1: Biopsy 3 x angulus (npl?) Vial 2: Biopsy 3 x cardia polyp
Mature intestinal metaplasia is noted, but Helicobacter pylori came back negative.
From what I can gather, they aren't entirely certain that the primary issue is pancreatic cancer. Initially, they suspected the pancreas, but after a duodenal ulcer ruptured, they used a gastric mucosal biopsy to rule out stomach cancer, which they took as confirmation that the problem lies with the pancreas. I'm currently at the hospital, and someone mentioned the possibility of seeking a second opinion. The hardest part is that I feel completely lost in all of this—just searching, reading, and wandering through information without knowing if there's anything else left for me to do.
My father was discharged from the hospital this past Thursday. Diagnosis: K921 Melena K920 Hematemesis C250 Malignant neoplasm of pancreas C787 Secondary malignant neoplasm of liver C780 Secondary malignant neoplasm of lung K295 Chronic gastritis, unspecified D500 Anemia due to iron deficiency, following blood loss (chronic) K317 Gastric and duodenal polyps
Summary: A 66-year-old patient was hospitalized due to melena; the medical history noted instances of hematemesis at home. Following epigastric pain and weight loss, an outpatient surgical workup was initiated. Abdominal ultrasound revealed multiple secondary lesions in the liver, measuring up to 10 cm, alongside a possible primary liver tumor. Changes were also noted in the pancreatic region, which could suggest enlarged lymph nodes or a primary tumor process. A colonoscopy performed three weeks prior showed no tumors, only signs of colitis. An outpatient abdominal CT scan showed diffuse secondary lesions in the liver, including an 8.5 cm conglomerate mass. There is suspicion of a duodenal tumor, though a continuous extension of a pancreatic tumor cannot be ruled out. Peritoneal dissemination is present. Upon admission, the patient was eupneic, afebrile, and normotensive. Digital rectal exam confirmed melena, and labs showed anemia, elevated inflammatory markers, as well as elevated GGT and ALP. Tumor markers CEA, CA 19-9, NSE, and CYFRA 21-1 were all elevated. A follow-up gastroscopy was performed: chronic gastritis with regional angular infiltration and a gastric cardial polyp. Pathology confirmed chronic gastritis and a hyperplastic gastric polyp. No malignant cells were found. The anemia was corrected with three doses of concentrated iron via IV along with a PPI; symptomatic abdominal pain gradually subsided, and the last stool sample was negative for hemoccult. A dermatologist examined some papular skin lesions on his back and recommended treatment. A follow-up chest CT was conducted: aside from a tiny subcentimeter nodular lesion near the caudal part of the hilus in the lower lobe—likely a secondary lesion—the rest of the findings were unremarkable. The patient was seen by an oncologist who does not recommend active oncological therapy, suggesting only symptomatic management instead.
Discharge medications include: Controloc 40 mg, Ramzid, Spamex as needed, Reglan as needed, Tramundin, Transtec 35 mcg, Megostat 10 ml, and Prosure (2x1 pack). An MRI of the pancreas is scheduled for April 22nd.
The oncologist didn't even actually examine him; he just looked over the paperwork. They suggested we seek a second opinion, so I intend to do exactly that. I’m looking for a private oncologist now and hope to have this sorted out by next week. I’m honestly a bit lost as to how this entire process works, so if anyone has any advice, please let me know... Dad is up and walking a little, eating everything, and accepting visitors. He was even humming a tune yesterday.
Tumor markers: CA 19-9 117, CEA 6.7, CYFRA 21-1 30.2
My father underwent an abdominal ultrasound on February 19th, followed by a gastroscopy and colonoscopy on March 5th, and then an abdominal CT scan on March 18th. Then, on March 26th, he ended up being hospitalized because a duodenal ulcer perforated, which led to an X-ray and yet another gastroscopy. Most recently, he had an abdominal CT on August 5th, and we have an MRI scheduled for April 22nd. I honestly can’t wrap my head around why he’s needed for two gastroscopies and two CT scans in such a tight window; what else does he have to endure before they finally provide a definitive diagnosis?
We spent the day at the hospital again—it feels like our second home lately—and they’ve scheduled his MRI for April 22nd. The doctors mentioned he’ll likely head straight home once that's finished. We're also expecting the oncologist to stop by this Wednesday. It seems they are ruling out stomach cancer yet again; even though that was suggested on the initial CT scan before his duodenal ulcer flared up, the doctor insists the stomach issue has been resolved. When I pressed her on where the primary tumor actually is, she suggested it’s most likely the pancreas after all. My father mentioned they might run another CT tomorrow, too. Honestly, this endless cycle of testing and shifting theories is driving me absolutely mad.
cosmiclynx14 said:Vomiting blood can be a symptom of stomach cancer... though, I suppose it could stem from another organ entirely, for all I know. As I understand it, an MRI can pick up on bone issues while a CT scan might miss them; they actually told us we have to specifically request head scans when he goes in for the MRI.
I’m really hoping things start looking up for your dad, that his strength returns quickly, and that he can begin treatment soon.
Thanks, cosmiclynx14. They haven't pinpointed the primary tumor yet, and he’s still staying at the hospital. He’s actually eating quite well and has a wonderful appetite, which is a relief. Yesterday, the doctors told him he couldn't eat anything after lunch because he has to go back for another ultrasound today. It’s been two weeks since he was admitted. He remains incredibly alert and upbeat, calling us constantly to check in; he’s curious about everything, and I even brought him some headphones so he could listen to the radio. He’s even trying to play "roommate" and help out the other patients if they need anything. He has lost some weight, though that’s hardly surprising given everything he’s been through. We are just waiting now.
cosmiclynx14 said:It’s the same situation with my dad; surgery isn't an option because there are multiple metastases in the liver... all we know for sure is that the primary site is in the colon...
He started chemo immediately without any surgery—twelve cycles total. We just finished the fourth, and after his latest CT scan, the metastases have actually shrunk by half! And they were even larger than what your father is dealing with...
The only thing is that the lymph nodes are enlarged and more numerous now, which I assume is bad news? Is that a really significant warning sign?? And I honestly can't wrap my head around why they haven't mentioned a single word about the primary colon tumor in the reports; how is that even possible? Is it a doctor's oversight or something else? My dad didn't have his previous files on him, but they said everything was saved in their system, so I wonder how likely it is that they haven't even looked at them...
I’m finding quite a bit of this confusing myself. My dad has been in the hospital for ten days now. For several days, he wouldn't even touch food or water, though he's finally eating again today. They still haven't identified where the primary tumor is located, and we're still waiting on the official results. The doctor mentioned today that they might need to run an MRI as well. I had always assumed a CT scan provided more comprehensive information than an MRI.🤷
My dad still hasn't received a definitive diagnosis. The abdominal CT scan indicated stomach cancer, enlarged lymph nodes near the pancreas, and several liver metastases—the largest being about 80 mm. I tried my best to make sense of the reports while we were waiting over at the surgical wing, but... most of it is just medical gibberish to me; all I could gather was that his heart and kidneys seem to be holding up okay... They had us pacing the halls of the hospital from 1:00 PM until 6:00 PM. He had more blood work done on Monday, provided a urine sample, underwent another scan, and they've scheduled him for yet another endoscopy. This follows the one he had back on March 5th. In the interim between the CT, the colonoscopy, and the gastroscopy, and before we even saw these latest results, he spent the weekend vomiting what looked like coffee grounds—massive amounts of it. It wasn't until later that the realization hit me: it was blood. Initially, the doctors didn't think he needed to be admitted, but after he lost so much blood, he’s been staying on the internal medicine ward since Monday. He’s currently on an IV and receiving a transfusion... He isn't allowed to eat or drink anything. When I pressed the doctor for answers today, she admitted they still aren't certain where the primary tumor is located. At first, they suspected the pancreas, then they pivoted to the duodenum. But now, following that bleeding episode, nothing feels certain anymore. They took a biopsy during the gastroscopy, and we should have the results in about a week. I asked the doctor straight out: if it is indeed stomach cancer, is surgery even an option? She told me no, because of the multiple metastases in his liver. Today marks exactly two months since my father suffered that fall on the ice. Since then, it has been a relentless cycle of running from one specialist to another... And then they have the nerve to say, "If only you had come in a month sooner." Just when I thought I finally understood the situation regarding his pancreas, they start talking about the stomach—though they still aren't sure if that's the culprit, or if perhaps a perforated ulcer is the real issue.
I feel as though I've been dropped into some twisted, horror-movie version of Alice in Wonderland. I truly don't know what to hope for.
Richard Sanders7 said:In my view, this wait is simply unacceptable. They really should have fast-tracked that abdominal CT, especially since getting targeted therapy started is such a race against time. If you can swing it financially, I’d suggest booking a private scan immediately to bypass the bureaucracy. How old is your father?
He was born in 1947, and honestly, until just last month, he was incredibly active and full of life. I actually went looking for a private abdominal CT, but it seems impossible to find one available here in the Midwest; apparently, those specialized scans are only handled at the major medical centers in Chicago. The problem is, he can barely handle the car ride to the hospital anymore. Is it possible for his primary care physician to issue an urgent referral for inpatient treatment?
Everything went sideways last night. We ended up at the ER before 10 PM, but we didn't finally make it back home until around 2:30 in the morning. He was in such abnormal, agonizing pain that we almost had to carry him inside. He kept drifting off, losing his sense of place, asking us if we had just come over to rest for a little while. The moaning was constant; he couldn't stay in a single position for even thirty seconds without crying out. Honestly, I don't even want to write about what we experienced in that waiting room. We were stuck there forever because they were mid-procedure on someone else. To top it all off, the ER doctor actually snapped at us, yelling that my father wasn't even an inpatient at the hospital—as if I have any control over his admission status. All I managed to learn from him was that on top of the issues with his gallbladder and liver, Dad is also dealing with an ulcer in his duodenum and gallstones... We eventually ended up at the internal medicine wing on the other side of town, where we had to wait outside. We didn't even get to see the doctor because she entered through a different entrance. A nurse told us she was administering a second IV drip which should help a bit, but insisted he needs to see his primary physician first thing tomorrow to get stronger medication since she can't keep him admitted. She suggested he head back to their facility once he completes a CT scan. So, everything is set for March 18th. The medication they gave him isn't doing a thing; he’s just lying there groaning now, frustrated by how helpless he feels.
My mother was asking me about it today, and after some thought, I told her it seemed like a "really healthy" choice! I ended up picking up some silymarin, and while browsing online, I stumbled upon this fascinating study from the US National Library of Medicine: Multitargeted therapy of cancer by silymarin National Institutes of Health link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2612997/ From what I managed to gather—relying quite heavily on Google Translate to make sense of the jargon—it doesn't seem harmful at all.
These findings suggest that by suppressing the cancer cells invasion through the specific inhibition of AP-1-dependent MMP-9 gene expression, silibinin represents a potential anti-metastatic agent. Together, the anti-invasive as well as anti- metastatic potential of silibinin could be of great value in the development of a potential cancer therapy.
The results from his endoscopy and colonoscopy came back clean, with absolutely no signs of malignancy. It looks like the issue is localized to the pancreas and liver, so thankfully it hasn't spread further. My dad is still waiting on his abdominal CT scan to get the full picture. For now, he isn't on any specific treatment beyond his blood pressure medication and some Zaracet to manage the intense pain in his leg. He’s actually keeping his spirits up quite well—he was even out working in the garden yesterday. I’m wondering if there would be any real benefit in picking up some silymarin for him.
Linda Patel21 said:feralsurfer72, my heart truly goes out to you regarding your father's diagnosis; please know that I understand the sheer weight of what you're carrying right now because I have walked through that same valley of shadows myself. I just want to encourage you to find whatever strength remains within you, as both you and your dad will need it for the battle ahead. No matter how grim the doctors make things sound, there is always something—however small—that can be done to ease a patient's discomfort, because they are the ones bearing the heaviest burden. Just stay by his side and pour all your love into him; I am sending you both so much strength, hoping for the best possible outcomes and as little pain as humanly possible.
Thank you, dear; we’re currently facing a grueling marathon of gastroscopies, colonoscopies, and CT scans... and while I desperately want to believe everything will turn out okay, the test results have been devastating. I’ve spent days and nights lost in tears, feeling as though the grief itself might actually kill me. He knew, of course, even though I tried so hard to mask it from him. I eventually had this sudden, sharp realization of how selfish my own mourning felt; he is the one who needs my help, my comfort, and my attempts to bring a smile to his face. I am trying my absolute best to be strong for his sake, but truthfully, I still have to take something to calm my nerves before bed, otherwise, I would simply spend the entire night weeping.
I can’t seem to find any peace; I’ve just been sitting here crying for my father. I honestly don't even know what all of this implies yet, but I can see enough to know things are looking grim. Every time I dig deeper into research online, the outlook feels even heavier. The only moment of stillness I get is when I'm right there by his side, because I truly never expected us to be facing this. Back in the winter, he took a nasty fall on some black ice, and he hasn't really recovered since. I had hoped there might have been some connection between that fall and how he’s feeling now. He isn't seeing his doctor until tomorrow afternoon. Here are my father's results from today: Within the parenchyma of both liver lobes, there are numerous oval, sharply defined hyperechoic zones surrounded by hypoechoic borders, varying in size with diameters reaching up to 10 cm. These findings on the ultrasound are consistent with liver metastases, though they could also represent a primary liver tumor process. In the pancreatic region, there are visible hypoechoic oval zones of various sizes, which may correspond to enlarged lymph nodes, though a primary pancreatic tumor cannot be ruled out either. The gallbladder, spleen, and kidneys appear normal. The liver is enlarged, and some of the aforementioned metastases are protruding through the liver's contour. I feel completely helpless; I think I would actually find it easier to deal with my own health struggles than this.