Pancreatic Cancer

Question

Aslamulaikum one of my family members has just been diagnosed with pancreatic cancer and they have recommended downstaging chemotherapy but haven&rsquo;t gave me a clear picture on what stage the cancer is on.                                                                    I need second opinion please. The diagnosis is pancreatic cancer with Sma encasement.              I think the cancer is either in late Stage 2 or early stage 3 from what I know but I don&rsquo;t know everything so could be wrong.

The cancer has spread to lymph nodes, not sure how many.

Don&rsquo;t know if the cancer has spread to blood vessels or other sites or organs.

After the first CT scan there was no mention of it spreading to other places so I assume it hasn&rsquo;t yet spread beyond the pancreas.

Not sure about the size of the tumour, I think it&rsquo;s most likely bigger than 2cm, since it&rsquo;s causing a lot of pain and discomfort. It&rsquo;s also affecting the normal function of the pancreas a lot. The tumour is part solid and

Dr. M Sanaullah Qureshi · Answer

detailed history needed for better outcome

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Dr. Amjad Sk Durrani · Answer

Assalam o Alaikom There are many ifs and buts in your text. Reports are not very clear. However, this seems to be irresectable tumour particularly when there is encasement and lymph nodes are  involved . She needs to start with chemotherapy immediately. If biopsy specimen available then send request for PDL1/PD-1 testing to prepare her for immunotherapy to start with chemo now or separately in future. If there are doubts regarding spread then request for PET-CT on urgent basis.

Dr. Muhammad Afham Shahid · Answer

Assalamualaikum-wa-rehmatullah-e-wa-barakatuhu

You should have shared the reports. However, please do ask all these questions from your treating Oncologist as well. If it has not spread, and is not stage 4, then neoadjuvant (Pehlay chemotherapy) will be strongly considered depending on your description. This is aggressive disease.

stage 2 or 3 matters less, when resectability criteria dominates. But such decisions should be taken with full confidence under the cover of your primary Oncologist. Not on platforms hearsay. Allah AP k Haq me aasani farmaye. Ameen.

Best regards

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