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Asking for Mother, Female, 63 years old, Lahore
In Dec 2017 my mother diagnosed with pancreas cancer unfortunately , in workup it looks resectable , the patient admitted for Whipple procedure but during operation tumor found as locally advanced whipple converted into gastrojejunostomy. see the attached image
Chemopthry started (GemCap) after 4 cycle CT Scan showed interval progression. see the attached image
doctor changed the protocol to Capox Oxaliplatin and capecitabine (Xelox) after 6 cycles CT Scan showed as Stable Disease (see the attach image), doctor gave 3 month break and asked to do scan after 3 month which was done @ 05/01/2019
Unfortunately, last scan showed the tumor as Progressive Enlargement & hepatic metastases in segment 3 see the attached image
Doctor Switched the protocol again (PIC - folfiri)
2 cycle of PIC Folfiri has been completed and 3rd one is due on first of march 2019
Problems:
1) after 2 cycle of Folfiri patient feels severe weakness HB drop to 6.9 Blood transfusion done
2
Have you been told about best supportive care only. I suggest you should consider leaving the chemotherapy and switch to pain management and supportive therapy only. Best regards
Patient diagnosed with ca pancreas and tried Couple of treatment combinations at different times now progressed. And still on chemo, you seem like following the perfect path of treatment and wisely dealing with situation. what are your concerns exactly?
best option for this patient at this stage is chemotherapy with Nab-Paclitexol with Gemcitabine, tolerable chemo with good result the chemo she received recently is very toxic
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