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Oncology (General Cancer)/periampullary carcinoma of pancreas

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Question
hi, my uncle has been diagnosed to have  periampullary carcinoma of 2 x 2 cm in the head of pancreas 4 months back. he went a cholecystojejunostomy , whipple was withdrawn as the tumour was situated just above the superior mesentric vein as said by the gastroenterologist. and he was not able to do biopsy for the same reason above mentioned. based on his cancer markers and investigatory procedures , he is on chemo presently at the appolo cancer institute chennai. now, he started getting the symptoms of gastric outlet obstruction as melenemetesis, he also got erosive gastritis as since he was on oral chemo so long, which aggravating his blood loss, his platelet counts are fluctuating often because of his chemo. he developed a solitary paraaortic group of lymphnode now. how can he be managed further ? is there no options of resecting the tumour at any cost since it is still in t2,n1,mo stage? any chances of transplants avail ? his BP is normal, he is 60 yr old male, h/o smoking, alcohol, h/o diabetic for the past 4 yrs. please guide us, we would be so grateful. i'm medical student doing my intern.

Answer
This was a tough question. Besides I'm not a surgeon. I'm a medical oncologist & radiation therapist. However treating a pancreatic cancer without any surgery will hardly produce any good result. And even with surgery the prognosis is not good. The only advice I can give you is to consult with another surgeon with much experience of pancreatic surgery.


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Oncology (General Cancer)

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Claes-Gustaf Nordquist, M.D.

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Questions concerning Cancer, Oncology, radiation Therapy, Tumours, Chemotherapy, Cytotoxic Drugs, Hormonal Therapy, Radiation Protection.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps. You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions in the number of questions there. I also answer questions in these other categories: General History, Military History, Brain Tumors, Breast Cancer, Colon Cancer

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I'm a medical doctor and specialist in medical oncology and radiation therapy

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