My Pancreatic Cancer
A 53-year-old female pharmaceutical executive was seen in May 2009 for a new diagnosis of pancreatic cancer.
At presentation CT-PET scan demonstrated the presence of a primary tumor located in the head of the pancreas.
Multiple hypermetabolic metastatic lesions were noted in liver and multiple nodal sites. CA 19-9 was 8511 (normal
“I HAVE STAGE IV PANCREATIC CANCER. I’M 53 YEARS OLD. I KNOW THAT THE AVERAGE SURVIVAL FOR MY ILLNESS IS 6 MONTHS. CAN YOU DO BETTER?”
[tabs tab1=”Diagnosis” tab2=”Significant Findings” tab3=”Pharmacology” tab4=”Management” tab5=”Comments” tab6=”Patient Update”]
[tab num=1]Patient has stage IV pancreatic cancer. Second pathology opinion was obtained and diagnosis confirmed. Stains for TTF-1, ER, PR, HER-2-neu, and alpha-feto protein were all negative.[/tab]
[tab num=2]Patient with excellent performance status, Karnofsky 90%. Only symptom mild dyspepsia and minimal anorexia.[/tab]
[tab num=3]Patient wished to be treated aggressively. Clinical trials reviewed with patient and felt to be inadequate. Patient chose to be treated with an oral biologic response modifier TAR-CEVA (targets EGFR = Epidermal growth factor receptor) and three chemotherapy drugs.[/tab]
[tab num=4]Patient received treatment with weekly IV Gemzar and Taxotere. Oral Xeloda (oral 5FU), and Tarceva were also used.[/tab]
[tab num=5]Patient tolerated the above four drug regimens extraordinarily well.
CA 19-9 dropped from 8511 in May 2009 to 22 on September 14th 2009. Her subcutaneous nodule has disappeared. Her CT scan demonstrated effectively no evidence of measurable disease.[/tab]
[tab num=6]Patient has a complete remission defined by normalization of CA19-9 and CT scan. A re-peat CT/PET is planned pending insur-ance approval. Her insurance company declined to pay for her IV Taxotere. The patient remains on maintenance treatment.[/tab]