What I’ve learned about Pancreatic Cancer

The aim of this post is to perhaps help someone notice the silent warning signs of this terrible disease or help with an idea about treatment and treatment options. I spent weeks of nonstop reading and I have summarised some of the important things Ive learned here.

Pancreatic Cancer – the silent almost incurable killer

You wake up one morning, your skin is yellow, your eyes are yellow. You think it is not a big deal, you don’t feel much pain, but you can’t eat any food. The symptoms have been getting worse for the past 4 days. Then other people see you and tell you that you are unbelievably yellow. You check in a hospital and you have a pancreatitis crisis, you nearly die. Doctors check and you await the diagnosis – the diagnosis is Stage 4 Pancreatic Cancer. You are in shock and disbelief because there were no symptoms but that is exactly how Pancreatic Cancer works.

My father was diagnosed with Pancreatic Cancer on March 8 2019. Upon the diagnosis the doctors told us that there is absolutely nothing that can be done and the best we can hope for is 5 months. The reason for that statement was the fact that the cancer had already spread with over 10 metastasis in the liver with the biggest one nearly 5 cm.

Pancreatic cancer is about the deadliest cancer there is with extremely poor prognosis due to the fact that there are virtually no signs until the tumor is so large and almost always metastasized that your bile duct is blocked. At that point often its too late and surgery cannot be performed.  Not only that but to add insult to injury the pancreas is hidden so well within the body that you cannot feel or see anything physically and the only way to make an early diagnosis is to get lucky with a CT Scan. 

However, over the course of my fathers battle I learned a lot of things about Pancreatic Cancer that I wish I knew several years ago. He passed away on 13th August 2019 after an unfortunately short battle. I still have yet to grasp and believe everything that happened.

I cannot bring my father back and modern medicine despite our 24/7 efforts and provision of the best possible care couldn’t cure him, however, I hope that with this blog post I can hopefully help someone that reads it see these early silent warning signs and prevent what happened to my father and my family. 

Like every cancer the best cure is prevention, prevention, prevention. This includes healthy eating with a lot of fruits and vegetables on the plate, being physically active and making sure you get enough sleep. Simple things that we tend to very easily ignore until something happens.

What I’ve learned about finding the disease before its too late:

Some sources :

  1. Unlocking diabetes at late ages > 50 can be a big warning signal for Pancreatic Cancer. This is the thing I wish I knew the most 2 years ago when my father developed Diabetes out of the blue, however, back then the only thing I knew about Pancreatic Cancer is that Steve Jobs and Pavarotti were among its victims.
  2. Weight loss that is not 100% intended can be signs of early stages of this cancer developing as it typically causes reduced appetite. This one is pretty difficult to spot because even as I saw my father’s appetite decrease and him loose weight he also gave the impression of being very happy about it and somewhat intended. However, thinking back, I can recall him telling me in January this year he hardly enjoys eating meat anymore and him saying he doesn’t eat much anymore because he gets full quick. Reflecting over it this was a pretty clear sign because he always enjoyed food quite a bit but before all he always loved his meat. Please note that in the early stages of Pancreatic Cancer (usually all the way to the last stage) lack of appetite and weight loss is very rarely accompanied with any pain. However, if there is lack of appetite, weight loss and some (however small) pain after eating you should immediately go for a CT Scan.
  3. You really should listen to the doctors and once every 6 months perform blood work, especially once you past 50. For me, as my father has developed Pancreatic Cancer, I’ve been told to check my CA 19-9 (Pancreatic Cancer tumor Marker) and CEA at least twice a year.
  4. Tumor markers are no panacea but they are actually pretty useful, especially if you start writing down your results early. The more data you have collected the easier it is for your doctor to detect early warning signs. 
  5. Don’t over stress small increases in tumor markers, as Cancer is one big inflammation if your CRP has risen due to inflammation its possible that your tumor markers are affected by it. However, if you have elevated CEA and CRP buy more than 2-3 points, I would say you better be laughed off as paranoid than sorry. 

What I’ve learned about threatment:

  1. There is NO miracle cure/drug.
  2. You will need to make a lot of difficult decisions.
  3. The real battle is emotional both for the patient and the family. The emotional strain of this disease is a lot more difficult to handle than the physical aspect of it. From one hand you are almost given an expiry date, from the other hand you need to believe and be extremely positive, which can be extremely difficult when there are problems every week. However, I suggest watching this video from Pancreatic Cancer Patient explaining just how important this is : https://www.youtube.com/watch?v=M5QBH3wDrQY . I truly believe positive thinking can make a huge difference in your prognosis.
  4. There won’t be any time for relaxation during the course of the battle. Since my dad got diagnosed every single week some new issue popped up that we had to deal with. Prepare yourself emotionally, strength of character is extremely important both for the patient and the family to be able to continually keep on walking forward instead of bending the knee.
  5. Every cancer is different and every person is different, which is why it is so difficult to threat with so many different mutations possible. I suggest doing a biopsy gene testing to see if you could be lucky with having some genes susceptible to targeted therapy or immune therapy / Micro sattelite instanbility result (very rare for Pancreatic Cancer). 
  6. If you can do surgery you should consider yourself lucky. Surgery improves 5 years survival rates to up to 30%.
  7. If surgery cannot be performed the prognosis is beyond poor and there are very few cases of people making a full recovery with only Chemotherapy in Advanced Pancreatic Cancer.
  8. Treatments for Pancreatic Cancer are largely lacking and targeted therapy still has a far way to go for this cancer. However, in the event of finding BRCA1/BRCA2 mutation even in Advanced Pancreatic Cancer it is possible to achieve 5 years + with targeted therapy because you are able to suppress Tumor Growth and switch between Chemo & Targeted Therapy.
  9. Chemotherapy is awful but in my experience it works. Every time for one reason or another my father had a delay > 3/4 days from his Chemotherapy we immediately saw his tumor markers raising and he started developing temperature which can be a sign of cancer cells dividing. Due to complications he had to take a 2 week break from Chemotherapy and by that time once the next PET Scan came out disease progression was established. It was after those delays in Chemotherapy that we saw huge deterioration in his condition.
  10. Radiation therapy doesn’t do much for Pancreatic Cancer and it is probably best to avoid it so you don’t damage the bone marrow making it more difficult for blood work to be in line with what is required for Chemotherapy. Radiation therapy in Pancreatic Cancer is usually required when the cancer has spread to the bones but its effects will be purely pain relieving and you can achieve that with Fentinyl patches that you can place on the painful spot. For me, without a shadow of a doubt it is a lot better to do more Chemotherapy than to do a Palliative Radiation therapy treatment. The Fentinyl body patches are great at relieving pain without causing any “high”.
  11. Studies conducted on Mice concluded that CBD Oil in conjunction with the Chemotherapy drug Gemcitabine increased life expectancy by 3 times. Link to study: https://www.analyticalcannabis.com/articles/combining-cbd-with-pancreatic-cancer-drug-posts-promising-results-in-animal-model-study-307430. New research is in progress on RSO (95% THC Oil) and its effect on Cancer and some studies have suggested that taking RSO after Chemo (very important after Chemo, not before) increases Chemo success rate significantly https://www.medicalnewstoday.com/articles/325612.php.
  12. The success of Chemotherapy depends a lot on the state of the liver and the pancreas is one of the organs that its pretty difficult to get the chemo drugs to.
  13. FOLFIRINOX is a brutal Chemotherapy, however, there are good alternatives if the patient doesn’t respond well such as NabPaclitaxel with Gemcitabine. New studies are combining these Chemotherapy drugs with Targeted Therapy drugs like Olaparib, however, they are highly toxic and the patient needs to be in good condition.

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