# Pancreatic Cancer



## Heid (May 31, 2010)

I'm currently working on a new story in which the protagonist finds out he has pancreatic cancer.

I've been looking into what the symptoms, causes etc. of the disease are. I'm just wondering what the doctor would say to my character and what the stages are (particularly the final stage) along the way.

The idea is the cancer will be diagnosed as being too far advanced to be cured. So what other options would be available? Would surgery still be appropriate or would a dose of medication be prescribed in its stead? The character will still continue to live their life so I imagine pain and discomfort would be evident but how severe if they are on medication? (Or does it vary from person to person?)

Cheers for any help.


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## Chesters Daughter (May 31, 2010)

Hey Heid, The best thing to do is Google Pancreatic Cancer Treatments, and Prognosis. All cancers are determined by stages 1 - 4, four being the worst. It is doubtful surgery would even be considered in a stage 4 patient, although they sometimes do it in a stage 3. Both chemo and radiation are used as treatment always, in conjunction with surgery if it's implicated, alone if it is not. Pain thresholds vary from person to person, regardless, toward the end, the pain would be intolerable. Painkillers are administered in the form of pills, shots, and eventually through an IV drip with a button for self administer. Pancreatic cancer is one of the most deadly, perhaps the most, if you intend for this person to stick around for a while you might want to consider choosing a different form of the disease. Hope this helps.


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## Heid (May 31, 2010)

Cheers. Some things to consider there.

The prognosis for pancreatic cancer is around a year, which gives me enough time to tell the events of the story I want to include. The big issue for me is making it believable and balancing it out so the disease is advanced and incurable yet still allows time for the protagonist to become involved in what I have planned (so far).

Again, thanks for your help.


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## Chesters Daughter (May 31, 2010)

I forgot to mention that they use patches that last for about a week that dispense very powerful meds and would allow for mobility for a longer period of time. Whether or not  he'd have enough time to finish whatever you have him doing depends on what stage you decide to diagnose him in. You must keep in mind that the radiation and chemo are both very debilitating and often keep patients in bed for long periods of time, the side effects are awful. Even if the pain is managed, this guy is going to be hard pressed to be moving about. Not sure what your intentions for him are, but he certainly can't be an errand runner. Hope this helps a little more.


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## Heid (May 31, 2010)

Patches may help me. There won't be much exertion but there will be a small amount of travelling; moving from place to place, visiting people that sort of thing. Nothing too strenuous. I've taken into account the fact that towards the end they will most likely be bed-ridden. So that at least gives me a rough ending (something I generally struggle with).

Would it be possible (or even wise) to forgo chemotherapy so as to avoid the side-effects. If my character sees the treatment as pointless as they have been told they will die anyway is it something I can eschew?


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## Chesters Daughter (May 31, 2010)

I am unsure how effective chemo is against this type of cancer, nominal at best considering the fatality rate. Some patients eschew that type of treatment to have what time they have left to be actually livable, so, yes, definitely an option. If he opts for treatment, it will commence immediately and aggressively, so he'll be down for the count from the get go, so I guess foregoing it is your best option. I should like to read this story, so if you post it here, send me a PM, I very rarely venture out of poetry.


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## Heid (May 31, 2010)

I'm hoping to turn it into a larger project. But I may post up an extract or two of some scenes. We'll see how it goes. Thanks for the advice.


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## Rosette (Jun 6, 2010)

It depends on how far along the cancer is and how old your protagonist is. If he's weak from the cancer, they will try to get him to get his strength back so they can possibly perform surgery.

Well, like most cancers, he would be easily tired out. Chemo or not, I think you start to throw up almost every thing you eat. Pain becomes very bad. Like, moving becomes difficult. And you lose a lot of weight.

Um, if you want more info, just msg me. I don't really want to post all of it in one post. But here is another good source.

https://health.google.com/health/ref/Pancreatic+carcinoma


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## Heid (Jun 10, 2010)

Cheers Rosette, I'll check out that link and if I have any more questions I'll get back to you.


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## Sam (Jun 15, 2010)

[an]What follows was not written by me but belongs to a close friend of mine who read this thread and wanted to give his thoughts.[/an]

   My father died from pancreatic cancer. For two years, his blood sugar levels fluctuated badly and doctors at Kaiser Hospital assumed he had become diabetic. The treated him with diet and oral medication to control his blood-sugar levels. Treatment failed as his sugar levels continued to fluctuate. My dad admitted to blowing his diet from time to time, so doctors blamed the fluctuations on his own behavior and did nothing but nag him about proper diet. No additional tests were performed.

  At the end of the two year period of treatment for "diabetes", dad developed severe abdominal pain. Kaiser doctors scheduled him for a "checkup" and found no obvious cause for the ongoing pain. I called my mom and told her to take dad to a private doctor at my expense. The private doc found his cancer within three hours. It showed up in blood tests that look for specific proteins that are produced by pancreatic cancer. In addition, the primary cancer was well defined in his CAT scan. Unfortunately, the CAT scan also showed that the disease had metastasized to his liver. Both organs were riddled with cancer.

  Mom and dad went back to Kaiser for treatment, but they set him up with hospice instead. They offered chemotherapy but gave zero prognosis for cure or even temporary remission. Dad decided there was no sense in wasting the few months he had left with medicine-induced sickness when there was no expectation of getting better.

  We kept dad at home until the night he died. At first, he lost a lot of weight but still enough energy to joke with family. He would not have been able to travel. Periods of lucidity gradually diminished while periods of sleep lengthened. Pain medication gradually increased until his talk became slurred and his thought processes began to deteriorate. Toward the end, dad slept twenty hours a day and stopped eating altogether. About a week before he died, he was sleeping in adult diapers and sipping water whenever we could get him to sit up. Mom did a stupid thing one night. She put corn silk down the garbage disposal and it jammed, so she picked up the phone to call a plumber. Dad had been listening to her discussion with my sister and suddenly appeared from the bedroom. He looked terrible, but said, "Goddammit Mary, how many times have I asked you not to put things like that down the disposal. Hang up that phone. We're not gonna waste money on a plumber when I can fix it."

  Dad went into the garage for his tools, slipped under the sink, removed the garbage disposal and disassembled it. It took about two minutes to remove the foul. Then, Dad re-installed the repaired garbage disposal, went back to bed and never woke up again. This is a completely true story with no exaggeration. To this day, our family marvels that dad's last activity was to take care of his family . . . as he had for 50 years.

  One of my good friends is currently caring for his dad in the final stages of the same cancer. His father's disease was caught early and chemotherapy slowed the progression of the disease. Like my dad, his father lost a ot of weight (25% of his body mass) in the beginning. During chemo, a few more pound dropped off, but after the drug therapy, his dad began adding weight. His energy level improved and my friend was actually able to take his father on a couple camping/fishing trips. Metastasis seems to be the key to the rapid health drop off with pancreatic cancer. Once the cancer shows up in another location like the liver or brain, death is imminent. My buddy's dad still has no metastasis and doctors are surprised that he's lived a year and a half longer than originally expected.

  My point in comparing pancreatic cancer in two people is to give you a real life picture of the possibilities. By the way, it is common for doctors to mis-diagnose pancreatic cancer as diabetes in early stages. My own internist told me if I ever develop symptoms of diabetes, he will automatically order the blood tests to rule out pancreatic cancer. I asked him why Kaiser didn't do that with my dad and he said, the chance of finding pancreatic cancer in people showing early diabetes, is less than one percent. As a result, it is not cost-effective to run all those extra tests when the vast majority of the time such symptoms are, in fact, diabetes.


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