3 ms·

Stage 4 Pancreatic Cancer

4 points by rateofchange 6y ago

Someone close to me was just diagnosed with stage 4 pancreatic cancer which extended to the liver. Wondering if folks on HN might have references to some of the latest advances in the treatment of this troublesome kind of cancer. An internet search yields lots of links but it is difficult to understand which are worth drilling down into. Hoping people on HN with experience in the domain might be able to offer guidance. The objective is to present her doctor with information she might not be aware of (can't assume everyone is up to date with the latest research, tools, trials, etc.). Thanks.

schoen 6y ago
I offer my sympathies because that is one of the most serious diagnoses one can possibly receive. :-( I'm sure you, your friend, and her doctor know about https://clinicaltrials.gov/ct2/results?cond=Pancreatic+Cancer+Stage+IV&term=&cntry=&state=&city=&dist= https://clinicaltrials.gov/ct2/results?cond=Pancreatic+Cance... I think it was using this search that my stepmother successfully and relatively quickly got into a nearby trial for a different cancer, though unfortunately it didn't save her.
- rateofchange 6y ago
  Thanks for the link. Just starting to get into this so, no, I didn't know about this resource. Yes, this is bad.
cell9840179419 6y ago
I am afraid solution for a cancer so serious as this (let's not forget Steve Jobs died of this inspite of arguably endless resources) is not in information search. She needs a good doctor aside from her oncology team. I have lost a colleague who sat 6 ft away from me at work, and 6 months younger. The end comes pretty fast. My heartfelt sympathies. There is one variant which can be cured. Jobs had that actually. If she got that and it did not metastise she may survive. It is her best hope.
brudgers 6y ago
In cancer diagnosis, Stage Four indicates that the cancer has spread from the primary organ to other organs. There is no stage five. With cancers of high mortality -- and pancreatic cancer is one -- quality of life is a usually a sound primary focus. Quality of life means different things to different people of course. For some people, the terrible side effects of highly aggressive treatments with debilitating surgeries and radical chemo-therapy are worth the price. For others, palliative treatments to lessen the worst symptoms of their disease allows them to be more present and whole during the time they have left. Oncology is a job just like anything else. Some oncologists focus on patient care. Some on business. You can throw as much money as you got and then some on cutting your friend's body and dumping toxic chemicals into her blood just for the sake of "doing something" because there's an oncologist out there who wants a new dock for a new boat at their lake house. Or you can find an oncologist who will do the best by your friend in good faith and provide an accurate prognosis based on hard to live with experience. Even if that means you don't hear what you wished someone would say. My beloved is a clinical social worker. Thirty years mostly in hospice and oncology. Our relationship has involved a lot sad conversations about the ways people die. There's a spectrum between calmly surrounded by loved ones and confused, mutilated, and painfully stuffed with tubes. It's not your choice. Good luck.
- rateofchange 6y ago
  Yes, this is a sobering diagnosis. And it has spread to the liver, which likely means the prognosis is far worse. I take your point about quality of life for what might remain. These are tough decisions those of us around her are going to have to make. I have friends who have reported about acquaintances who beat pancreatic cancer diagnosis and went on to live twenty or thirty years. I suspect these were early onset rather than stage four. This company seems to have had early success with metastatic pancreatic cancer. We've reached out to see what they have to say. https://nantkwest.com/nantkwest-and-immunitybio-to-initiate-a-phase-2-study-of-immunotherapy-for-metastatic-pancreatic-cancer/ https://nantkwest.com/nantkwest-and-immunitybio-to-initiate-... From the article: "Pancreatic cancer kills an estimated 47,000 people annually; it is the fourth leading cause of cancer-related death in the U.S., and 57,600 new cases are expected in 2020. Less than 5% of these patients will live for more than five years after diagnosis, and the median survival prognosis is 5 to 8 months." The end of that paragraph is quite sobering.
  - brudgers 6y ago
    One thing I didn't cover is that "cancer" isn't one thing. And neither is pancreatic cancer. Steve Jobs had a rarer and less aggressive form. That's why he lived with his diagnosis as long as he did. His pancreatic cancer was a different pancreatic cancer from the most common pancreatic cancer. The median survival rate for pancreatic cancer is low because it tends to be diagnosed late. This is the case with your friend because the cancer is at stage four. In terms of quality of life, seeking enrollment in a clinical trial involves a lot of meetings and paperwork and often travel. Keep in mind that the driving force of the clinical trial you link is a business venture with a medical component. The trial is randomized which means some enrollees won't get the treatment being tested. In terms of anecdotal evidence of long survival, misdiagnosis is a real possibility as one goes further and further back, e.g. a person diagnosed in 1955 who lived to 1985. I'm not sure why the patient can't make their own decisions, but I don't have all the facts. I am sorry that you are dealing with this.
    - rateofchange 6y ago
architect 6y ago
If you haven’t seen this already you might wanna check out this article https://www.sciencedaily.com/releases/2020/05/200512151941.htm https://www.sciencedaily.com/releases/2020/05/200512151941.h... Good luck and hope your friend can recover fast!
- rateofchange 6y ago
  Will do. Looks interesting. Thanks. A friend of mine, who was diagnosed with prostate cancer, went through a radical change of diet. This included juicing lots of vegetables and cutting out most meats. He thinks the dietary adjustment played an important role in his cancer disappearing five years ago.

4 points by rateofchange 6y ago

schoen 6y ago

I offer my sympathies because that is one of the most serious diagnoses one can possibly receive. :-( I'm sure you, your friend, and her doctor know about https://clinicaltrials.gov/ct2/results?cond=Pancreatic+Cancer+Stage+IV&term=&cntry=&state=&city=&dist= https://clinicaltrials.gov/ct2/results?cond=Pancreatic+Cance... I think it was using this search that my stepmother successfully and relatively quickly got into a nearby trial for a different cancer, though unfortunately it didn't save her.

rateofchange 6y ago
Thanks for the link. Just starting to get into this so, no, I didn't know about this resource. Yes, this is bad.

cell9840179419 6y ago

I am afraid solution for a cancer so serious as this (let's not forget Steve Jobs died of this inspite of arguably endless resources) is not in information search. She needs a good doctor aside from her oncology team. I have lost a colleague who sat 6 ft away from me at work, and 6 months younger. The end comes pretty fast. My heartfelt sympathies. There is one variant which can be cured. Jobs had that actually. If she got that and it did not metastise she may survive. It is her best hope.

brudgers 6y ago

In cancer diagnosis, Stage Four indicates that the cancer has spread from the primary organ to other organs. There is no stage five. With cancers of high mortality -- and pancreatic cancer is one -- quality of life is a usually a sound primary focus. Quality of life means different things to different people of course. For some people, the terrible side effects of highly aggressive treatments with debilitating surgeries and radical chemo-therapy are worth the price. For others, palliative treatments to lessen the worst symptoms of their disease allows them to be more present and whole during the time they have left. Oncology is a job just like anything else. Some oncologists focus on patient care. Some on business. You can throw as much money as you got and then some on cutting your friend's body and dumping toxic chemicals into her blood just for the sake of "doing something" because there's an oncologist out there who wants a new dock for a new boat at their lake house. Or you can find an oncologist who will do the best by your friend in good faith and provide an accurate prognosis based on hard to live with experience. Even if that means you don't hear what you wished someone would say. My beloved is a clinical social worker. Thirty years mostly in hospice and oncology. Our relationship has involved a lot sad conversations about the ways people die. There's a spectrum between calmly surrounded by loved ones and confused, mutilated, and painfully stuffed with tubes. It's not your choice. Good luck.

rateofchange 6y ago
Yes, this is a sobering diagnosis. And it has spread to the liver, which likely means the prognosis is far worse. I take your point about quality of life for what might remain. These are tough decisions those of us around her are going to have to make. I have friends who have reported about acquaintances who beat pancreatic cancer diagnosis and went on to live twenty or thirty years. I suspect these were early onset rather than stage four. This company seems to have had early success with metastatic pancreatic cancer. We've reached out to see what they have to say. https://nantkwest.com/nantkwest-and-immunitybio-to-initiate-a-phase-2-study-of-immunotherapy-for-metastatic-pancreatic-cancer/ https://nantkwest.com/nantkwest-and-immunitybio-to-initiate-... From the article: "Pancreatic cancer kills an estimated 47,000 people annually; it is the fourth leading cause of cancer-related death in the U.S., and 57,600 new cases are expected in 2020. Less than 5% of these patients will live for more than five years after diagnosis, and the median survival prognosis is 5 to 8 months." The end of that paragraph is quite sobering.
- brudgers 6y ago
  One thing I didn't cover is that "cancer" isn't one thing. And neither is pancreatic cancer. Steve Jobs had a rarer and less aggressive form. That's why he lived with his diagnosis as long as he did. His pancreatic cancer was a different pancreatic cancer from the most common pancreatic cancer. The median survival rate for pancreatic cancer is low because it tends to be diagnosed late. This is the case with your friend because the cancer is at stage four. In terms of quality of life, seeking enrollment in a clinical trial involves a lot of meetings and paperwork and often travel. Keep in mind that the driving force of the clinical trial you link is a business venture with a medical component. The trial is randomized which means some enrollees won't get the treatment being tested. In terms of anecdotal evidence of long survival, misdiagnosis is a real possibility as one goes further and further back, e.g. a person diagnosed in 1955 who lived to 1985. I'm not sure why the patient can't make their own decisions, but I don't have all the facts. I am sorry that you are dealing with this.
  - rateofchange 6y ago

architect 6y ago

If you haven’t seen this already you might wanna check out this article https://www.sciencedaily.com/releases/2020/05/200512151941.htm https://www.sciencedaily.com/releases/2020/05/200512151941.h... Good luck and hope your friend can recover fast!

rateofchange 6y ago
Will do. Looks interesting. Thanks. A friend of mine, who was diagnosed with prostate cancer, went through a radical change of diet. This included juicing lots of vegetables and cutting out most meats. He thinks the dietary adjustment played an important role in his cancer disappearing five years ago.