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There are some very good hospitals for treating cancer in NC. Duke is quite reputable.
Most people will not stay in the hospital for their cancer care. She should have seen an Oncologist who specializes in pancreatic cancer and/or gastrointestinal cancers while she was in the hospital, and then be scheduled for follow-up with that doctor as an outpatient. Rarely, some people will get their first dose of chemo as an inpatient, but usually all care is as an outpatient.
You will quickly learn that you need to prepare a list of questions for each doctor/provider. Do not let them leave until all questions are answered, and the plan is clear. My last question is always... 'when is our next appointment'?
I would recommend going to the PanCan website, sign up to get an advocate, and begin reading their information and referral list.
Most likely your Mom will be considering chemotherapy for her treatment for Stage 4 PC. The most aggressive doctors are using a combination of 3 chemos called 'FOLFIRINOX'. It is also common to get a treatment with the chemotherapy Gemcitabine + one other chemo (such as Abraxane or Oxaliplatin). The more chemos, the more side effects. As we get older, we have more side effects and have trouble with the more aggressive treatments. But you never know until you try. Typically, surgery and radiation are not used for Stage 4 disease. But in some rare cases, people respond well to chemo and more aggressive treatments have been done.
I strongly suggest asking if a Palliative Care doctor can become a member of your Mom's 'team' of doctors during her fight. You really need a team, to make sure that your Mom gets the attention she needs. Palliative Care doctors focus on the quality of life symptoms like energy, pain, appetite, mood, sleep and many more. And studies have shown that patients with advanced cancer like your Mom do better, live longer, and are happier when they get Palliative Care in addition to their chemo. Some clinics do not have enough of these doctors to see all of their patients, but they are becoming more widespread, and are especially important if you are older and if you have Stage 4 disease. Then the oncologist can focus on the chemo etc.. Other doctors that sometimes are helpful on the team are gastroenterologists, and we also consulted with the pain doctor and Psychiatrist in our cancer center when we needed them.
FYI - depression is one of the early and common symptoms of PC. Make sure it is aggressively treated if your Mom has it. It is a symptoms, just like pain or digestion problems. Don't let the doctors neglect it.
I hope you can be there to support your Mom in whatever she decides she wants to do in this struggle. It is very important that she make decisions as she wants and is able. Good luck, and come back here for questions and support.
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