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Pancreas Cancer

Anytime was posted 10/18/2015 10:10 am by Anonymous
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Many gastroenterologists 'forget' that gastroparesis is such a common complication of PC. It always surprises me how many people post of symptoms that are because of gastroparesis, yet their doctors don't diagnosis it or treat it properly. Many talk of these new symptoms and problems as part of the 'new normal' the discover after being diagnosed with PC, or if the symptoms get worse after having Whipple surgery.

I never accept anything unpleasant as 'normal', and refused to accept it for my Mom.

Keep asking questions. Surround yourself with a 'team' of doctors and nurses that will each have their area of expertise and interest. No one doctor can do it all, unfortunately. So be persistent when you need help.

For my Mom, her initial doctors were her oncologist and her primary care doctor and a cancer psychiatrist. Her primary care doctor did all of the management of her diabetes and watched her anemia. Very early on, we added a gastroenterologist with expertise in the pancreas. Fortunately, our oncologist referred her to this doctor, and he helped tremendously with diagnosing gastroparesis and treating it, pancreatic enzymes, and with lower abdominal gas. While the oncologist (and the oncology nurses, especially the chemotherapy infusion nurses) can be helpful for treating nausea and constipation, the gastroenterologist was sometimes help for those too.

When things got complicated, we added more doctors. The most important early doctor was the Cancer Center Psychiatrist. I cannot emphasize this enough. Depression is a symptom of PC. There is actually something produced by the cancer that affects the brain and causes depressed mood. This is critical to treat, and should never be brushed away as being 'normal', or 'understandable'. It usually should be treated with medication. It is critical to treat, as you will feel better, be more active, sleep/eat better, tolerate chemo better and survive longer with a better quality of life when you treat depression. This is a no brainer. My Mom's cancer psychiatrist also helped with issues with sleep, and helped her profound fatigue (also caused by the cancer and worsened with chemo) by starting her on the stimulant - ritalin. An excellent decision, which improved my Mom's quality of life a lot.

Other experts that my Mom saw when needed included a nutritionist, the pain specialist, and finally (and too late....) a Palliative Care Doctor. Palliative Care doctors treat the 'quality of life' symptoms, such as pain, nausea, appetite, sleep, depressed mood, constipation and many more things. How convenient.... the expertise of many doctors all wrapped up in one! They focus on helping you to feel the best you can. In the past, they worked primarily with patients on Hospice who are no long pursuing aggressive treatments for the cancer. However, many cancer centers are now starting to pair up these Palliative Care doctors with patients at earlier stages of their fight... especially older patients and patients with advanced cancer who often have more side effects of the cancer/treatments. Studies have shown that having a Palliative Care doctor that works side by side with your oncologist leads to better quality of life, reduced pain and discomfort, improved mood, and a longer survival. Amazing. Another no brainer. Unfortunately, these doctors are still too few and far between.

Realize that everything is trial and error. Sometimes a medicine works, sometimes it doesn't. Sometimes you need a higher dose, or to change the time of day you take it, or to add a different medicine. Sometimes a medicine causes a side effect that is unacceptable, and needs to be changed. Sometimes you need to stick with something for a few weeks before giving up on it, because your body needs time to adjust. Keep asking for help when something doesn't seem to work. These things take time.

Take one day at a time.



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