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Pancreas Cancer

torn on next steps was posted 04/25/2016 02:46 pm by morninglemon
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My family feels like torn about what to do next. After a CT scan 3 weeks ago showed that my uncle's mets have spread significantly while on gemzar/abraxane, he opted to discontinue chemo. His oncologist had given him the option of 5fu because he didn't feel my uncle would tolerate florinox, and my uncle decided he was done with all the chemo and side effects. We are looking into clinical trials in our area, but everything nearby (he can't travel) are phase I/IIs, with a waitlist for an immunotherapy trial. Of the 4 we have contacted so far, 3 have said they don't accept my uncle's insurance for the initial consult. And my uncle's daily condition (the pain is worsening, the ascites is coming back quicker, he's lost another 10 pounds in the past 2 weeks) is getting worse much faster than I thought. He had two hospitalizations in April and in the two weeks between them, another CT scan showed his liver mets have spread again.

At this point, what should we do? He's not on chemo; we are waiting to hear back on the trials but at the rate he is declining even if we get into a trial he may not be able to do it. We have scheduled an appointment for another second opinion next week (we don't like his current oncologist, who refuses to provide guidance on the clinical trials, and says he is not equipped to manage his pain better). His oncologist and all the palliative care doctors we've seen while he was in the hospital are pushing us to accept hospice. Right now we are trying to manage the pain at home and drain the ascites whenever he needs it (he refuses to put in a catheter because they've been draining from different spots each time). My family is wondering whether at-home hospice care would be significantly better care than we are currently providing while we wait to hear back from the trials.

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