feet proublems with cancer

[DLM58]

Hi, I'm 50 years young and have panceatic cancer. Had the Whipple surgery June 2007. The cancer has spread to my liver and surrounding lymph nodes. Had my entire pancreas removed leaving me diabetic which can lead to feet proublems. My concern is wheather or not the pancreatic cancer can also lead to feet proublems. My feet and ankles are sore and swollen. Anyone have any info please let me know. Thank you.....................

[DLM58]

What can you tell me about the cancer marker CA19-9???????????
Thank you Dawn Miller

[Fernando Roque, MD]

Hi.  Portal vein thrombosis, if left untreated can cause blood to get dammed back to nearby blood vessels, such as those around the esophagus.  These vessels get engorged with blood, swell and become more prominent (they're called esophageal varices).  Some of these blood vessels may eventually burst and cause a lot of bleeding.

Blood going through the portal vein eventually end up in the liver, where waste material and toxic substances are processed into less harmful substances.  When the portal vein gets blocked, the blood doesn't get to the liver and doesn't get "detoxified".  These toxic substances may eventually end up in the brain causing what is called "porto-systemic encephalopathy".  This is a condition where a person's brain functions get impaired due to the increase in circulating toxic substances which were not filtered in the liver.

The decision to treat your portal vein thrombosis has to be weighed against your primary condition, which is the pancreatic cancer.  The doctor has to ask whether treating the portal vein thrombosis at this time will have an added benefit to you in terms of survival and in terms of quality of life.  You should speak to your doctor about it.

[DLM58]

Hi, I was wondering what would happen if a thrombosis of the main portal vein was left untreated? Thank you Dawn

[DLM58]

Thank you for the web site I went to it and it gave me what I neded to know. I was wondering what would happen if this condition went unattended. My doctor said nothing to me about this condition, actually I found out that I had this only because I read the radiology report to the CT scan that I had done on July 15th.The only thing my doctor told me was that the main portal vein was blocked never said what needs to be done or even if he thought anything should be done.

[Fernando Roque, MD]

Hi.  There's an excellent article about portal vein thrombosis which you can access online (http://www.emedicine.com/radio/topic571.htm).  In your case, your portal vein probably thrombosed because of an increased tendency of your blood to clot, which was induced by your cancer.  The usual procedure to treat this condition is to create a shunt (transjugular intrahepatic portosystemic shunt [TIPS]) to bypass the thrombosed section of the vein.

[DLM58]

Hi, I was wondering if you could tell me a little about thrombosis of the main portal vein and what is done to fix this condition........thank you

[DLM58]

Thank you again for the info.

[Fernando Roque, MD]

Hi.  Pancreatic neuroendocrine tumors are slower growing and relatively less aggressive than the more common pancreatic adenocarcinoma.  However, since pancreatic neuroendocrine tumors are rare, not enough cases can be gathered to accurately determine long term survival rates, so I can't give you exact figures.  

I suppose that the "water pill" you're referring to is a diuretic drug like Furosemide (Lasix).  I agree that it's not going to do you any good since I think the cause of your swelling is not excess water, but lack of albumin.  Improving your intake of protein may help correct that swelling.

[DLM58]

Hi, Thank you for your medical input. I was diagnosed with Stage IV Pancreatic Neuro endocrine Tumor with mastastases to the liver back in 2007 and had the Whipple surgery where the entire pancreas and spleen and numorous lymph nodes were removed. As for the swelling in my feet and ankles my doctor gave me a water pill that is not doing any good. My oncologist sent me for blood work to check my uric acid level. He says he wants to check for gout. No results yet on the blood work, hopefully Monday I'll have the results.
One of my other concerns, the type of pancreatic cancer that I have, is this type of cancer as fatal as other pancreatic cancers?
I am involved in a clinical trial at Fox Chase Cancer Center in Philadelphia, Pa. and I am taking a drug called RAD001 ( chemo drug ). I started the trial in December 2007 and I have a CT scan done every 3 months. The first CT scan showed some shrinkage to the leisions that were found on my liver and surrounding lymph nodes. My last CT scan showed no further shrinkage.
I appreicate all the info you give me and the prompt response.
Thank you very much for being here to help.

[Fernando Roque, MD]

Hi.  The pancreatic cancer itself may not directly cause the numbness, soreness and swelling in your feet.  However, the diabetes which was induced by removal of the pancreas can cause peripheral neuropathy (numbness, tingling or pain sensation at the tips of both hands and feet).  The swelling of your feet may also indicate decrease in production of albumin by your liver.  Albumin is a protein present in the blood.  It acts like a sponge and prevents fluid from leaking out of the blood vessels and into the surrounding tissue.  If the liver sustains significant damage (which may be the case when cancer spreads to the liver), its function of producing albumin may be impaired.