Very helpful. Please keep up the effort. Every hour spent here is many hours with individual patients and their care givers.

Hi, Dr Evans. My issue is that the tumor is at the body tail and was less than 3 cm at time of diagnosis and would have been resectable at this time. However, a lymph node was enlarged and abutting the blood vessels. I started on Fulfirinox which did little in terms of reducing the tumor, in fact it grew slightly, as did the lymph node. I was then moved onto Gemzar and this was night and day, from staying awake to take my next tylenol 3 to kill pain and using fentynil patches to help contain pain to no pain at all in 3 days after dose 1 of the Gemzar. The resulting CT scan three months later shows that the tumor had become immeasurable and the lymph node had shrunk but still had a some connections to the blood vessel. In your talk you do not implicate the lymph nodes in the staging, for example N0, N1, N2 etc. Why is that and what does this imply in making surgical decisions? It seems to me that there is little data on biopsy of the lymph node, are they cancerous or just doing their job of dealing with an infection. Currently I have finished my full Gemzar treatment and awaiting my final CT scan to decide on surgery with a possibility of proton radiation if there are still complications. All CT scans have shown no metastatic involvement of any other organ and so I'm not Stage 4. I am in the Penn Med system in Philly.

What if,this is the case doctor,. after 4 years of surgery..there is a cancer recurrence?

You did not explain the difference between locally advanced type A and B !

Treatment options not discussed for stage 4...

I need help! My husdand was diagnosed with Prostate Cancer in 2020 while getting radiation therapy he had a X-ray/CT that showed nodules on his lung for biopsy and was told he has Non Small Cell Lung cancer, begin treatment for NSCLC soon after with immuno therapy after a year in 2022 and a couple months after immuno therapy it spread to the left side with more nodules & started chemotherapy again, had a procedure, ERCP for jaundice and dark urine and had a mass on my pancreas & biopsy revealed pancreatic cancer, I can’t believe this, any suggestions, please!

My mother is 80 years old and doctor have told that she has crossed more than 4th stage. Pancreas and liver cancer is spread.