Long-Term Stabilization in a Patient with Nonresected Pancreatic Carcinoma Undergoing Chemotherapy

Abstract

Background: Surviving more than one year after diagnosis is uncommon in patients with nonresected carcinoma of the pancreas. The effect of ‘alternative medical treatment’ to malignant tumors is doubtful; nevertheless, oncologic patients tend to use those therapies. Case Report: A 60-year-old patient with asymptomatic jaundice underwent laparotomy in June 1991. A pancreas tumor was found but not resected because of an unsuspicious biopsy. Further histological evaluation of the specimen showed an adenocarcinoma of the pancreas. The patient, however, refused resurgery. From July to November 1991 he underwent a chemotherapy (FEM regime) in our hospital. In September 1991 he decided to take part of an ‘alternative therapy’ additionally. Meanwhile several follow-up studies using CAT (computer-assisted-tomography) and MRI (magnetic resonance imaging) showed neither progress of the primary tumor nor distant metastasis. In July 1994 the patient returned complaining weight loss and pain. A CAT-guided biopsy was done, histology again showed lesions due to pancreatic adenocarcinoma. Staging by CAT and angiography showed progress and a tumor that now was nonresectable. Despite another chemotherapy the patient died in February 1995. Conclusion: Long-term survival of pancreatic carcinoma that primarily cannot be resected is rare. This report presents such a case. It is impossible to clear up the reasons for this uncommon course. Since tumor stabilization caused by chemotherapy in pancreatic cancer is doubtful, a specific tumor biology has been discussed as the reason for the long survival time.