Pancreatic cancer (yellow stool, back discomfort, masses on liver)? Ultrasound, lab results

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About me:

-          29 years old, 85kgs, doing sport, so barely have any stomach and 190cms, male, white, Hungarian

-          No smoking, no drinking

-          In the family history there were a few cancers (one grandfather beat prostate, the other died from lung cancer, but was a chain smoker for 55 years before that)

-          Currently taking probiotics, 40mg otilonium bromide once a day (spasmomen, taking it only for a few days) and calcium carbonate (600mg, once a day before going to bed because of my colon problems) and some vitamins

-          Never smoked, never was an alcoholic, and I do not use any other substance (tried marihuana for a few times but that is it)

Long story short:

-          Have had stomach problems for over 5-10 years, almost always only stress related diarrhea, no pain etc

-          Recently symptoms were getting worse (in the last year the amount of stress in my life went up a lot), so I went to the doctor

-          Since 3-4 weeks my stools are yellowish, sometimes float, sometimes do not (it is never difficult to flush it though), and sometimes I see undigested pieces in them. I also head some watery-foamy diarrhoea, 3 times so far. I also have some lower back waist pain which is probably related to bad posture as it gets worse as I hunch over and disappear if I lay back. About a week ago I started to notice some pain in my back around my right shoulder blade. It seems that if I am not paying attention then I do not feel it, I only feel it when I am focusing whether I feel it or not, but it seems to getting worse gradually.

-          I started to panic since the yellow stools and the back pain that came later, and since then I am afraid of having pancreatic cancer. Since this happened I am searching for hours every day about symptoms etc.

Examinations I have had:

-          2 ultrasound, one done by GP, one by someone who is an internist. The second one was done as I told him about my concerns about having pancreatic cancer, so he was focusing on that.

-          Both ultrasound said that they had a clear look at my pancreas and all seemed fine. See the first ultrasound picture attached here:

https://imgur.com/a/g8G60kz

I was told that this is an extraordinarily good picture of a pancreas made by an ultrasound.

-          However, they have found 2 spots on my liver, but it was identified by the doctors as hemangiomas. The internist told me that he sees way more cancer and mets then hemangiomas and the look completely different. Both doctor emphasized that my pancreas is all good.

https://imgur.com/a/gSqP3wU

 

-          Have had physical examinations and blood tests: lipase (31 U/l and normal range is everything below 60 according to my lab), amylase (72U/l and normal range is 15-94), AST (25 U/l, with normal range 2-37), ALT (33U/l and normal range is 2-45) all normal. All tumor markers negative (C 19-9 is 6.79, normal value according to the lab is 2-37). They have found elevated B12 levels (1026 pmol/L it should be normal in 138-652, but I take a multivitamin about every/every 2nd day that consist 50 times the daily recommended value of B12). The lab also identified slightly lower RBC (4.49T/l, normal range 4.5-5.8), HGB (135g/l, normal range is 140-180), and HCT (0,4l/l, normal range 0,42-0,51) and slightly higher bilirubin direct (3.5 umol/l, and considered to be normal below 3.4, but as far as I google-d it, other labs consider the normal level to be below 5). My alkaline phosphate level is 131 U/l, but my lab has a reference range of 80-300 (which seems high compared to the values I have found online, but everything that I have found said that normal ranges can vary from lab to lab). So, it seems that all my pancreatic/liver enzymes (and also bilirubin) are quite normal, I have some blood measure that are slightly below the normal ranges, and my tumor markers does not show any signs of cancer, neither the ultrasound results. AFP, CEA also negative.

Details (I translated from Hungarian, so I only translated the results):

https://imgur.com/a/NuFP4lQ

 

Should I worry of having pancreatic cancer? Or should I go to a psychologist because of my anxiety? I am afraid because I know that normally US is not the most reliable in finding PC, but the doctors reassured me that in my case the pictures that they took were extraordinarily clear. Blood results are also find, but I am not sure whether I should push for CT/MRI?

I also uploaded the longer story with details regarding the ultrasounds and my symptoms to here:

https://imgur.com/a/wptLoY5

 

Thank you reading and thank you for the help!

1 like, 17 replies

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  • Posted

    I would ask for a MRCP, it’s the only noninvasive test that really looks at the pancreas. In my experience the ultrasound didn’t catch my two pancreatic ducts which in turn caused chronic pancreatitis. I don’t have PC but you can live without your pancreas. I have to have mine removed. You would have more symptoms if your pancreas was acting up though … there’s a lot of pain after eating, vomiting, migraines, heart burn the list goes on and on. 
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    • Posted

      Luckily for me my ducts were clearly visible according to the doctors. The second ultrasound was taken by an internist, and he measured my pancreatic duct and also my common bile duct and commented on my paper that both of them has normal size, none of the is dilated.

       

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    • Posted

      I’m glad your ducts were visable but if you want peace of mind then ask for a MRCP. An ultrasound isn’t a clear working image of your pancreas with contrast and without. There’s really only three tests that look deeply at and/or into the pancreas. There’s the MRCP which is a really fancy MRI. Then there’s an EUS and ERCP. Both of those they don’t perform for diagnostic purposes because they can cause a pancreatitis attack. They may elect for an EUS before an ERCP too but regardless you’re put under. I’ve been through it all. ERCPs are more like mini surgeries on the pancreas. I’ve had six in attempts to treat my Pancreas Divisum and chronic pancreatitis. A lot of doctors don’t have the knowledge of the pancreas. They don’t understand blood work doesn’t matter if you already have chronic. It took the doctors over a year to diagnose me because of my age and my tests were coming back normal. I don’t suffer from diarrhea which is one of the biggest symptoms. They had me get an EPI (fecal) test. This measures how much I digest/absorb fats. The pancreas produces digestive enzymes and if it’s not working correctly then you’re not digesting properly. I have to take digestive enzymes because my pancreas is not producing enough. There’s also a medical condition regarding digestion separately from pancreatitis but I don’t remember what it’s called. I do know that all the person has to do is take enzymes for it. There’s many conditions that can mimic pancreas symptoms. Those of us with pancreatitis have to be careful with foods. We have to stick to a low fat and sugar diet. I was also advised that I could develop food intolerances which is something I didn’t have before. We are all unique and will all have different experiences. All we can do is give you advice from our experiences. 
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    • Posted

      Thank you for the advice. My problem is, that my doctors are quite reluctant to do anything, because I do not really have any classic symptoms, and so far everything that they have done came back normal, or not causing any suspicion. So, my pancreas can be seen way better than it is seen for the average people. My blood work (including cancer markers) all normal with a few minor differences from the normal range. So my doctors are quite convinced that my problem is anxiety, and I need to work on that. I am going to have an appointment in the hospital with a internist. We will see that he/she says, but the doctors are also starting to convince me that all I should do is relax, because there is not a single thing which is pointing to pancreatic cancer or cancer at all.
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    • Posted

      Well, after the hospital visit the doctor scheduled an MRI to examine my liver and to make sure that they are hemangiomas, nothing serious. My pancreas should be also visible by the MRI.

      The last 3 weeks was quite good, everything went back to almost completely normal, I gained some weight too. However, 3 days ago, it started all over again, yellow stool etc. But at least they are not floating, which is a bit reassuring.

      I am trying to relax as I think probably most of my symptoms are caused and enlarged by my anxiety. At least during the last couple of weeks my stool were normal, and I am trying to be stayed reassured by that. I am going to receive a 3rd bloodwork result today too. Hopefully it will point away from any major issue again. But since I have diarrhea again, I am worried again a lot.

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    • Posted

      Hey Man, feel free to message me, we can chat. I am in such a similar situation. I am a bit younger - 26, but had all the tests and I still have pain and similar symptoms. If you feel like chatting - message me. It helps to talk to someone who know what you are going through
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    • Posted

      I am right there with you. Trying to found answers for the past year. I am 60 so obviously I am in the age group that this is more prevalent. Like you, 

      I have bhad allhe testing. 2 cat scans, colonoscopy/endoscopy, mri/mrc of lab work, bone scan that showed a hotspot on 7th rib. The list goes on and on, all normal. Even so I continue to have all the symptoms.  Ever changing stool, pain under left rib sometime tingling pain, sweats.  I just had a great week, today staring again.  I read too much and like you I am scared and a very nervous person. Have an appointment for second opinion with gastro dr September 26th.  Good luck!

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    • Posted

      Stress and anxiety play a big role. Whenever I get extremely stressed out, I end up getting a pancreatitis attack. Fortunately, I know what to do because I don’t want to drive over an hour just to stay in the hospital. There’s no hospital around me that are equipped to treat pancreatic issues. Whenever I start to feel pain I take Tylenol (I’m not allowed to take Motrin or Aspirin as it destroys the stomach lining) and I put heat packs on my abdomen. I drink Ensure and chicken broth then a couple days later I will slowly incorporate bland foods. I don’t know your age but I’m only 38 and it’s not common for someone my age to have chronic pancreatitis or PC unless you have a family history, cystic fibrosis or Pancreas Divisum. However, it is common amongst the elderly. I was stumping the doctors because I didn’t have all the classic symptoms and they were relying on the blood work. I requested copies of all my tests and looked up the medical terminology since my CT Enterography showed “atrophy of the pancreas”. When researching it, I found out that it meant irreversible degeneration of the pancreas, usually associated with chronic pancreatitis. I brought that to the attention to my primary doctor. I was then referred back to the GI and that’s when the MRCP was ordered and the Pancreas Divisum was found. Even after the PD was diagnosed the GI thought my symptoms were IBS related. I asked to see a pancreas specialist. I had my first ERCP and was diagnosed with chronic pancreatitis. I don’t think I would have a diagnosis if I didn’t do the research. However, I also have a history of my intestines adhering and I remember that pain. I don’t have any organs left except my kidneys, pancreas and spleen and I knew something wasn’t right. I am very close with my doctor and she knows if I am complaining about pain then it has to be bad. (I have had surgery every year from 2003-2016) not related to my pancreas issues which now I know I was born with. I had to learn to let go of the things out of my control. Once I did that, I figured out what worked with my body. It’s not an easy battle but it’s possible. I try to keep a positive attitude and distract my mind. I hope you find answers soon and your symptoms get better.  
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    • Posted

      Thank you so much for this post.  It helps me to hear this.  I have a question for you, these symptoms will get better for 5 or 6 days.  Then the stool Starts again all with some of the other symptoms.  It is like a roller coaster!  Have you experienced this?
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    • Posted

      Yes, it’s a roller coaster. I never know how I am going to feel when I wake up. Some mornings I wake up at 3am to run to the bathroom to vomit then my head starts pounding and turns into a migraine on top of all my other symptoms. Other days I suffer with kidney stones I developed from pancreas issues. I never really know how I will wake up and I keep losing weight. I see my specialist in November to find out when they’re removing my pancreas. My stool color change and that’s my indicator (other than pain to rest my pancreas). I don’t get diarrhea, my stool goes from normal brown to clay/pale color. This lets me know my ducts are clogged and bile isn’t flowing correctly. It’s really a battle but when it’s the pancreas it’s debilitating pain. I’m already on medication for another medication condition and it doesn’t come close to helping pancreatitis pain. Usually only a hospital can help when it’s a bad attack.    
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  • Posted

    I’m no doctor but I have had pancreatic cancer and I would have loved to have the results you have because it would mean there was NO cancer. Yes, it’s a hard disease to definitively diagnose but so far you are showing no real signs of it. Worrying about it will only make the symptoms you do have worse so getting some treatment for anxiety is a good start. You may find with the right mental tools a lot of your symptoms will ease. I have had bad anxiety in the past and it plays hell with your gut. 

    If you are determined to go down the testing route (and I understand your doctors reluctance based on your results so far) then an EUS will give you a better look at your pancreas. It also runs the risk of triggering a pancreatitus attack and they are very unpleasant. Of course you know your body best but from what you’re saying here, your main problem is anxiety. By all means keep an eye on your symptoms but don’t let it become an obsession. Serious illness does reveal itself in time and if you had PC then frankly by now you’d be very ill. I see so many people on here who have worked themselves up by looking on the internet then refusing to believe their good test results. I would trust a doctor over the internet any day. They are better placed to interpret your medical history. Of course, they’re human and not perfect but there is a lot on the internet that is out of date and frankly cintradictatory so my advice would be to get some treatment for your anxiety and see if that helps. And PC isn’t necessarily a death sentence anyway - I’m living proof of that!

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    • Posted

      Thank you for your reply. I know that my results are quite good. However, it is a bit annoying that I have problems with my stomach almost all the time nowadays, they are worsening in the last 6 months quite obviously, and the doctors are refusing to do anything. My GP concluded IBS after a stool test for bacteria and IBD. The ultrasound was forced by me. After the ultrasound the GP told me that it is 90-95% likely that it is only hemangioma. I know that 90-95% is quite high, but unless you cannot say it by 100% (or at least 99) then you should do something. At least a bloody blood test. I had to go to a private doctor for the blood tests.

      I know that it is possible that all my symptoms are generated by my anxiety. But I am not sure what came first, the symptoms or the anxiety. Because if I have random problems with my stomach I get quite anxious, it is my weak spot for sure. But I know that these problems can be generated/can worsen due to anxiety.

      After the ultrasound I got pretty anxious and started to read on the internet. I found a couple of stories where IBS was concluded and after a few months it turned out to be cancer, specifically pancreatic for a couple of times, and I know that pancreatic cancer metastases to the liver (where I have those most likely benign masses) quite frequently. So yeah, I am afraid a bit for sure.

      I also feel ashamed because I know that a lot of people are struggling with this disease and I feel bad by complaining as I am not diagnosed with anything currently. But this uncertainty is hard on me.

      Thank you for replying again! I wish you the best!

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    • Posted

      Don’t feel ashamed. As you have already admitted you have anxiety. I have anxiety as well. I was very anxious throughout the year it took the doctors to diagnose me. However throughout that year what I learned was that unless you have a family history, cystic fibrosis or Pancreas Divisum then it’s rare for you to get PC especially if you’re under 50. I still get anxious sometimes even though I have a diagnosis. It was a struggle for me to get tests as well because everything was coming back normal. I kept insisting on tests because I had horrific abdominal pain and many more symptoms. The weight loss alone scared me. I lost close to 50 pounds in a matter of months. (I’m bedridden due to another medical condition and I wasn’t trying to lose weight). I couldn’t keep food down and when I tried to eat there was so much pain afterwards I got scared to eat. My stool was clay/pale color and of course Dr. google said my symptoms pointed to PC which freaked me out more. I learned to distract my mind and it worked. Medical is out of my control and that was something I had to accept which was hard for me to do. Keeping a positive attitude and journaling my food helped until I got a diagnosis. 
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  • Posted

    Lac I'm going to assume your doctors have been thorough and your test results don't reflect PC, at all.  That you have a problem believing everything is fine makes me think you do have Health Anxiety.  That's an illness in it own right and requires expert treatment.

    Health Anxiety can cause all the physical symptoms you list, all of them.  It's like you're on a hamster wheel going round and round increasing your anxiety at every turn which in turn increases your physical symptoms.

    Ask your doctor to refer you to a specialist who can help you manage this illness.  Good luck.

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  • Posted

    Laci,

    I am right there with you. Like you, I have been having symptoms for a year. bowel issues that consists of constipation alternating with floating light brown colored stool, pain and tingling under my left rib cage and around my back, indigestio & sweats. I have had mri/mrcp, 2 catscans, colonoscopy/endoscopy, and tons of lab work. All normal!  Had a bone scan, had a hotspot on 7th rib right where pain is.  After all that, I have no answers and I am still experiencing symptoms.  My good days are slowly being taken over by bad.  They say how cancer is hard to detect especially in the tail.  Dr’s think I am crazy and just shove me from dr to dr. All I want is to feel good again, been a long year with no end in sight and hoping misdiagnosis will make it too late.  Good luck!

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