Re: Pancreatic cancer and BPD

[Guest guest]

Pam,

First of all the Pancreatic Cancer thing is way overblown. Second we

should understand that the BPD is actually a part of a procedure not

a procedure unto itself. BPD stands for Biliopancreatic Diversion,

and is a malabsorptive technique where the bile combines with the

food further downstream rather than at the top of the intestinal

tract. This causes fats to be malabsorbed while keeping the

absorption of protien and carbohydrates relatively good.

What Scopinaro refered to as " BPD " was a BPD with diatal

gastrectomy. The bottom part of the stomach was removed (including

the pylorus) and the lower part of the intestine was hooked up to the

top part of the stomach.

The procedure we know as " DS " is actually a BPD with sleve

gastrectomy and duodenal switch. The " sleve gastrectom " cuts the

stomach along the greter curvature and maintains the pyloric valve.

Just below the pyloric valve the duodenum is cut. The lower

intestine is then attached to the duodenum, and the upper intestine

is detached from the lower intestine and then re-attached further

downstream.

I have access to ample information on the BPD and BPD/DS. The

abstracts can be found in my folder. Look under the Files section

and then " Hull's Folder " and you will find journal abstracts

and articles.

Hull

> This talk is scaring me. I am trying to do research on the

Scopinaro

> without much success. My surgeon said the px. would be the gastric

> sleeve part of the procedure, then a pyoloroplasty instead of the

> DS. I thought that the Scop and the BPD were the same thing. With

> what I was told, the pyelorus is still there, but the nerves have

> been cut so it remains wide open. Are these two different pxs? If

> the pt. has a sleeve gastrectomy and the pyelorus is not dissected

> free from the stomach, would one be more prone to the pancreatic

> cancer?

> Pam in PA

[Guest guest]

In a message dated 10/22/01 2:30:38 PM, duodenalswitch writes:

<<

First of all the Pancreatic Cancer thing is way overblown. >>

Chris: I don't think mentioning that it is a risk of lower antrectomy

removal is 'overblowing it'. I have mentioned several times that the risk

wasn't huge and that not every person who had this type of surgery would end

up with pancreatic cancer. However, what DOES bother me is that not one

surgeon seems to be informing his/her patients of this when presenting info

about the traditional BPD (by this, I am not referring to the intestinal

arrangement but the type of gastrectomy used in the traditional 'bpd'

surgery).

Yes, the fact that there is a risk for pancreatic surgery can be taken with

extreme fear by some, but if people would actually READ the sources I posted

way back when (and these are all in the archives), they could be better

informed and able to decide whether this is a a risk they would be willing to

take. It is also crucial for those with family history of pancreatic cancer

to know this information.

I have repeatedly stated that this risk was associated with lower antrectomy

removal (and hence the BPD gastrectomy) but NOT the DS sleeve gastrectomy or

RNY.

all the best,

[Guest guest]

In a message dated 10/27/01 2:39:44 PM, duodenalswitch writes:

<< I have to agree with you wholeheartedly. My father died of

pancreatic cancer which may or may not leave me with a predisposition

for getting this disease. He was the son of an extremely diabetic

mother, (not obesity related). My doctor says there is a connection

between a familial history of diabetes and pancreatic cancer. So,

anything that might put me at a greater risk for developing this

cancer, ie, diabetes in the family, or surgery that could increase my

risks should be evaluated very carefully!>>>>

Theresa: Sorry to hear about your father. I think that for anyone with a

family history of pancreatic cancer, this information about slight increased

risk after a BPD is crucial, although perhaps not as important to those who

do not have a history. Even for myself, I would seriously consider ANYTHING

that raises my risk of pancreatic cancer with great concern since it is often

not caught immediately and is quite fatal. The symptoms mimic what a post-op

DSer may experience so I think it would be quite difficult to diagnose and

might be ignored early on. I think that ANY BPD patient should be informed

of these studies (done on peptic ulcer patients) and also be given a

comprehensive aftercare with testing/etc. for increased pancreatic cancer

risk. This way, they could be monitored more closely and the cancer could be

caught in it's earliest stages if indeed the patient developed it.

<<<<<<<Oh, and in talking with my DS surgeon, he feels that lactose

intolerance really may now NOT be considered a side affect of WLS.

He is finding that immediately post op, many folks have a sensitivity

to lactose that they are losing within a healing timeframe post op.

So for those of you who feel that you became lactose intolerant post

surgically, or even pre surgically, you might try to reintroduce

lactose every couple of months and see if this has reversed for you!

>>>>>>

Wow - that's great news! The former nutritionist at Mt. Sinai also believed

that many post-ops may not have 'true' lactose intolerance but an aversion to

milk products immediately post-op that will dissipate in time. Pretty

interesting! Thank God, I didn't experience this side affect after surgery

(hope I don't develop it,e ither) but I can imagine the extreme discomfort it

would bring, especially right after surgery.

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

nine months post-op and still feelin' fabu!

preop: 307 lbs/bmi 45

now: 207

[Guest guest]

My father died of

pancreatic cancer which may or may not leave me with a predisposition

for getting this disease>>>>>>

Theresa......

My moms sister just died last Sat from pancreatic cancer and she also was

diabetic but type 2 for the last 20 yrs but had it under good control all

that time. She was diagnosed with cancer just 3 weeks before she died so it

was very fast and she was in NO pain at all.

After reading that thread about pancreatic cancer it made me kind of nervous

that she died from this almost a year after my own surgery but Im

understanding that preventing diabetes in the first place helps in making

our risk alot lower in getting this disease, am I right? I hope so! She

was the very first one in my family to have that type of cancer. My mother

is never sick!

Hugs, Judie

[Guest guest]

The symptoms mimic what a post-op

DSer may experience so I think it would be quite difficult to diagnose and

might be ignored early on>>>

what are the symptoms???

Judie

[Guest guest]

Sheryl,

You can't live without a pancrease. Did perhaps she receive a

transplant?

Theresa

P.S. The issue is post surgical risks, meaning that should one

develop pancreatic cancer post op, at the point one becomes

symptomatic, it is too late. My dad was diagnosed as having

diabetes. He did not respond to any medications or diet adjustments.

When he became jaundiced, they did exploratory surgery and found he

had pancreatic cancer. It often disguises itself as diabetes. At

that point, the cancer was so invasive, he died within a month of

discovery.

> In a message dated 10/27/01 7:05:06 PM Eastern Daylight Time,

> jhensel@c... writes:

>

> << The symptoms mimic what a post-op

> DSer may experience so I think it would be quite difficult to

diagnose and

> might be ignored early on>>> >>

>

> But wouldn't pancreatic cancer be caught at the time of surgery by

the

> surgeon? When they're in there it's normal practice to look around

and feel

> around. I know my aunt went in for a gall bladder removal and was

diagnosed

> with pancreatic cancer in an early stage. Her pancreas was later

removed,

> making her a diabetic but removing all cancer thus saving her life.

> Sheryl

[Guest guest]

Theresa..

Sure you can.. what would our pancreas transplant patients do post

rejection if that were so? Yes, they need an insulin pump to try and

keep blood glucose under control.. but yeah.. its possible. Just not

fun.

Hugs,

Liane

> Sheryl,

>

> You can't live without a pancrease. Did perhaps she receive a

> transplant?

>

> Theresa

>

> P.S. The issue is post surgical risks, meaning that should one

> develop pancreatic cancer post op, at the point one becomes

> symptomatic, it is too late. My dad was diagnosed as having

> diabetes. He did not respond to any medications or diet

adjustments.

> When he became jaundiced, they did exploratory surgery and found he

> had pancreatic cancer. It often disguises itself as diabetes. At

> that point, the cancer was so invasive, he died within a month of

> discovery.