Nov. 17: We met with Mom’s surgeon, Dr. Matzke, this morning to review the results of her most recent, finer sliced, ultrasound. At this point, Dr. Matzke doesn’t think that the tumor can be removed. However, she’s right on the borderline of resectability, so he wants her to get an endoscopic ultrasound to see if he can get a better view of the relationship of the Superior Mesenteric Vein (SMV) to the tumor. She has that procedure scheduled for Tuesday, Nov. 22 at the University Hospital. Our next meeting with Dr. Matzke is on Monday, Nov. 28.
Dr. Matzke couldn’t tell from the scan if the vein is invaded by the tumor. It appears to be wrapped more than 50% around the vein, and it’s unclear from the scan if there’s a fat plane between the vein and the tumor that could be used for resection.
On a positive note, Dr. Matske found that the vein is not clotted, one of the concerns he raised last week. There is quite a bit of corollary vein development (tiny veins that Mom’s body has created to compensate for the SMV), which worries him.
Mom will go under general anesthesia for the endoscopic ultrasound, and they’ll be looking to see if they can get a better picture of the tumor/SMV area. At this point, from the CAT scan images, Dr. Matzke said he wouldn’t do the surgery. So in reviewing the results from the endoscopic ultrasound, he’ll be looking to see if he gets a prettier picture.
Dr. Matzke trained at the Rochester Mayo clinic, and he recommended that we get a second opinion from Dr. Mike Farnell, who he said is probably the best pancreatic surgeon in the country. Dr. Farnell does around 15 Whipple procedures each month.
We’re also planning on going back to Dr. Sharon Webber at the UW Hospital to get a third opinion. Those appointments will probably take place in early December.
That’s the update for now. Surgery to remove the tumor isn’t a clear option, but it hasn’t yet been ruled out.