Is it possible for someone to have stage 4 pancreatic cancer with liver metastasis after?

Question

after having had an exclusive and complete, state of the art, head to toe medical check up 6 months prior without any red flags.
Is this a turbo charged cancer or did someone drop the ball?

My husband's friend and collegue has just been diagnosed.

To happy Dawg:
The state of the art physical was one that had the 3D imaging of the entire body. The one that Oprah featured once when she had a physical done with Dr. Mehmet Oz. It's a $6,000 dollar test but is the most sophisticated imaging technology available.

Also, this test is not covered by insurance.

Answer 1

Yes, it is possible to miss cancer even with a complete state of the art check up. In general there are no symptoms and looking for cancer is like looking for a tiny needle in a haystack. You need to know exactly in the entire body where to look for that one malignant cell that may be cancerous. Sometimes in our anger in a tough medical situation people want to reach out and blame someone. Be extremely angry at the disease, that is where you should focus your energy. It is not any one persons fault.

Consider this please . . cancer is a progressive disease. It starts out microscopically . . one single mutated cell . . there are no symptoms. That cell begins to multiply uncontrollably. Some of these malignant cells have the ability to double in as little as two to four weeks. It can grow rapidly from that point on . . and still be undetectable. It is extremely difficult to find any type of malignant tumor that is under 2cm. So, unless someone has a medical exam at just the right moment . . cancer can easily be missed. The ease with which cancer can be missed is one reason that doctors recommend to cancer patients to have CT, PET, or MRI pretty routinely (ever 2 to 3 months) in order to detect any growth or spred of the disease. Even with all the imaging tools we have . . cancer tumors can be underestimated . . and may not pick up the extent of the disease.

So, yes . . in answer to your question . . high grade, aggressive type cancers are 'turbo charged' and can grow uncontrollably within weeks to months. That's why they are so deadly . .by the time anyone notices them they are already advanced.

PLwC: Pancreatic Cancer
http://www.plwc.org/portal/site/PLWC/menuitem.6067beb2271039bcfd748f68ee37a01d/?vgnextoid=1357ea7105daa010VgnVCM100000ed730ad1RCRD&vgnextfmt=cancer

NCI: Pancreatic Cancer
http://www.cancer.gov/cancertopics/types/pancreatic

ACOR: Mailing list - The Pancreatic Cancer Support & Information eCommunity
http://listserv.acor.org/archives/pancreas-onc.html

Confronting Pancreatic Cancer
http://www.pancreatica.org/

Answer 2

Sorry to hear this. Very grim news. I doubt that anyone dropped the ball. A billion cancer cells forms a mass only about the size of a marble. It is easy to miss hundreds of millions of cancer cells with all the blood tests, CT scans and MRI's that we have. Finding the metastatic disease earlier would not have helped anyway since we don't have good systemic treatment that can cure metastatic pancreatic adenocarcinoma even if found when it is smaller.
It's unfortunately all too common for people to look for someone to blame when they receive bad news like this.
This person already had spread of disease to the liver when the initial primary tumor was managed - it simply was not detectable. Again - sorry. I saw this situation innumerable times in my 20 years as a cancer specialist. It's one of the reasons I retired early.

Answer 3

I have been a cancer nurse for about 12 yrs and honestly, pancreatic cancer is one of the most aggressive cancers (other than melanoma) I have ever seen.
I would be curious to know what "state of the art" check up was for your friend. Unless he had a MRI and possibly a ERCP along with several other test, I would understand it could be missed.
Pancreatic cancer is usually very painful and travels quickly into the liver and bowel unless it is treated aggressively, the chances of survival are very very slim for more than a year.