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Sharp Pain Under Right Rib Cage, Loss Of Appetite And Abnormal Pancreatic Mass. Is It Cancer?

Posted on Tue, 19 Nov 2013

Question: Hi, I was told by my doctor, that my pancreatic mass was abnormal. amylase 163 / lipase 172, what does this mean? Do I have cancer there ? Be waiting for your answer. Thank You.

Answered by Dr. Shafi Ullah Khan (1 hour later)

Brief Answer:
Too Early to say malignancy

Detailed Answer:
Hello XXXX!

Before explaining the possibilities. let me ask you some questions.
Have you lost weight 10 to 15 kgs in last 6 months?
have you mid epigastric pains( between rib cages soft spots)? any night time relentless pains?
Have you diabetes? if yes has it started in a year or two?
Are you jaundiced(yellowish tints skin and sclera?
is these some mass palpable under your right rib cage painless mass?(gallbladder)?
Are there any bumps or nodules near your belly button?
Any palpable bump/lymph node near your shoulder bone left one specially?
HAve you got a rectal exam? was there a mass there?(blummer's shelf)
Is there any evidence of malnutrition? (low serum albumins or cholestrol levels?)

if any of these answers are yes then i am afraid you would need to verify it with some work up before saying for sure its a malignancy.

Complete blood count
Hepatobiliary tests( Bilirubin.total conjugated, ALT GGT AST ALT etc)
Serum Amylase Lipase Amylase to Lipase ratio urinary amylases.
Tumor Markers CA19-9 CEA
Ctscan abdomen and pelvis
Transcutaneous and endoscopic ultrasounds
MR scans
ERCP endoscopic retrograde cholangiopancreaticography.
PET

All these tests will confirm the presence or absence of malignancy.
With information you provided it is hardly impossible to say anything, But as your doctor said a mass. At this age of 70 pancreatic cancer is a major od but you need to run some labs to be sure.

Hope I was of some help. If you don't have any follow up questions kindly close the thread and rate the answer,

Regards
Dr Khan

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shafi Ullah Khan (1 hour later)

1- lost 6lbs in 6 mons. Have sharp pain under right rib cage. Node above belly button, pain when pressure is applied. Diabetic for 27 yrs. No appetite. I'm due for a CT scan in 1 week.

Answered by Dr. Shafi Ullah Khan (5 minutes later)

Brief Answer:
Lets Wait for the CT

Detailed Answer:
Hello dear!
6 pounds are not enough significant weight loss for a malignancy. loss of appetite is a sign. so is the node (sister XXXXXXX XXXXXXX nodule probably) a sign of pancreatic malignancy.
lets week for the CT scan thrn and hope for the best.I am sure things will come out true. But you should hurry as this disease needs to be caught early other wise it damages the prognosis and outcomes.

Cheers and good luck. If need to ask any more questions feel free to. Other wise close the discussion and rate me with a generous stars if i was of some help

Regards
Dr Khan

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Above answer was peer-reviewed by : Dr. Vaishalee Punj