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Periampullary Adenocarcinoma.

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My father has underwent the whipple procedure on 4th jan,14 . He had tumour of size 3.5x2 cm of type periampullary adenocarcinoma possibly arisings from cbd also superficially invasion in duodenal and no lymphnode invasion . Tumour staging was pt2 n0 mx. Pancreas is also free from invasion. Will somebody help me what could be further treatment and if there is chemo solution then when should I start taking it.

Category: Oncologist

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Category: Hematologist
Dr. Prasad Eswaran is online now

Expert:  Dr. Prasad Eswaran replied 4 Days.


Thank you for your consult at DoctorSpring.com.

I would like to know the grade of the disease from the surgical pathology report. Could you give me the complete details of the pathology reporrt ?

1. As per evidence, pT2N0 might require adjuvant chemotherapy based on other prognostic features on the pathology report.

2. In case chemotherapy to be started, it is usually started by end of 3 - 4 weeks from surgery when patient has completely recovered from surgical procedure. But it may get delayed until 6 - 8 weeks based on recovery from jaundice.

Hope I answered your queries. Glad to answer more if any.


Patient replied :

Thank you for your reply it was quite useful.
I am attaching required reports, please go through as per your need.
Reports attached are..
CT Scan pre operation.
Histopathological report.
Discharge summary report.
Toumour slide re-examination report at aiims.

Please also tell me if chemotherapy can be avoided or not, if he want to go for only radiation therapy because of side effect of chemotherapy, if there is any alternative for chemotherapy which can be easily tolrated with minimum side effect and may be less effective only if chemotherapy is not full cure. As being his son I also know he is very suspicious regarding things.
Please help me on whether chemotherapy will put that much benefits on which he can invest his 6 month which could be utilised otherwise.
I am quite confused right now also don't want to put him in more painful troubles until there is no other way left. Please reply with understanding my situation.
Thanks in advance.

Expert:  Dr. Prasad Eswaran replied 3 Days.


Thanks for appreciation.

It would be advisable to undergo chemotherapy for the present disease status. I hope your oncologist would give you a clear idea of all pros and cons of undergoing chemotherapy. Chemotherapy would definitely help in reducing the risk of recurrence and distant spread to other organs. Benefits are more compared to the risks undergoing. I would advice you to meet with your Oncologist and discuss the treatment options .

Hope this helps you to decide on further treatment.


Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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