Reader’s Question

My mom is 65 and was recently diagnosed with Stage IV pancreatic cancer. She has severe nausea/heartburn/pain/vomiting and can’t start the chemotherapy until this improves. She was feeling severe nausea/bloating for 3-4 months before diagnosis and had duodenal bypass surgery, which did not improve her symptoms. I’m wondering if some of these symptoms could have a psychophysiological component to them since she’s had them for so long and nothing seems to be improving them. If so, do you have any suggestions of what we can do? Also, I don’t know if it’s pertinent, but she is a compulsive overeater. She has lost 30 pounds in the last few months, but she still weighs about 270 pounds.

Our Clinical Psychologist’s Reply

Experts at the Mayo Clinic cite almost everything you noted as the most common complications of pancreatic cancer (i.e., weight loss, pain, vomiting, duodenal obstruction). While it is possible that anxiety about her circumstances might be prompting or exacerbating some of her gastrointestinal symptoms, her physical condition is a much bigger concern. The fact that symptoms existed three to four months before your mother’s condition was diagnosed doesn’t necessarily indicate the symptoms must be of different origin, and the mere fact that a duodenal bypass didn’t bring her relief from the nausea and bloating also doesn’t necessarily point to psychological factors being responsible for her distress.

It’s best to discuss of these concerns with the oncologist. If a determination is made that psychological factors might in fact be causing or exacerbating any of her symptoms, treatment for such can be incorporated into her overall treatment plan.