Ask a doctor on the topic of Internal medicine

Pancreatic cancer?

March 10, 2018 | 40,00 EUR | answered by Dr. med. Frauke Gehring

Hello,

Yesterday, I noticed a larger bump above my belly button on the right side. I initially thought it was a umbilical hernia, so I went to see my doctor, who is also an internist and gastroenterologist.

However, he could not find any umbilical hernia, neither by touch nor on ultrasound. He mentioned that there was a lot of air in the intestine at that spot, which could be causing the bump. It does surprise me though, that the bump is still there today even though I have had a bowel movement, so the air should have moved according to my understanding.

Other than that, everything seemed fine on the ultrasound. My prostate is slightly enlarged, which has been the case for years, and my liver is also affected by my overweight.

What did unsettle me, however, is that the doctor wants to perform a lab test next week, including blood work and testing the stool for elastase, because he thinks the air formation could be due to a low secretion of this enzyme in the pancreas.

Now I am quite panicked that he wants to test the pancreas, as a low secretion of this enzyme can occur in pancreatic cancer.

About 6 months ago, I had a thorough check-up by an endocrinologist. The ultrasound and lab results were fine back then, and as far as I know, amylase and lipase were also tested and were fine.

Currently, I sometimes have loose stool, but with normal color. This is not uncommon for me and has been happening on and off for years. Additionally, I currently have lower back pain (for about 2 weeks) in the lumbar region, which I attributed to a muscle strain. At least it felt like it.

My questions:
How high do you estimate the risk of me having pancreatic cancer? The doctor did say the pancreas looked good on ultrasound and was in order - but could it be possible that he said that just to reassure me and maybe wants to wait for the upcoming tests?

Do you have an explanation for the bump, which the doctor saw on ultrasound as a bulge with air underneath, if it's not a hernia but I also find it unlikely that it's air, since it hasn't moved away even 24 hours later?

About me:
I am male, 41 years old.
Severely overweight, since I have been taking antiepileptic drugs for several years.
Pre-existing conditions: Epilepsy since 2011, hypothyroidism.

Thank you in advance for your response.

Dr. med. Frauke Gehring

Good day,

The likelihood of getting pancreatic cancer at your age is so tiny that you don't need to think about it for another second. Your doctor seems to be very precise, or he is bored, or you are privately insured and the earnings attract him.

The bump could also be a benign fatty tumor, a lipoma. If a back problem affects the small nerves of the abdominal wall, muscle tension can also be affected locally. I see no reason to worry.

Sincerely, Dr. Gehring