@tiffboss Thank you so much for responding! So inspiring to hear a positive outcome!.

@colleenyoung and all others:
It has been a rollercoaster ride of up and down emotions and very confusing times & information & conflicting opinions so I apologize for my delayed response.
Short answer: We don't know yet. Have a few more appointments next week. Hope to have a game plan soon.

Long answer:
We live in Chicago so we started with Northwestern Memorial Hospital (his cancer was diagnosed here after a CT his internal medicine doctor ordered after upset stomach symptoms which she thought might be related to ulcer) and then got second opinion from University of Chicago. The diagnosis, prognosis and course treatment plan was the same and decided to go with Northwestern Memorial to start chemotherapy right away. And we do like our oncologist there. A month into his treatment, we went to see Dr. Bilimoria (who did his medical school & residency at Northwestern Memorial and fellowship at MD Anderson and is now at Arlington Heights) who came highly recommended by doctor friends as the lead pancreatic surgeon and was told that he has more experience than any other pancreatic surgeon in the area. In fact, he was the only surgeon we talked to that gave us hope about potential surgery after chemo and if chemo doesn't work, potentially being eligible for nanoknife where others have basically said "there is nothing we can do here, get your affairs in order".

So, we decided to continue to work with our oncologist at Northwestern Memorial Hospital and Dr. Bilimoria as the surgeon if and when he became a candidate. We saw him every few months to get scanned and talked about his progress and next steps. So, now after 12 chemo sessions, he is now recommending nanoknife as surgery is not an option as chemo didn't shrink the tumor. We asked to get some statistics on nanoknife but his office recommended we reach out to Angiodynamics (the company who makes nanoknife) as they would have the most comprehensive stats. (I will get to it sometime this week hopefully)

On the other hand, our oncologist and now another new oncology surgeon we talked to yesterday at are "very strongly recommending against it". Our oncologist said, if we choose to do nanoknife, she would highly recommend continuing chemo regardless and said his lab results are good and no reason why he can't continue chemo as is. (in fact, we had our pre-scheduled 13th session on Thursday so if we do nanoknife, have to wait another 4 weeks). Our reason of wanting to go with nanoknife now was so that he wouldn't have to do chemo anymore so if that's not an option, would it be worth doing nanoknife and if we do, do we choose to go against oncologist's wishes on chemo.

Our oncologist at Northwestern is hopeful with clinical trials that are in works (she mentioned RMC-6236 monotherapy and potentially others that are specifically for KRAS mutation. His tumor does) though he won't be eligible for it unless he gets worse or when the clinical trial becomes available for him and others in 2+ years if it continues to show such positive results. Her thinking is to continue with chemo as is and if things get worse, there are promising trials we can tap into.

This other oncology surgeon at Northwestern we talked to yesterday wants us to see a radiation oncologist as he said he is seeing very promising results with "proton radiation therapy (vs. photon radiation therapy) and he referenced "dose escalation therapy 2024" clinical trial and if I understand correctly, is available to patients outside the clinical trial as well. Appointments being scheduled to discuss further and meet with radiation oncologist next week.

So, we are at a crossroads:
-Stop chemo now and do nanoknife in 4 weeks with scans every 3 months after and hope that there is no spread, no new growth...etc.
-Stop chemo and try radiation therapy and if it works, could we do surgery? and if it doesn't work, try nanoknife then if he is still eligible (no spread)?
-Skip nanoknife and continue to do chemo as he is stable and hope to be eligible for surgery (more complicated than nanoknife but as I understand it is the gold standard for "being cancer free") when a successful clinical trial is available to shrink the tumor enough.

Thank you for reading (it was somewhat therapeutic to write)...