@maxmom ,

Is your cancer PDAC? What type of scans (CT/MRI/PET) have you gotten, and what type is next? How often are you getting the Gem/Abrax, and how often are you getting your CA19-9 tested?

I've insisted on getting my CA19-9 tested biweekly (at every chemo treatment) and not regretted it. It can bounce around a bit for various reasons, and the more often it's tested, the easier it is to "smooth" the data and see a real trend.

Although your goal is to see one tumor go from borderline to definitely resectable, the one thing you don't want to see is a metastasis to a distant area. Stable, borderline-resectable disease gives you a chance to increase or change your chemo regimen, perhaps adding cisplatin if you have a DDR mutation such as ATM.

And although imaging is (the non-invasive) king, it can't detect some smaller metastases. At least two patients on this forum have had a surgery postponed due to rising CA19-9 even though no mets were spotted on imaging because it suggested the possibility of metastatic disease they would not know to remove. You might ask your oncologist (and ideally the surgical oncologist) if they have a threshold for CA19-9 (both an increased amount and an absolute level) that would cause a delay.

Overall health (performance status) is also a good positive indicator in a surgeon's decision making process. I'm glad to hear you're feeling better on the GA. Keep doing whatever helps you feel good and take all that positive energy with you to the next scans and appointments!

Wishing you all the best. 🙂

--mm