Hi @sheridanb, I'm tagging @mnewland99 @ashley2235 @stageivsurvivor @elisabeth007 @markymarkfl @granite @vannkraken to see if they have some knowledge and experience to share regarding your follow-up question:

"I noticed some who answered have had the guardant or other tests done multiple times. Is there a standard time table for this?"

Sheri, have you had a chance to ask your cancer team about frequency of genetic testing or if it needs repeating, why and when?

Hello sheridandb,
For me, before my surgery, I received the Ambry genetic blood test (Ambry probably because its inventor is local to Orange County). After my surgery, my pancreatic tumor was tested and 4 mutations were found. Mutations revealed were KRAS12D, ATM, TSP-*. I dint have them, but there are some mutations (BRCA, KRAS12C, D) that have treatments specific to them. After surgery, I did the standard 5FUchemo for 6 months. It SEEMED to work with the exception of hepatic artery spread that occurred prior to starting chemo as 4 months following completion of chemo my cancer spread to liver and maybe abdominal peritoneum.Biopsy was done for liver and biopsy for peritoneal nodules and hepatic artery was inconclusive; no additional pathology was done on this biopsies. GAC chemo has history, in some cases, to be successful for liver cancer (and lung cancer). GAC was working ok until I took a chemo vacation and it seems to have spread to femur. I personally don’t think it’s necessary to repeat your baseline genetic testing, but most likely the somatic testing could be repeated to determine any new mutations if you already have ample tumor tissue that could be tested. Maybe you repeat somatic if you find early on that you aren’t getting a response to chemo or radiation? It seems drs could be more proactive, but it depends how much existing tumor tissue you have available to test.

Regarding frequency of genetic testing for somatic mutations, I have asked a number of geneticists this question and the consensus is at least four years. There are not enough new pathogenic mutations found to justify the return on investment. I’ve had testing repeated times in the past 12 years and it has not revealed any new mutations.