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@mavisann

mrajat,
I am not advocating for a particular treatment plan or provider, I know nothing about what’s best for you.

You wrote,
“I asked both the surgeon at MSK and U. Penn whether PET scan is needed and they both advised against it. I wonder if that was not to disqualify me in lieu of a possible false indication of metastasis.”
My thought,
Heard if PC has spread to other organs then having surgery, rushed or not, may not help you but can actually hurt you.
How can it be in your best interest to not use all available medical technology?
Why guess at what you’re dealing with?

The best available information should help you make the best informed decision.

Are you being rushed?
Your treatment path is a critical decision, you may only get one chance.
With PC time is of the essence but maybe not if you don’t have all available information.

As I mentioned my wife is currently being treated at Mayo.
She gets extensive blood test before every chemo in addition to CT and PET-CT scans at initial diagnosis as well as after every 4th chemo session to see what’s going on and judge effectiveness of chemo treatment to see if a chemo switch is needed.

FYI, Mayo believes in the benefits of PET scans, maybe doing chemo first influences that?

From the Mayo Clinic Health Letter, January 2021,
Pancreatic cancer
New treatments, better outcomes.

“We have incorporated positron emission tomography (PET) scans heavily into our practice to judge effectiveness of chemotherapy. If the tumor is dead on a PET scan after chemotherapy, we have a much better predictor of that person's survival before considering surgery. This has been game-changing for people with pancreatic cancer.”

“Many thought that if a person didn't respond to initial chemotherapy then he or she wouldn't respond to any chemotherapy. This was false. A significant portion of our patients undergo a switch in chemotherapy. This has also been practice-changing.”

You can watch the PBS documentary by Ken Burns,
The Mayo Clinic
Faith • Hope • Science
on TV today in your own home (with PBS donation) and/or you can buy the book and read it online today or in paper form this week.
It mentions and highlights
Mayo’s method of treating Pancreatic Cancer.

The film/book also emphasizes two long established points about The Mayo Clinic:
The elder Dr Mayo had a simple philosophy he tried to impart on his two sons:
“The needs of the patient come first.”
and
Every physician at Mayo Clinic is on salary and have no financial benefit for ordering extra test or procedures.

Again, I am not trying to sway you to Mayo, I know nothing about what’s best for you and you are already being seen by two excellent institutions with excellent experienced physicians.

In poker terms, you and my wife and all who have PC were dealt bad starting cards.
While unfortunate, now the question is how do you play those cards?
You can still win poker and PC with bad starting cards.

We hear of health benefits of taking vitamins D3 & K2 to help your immune system in fighting cancer and getting yourself in best shape to heal.

I will end where I started.
I am sorry for my rambling. I do not want to confuse or overwhelm you.
I am not advocating for a particular treatment plan or provider, I know nothing about what’s best for you.

God bless and good luck.

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Replies to "mrajat, I am not advocating for a particular treatment plan or provider, I know nothing about..."

Thanks Mavis! The surgeon at MSK felt confident based on the MRI and CT angio pancreatic that the tumor can be resected. He said PET scan won't tell him anything or change his recommendation, so not knowing the specifics it's hard to challenge him on that or insist on getting the PET scan.

Given the medical fraternity is so split on adjuvant and neoadjuvant, I decided to take a chance and just get the surgery done. In the rare scenario that there is no cancer, I could also be spared chemo (I am thinking).