Hi @colleenyoung,

This neoadjuvant approach by Mayo was reasonable, made sense and felt right to us.
Important to have confidence in, and ‘buy into’, the institution, the doctors and the treatment plan.
We are “ALL IN”.

The aggressiveness, propensity to quickly spread and high recurrence rate of PDAC made systemic chemotherapy in a multimodal treatment plan desirable to us.

Read many patients do not receive recommended adjuvant chemo because of surgical complications or overall weakened health or a feeling chemo is no longer needed.
Chemotherapy first could eliminate that risk plus offer an opportunity to reduce tumor size and vessel involvement.
Deem these beneficial.

Neoadjuvant chemo permits monitoring the known primary tumor with regular PET, CT, CA19-9 and CEA testing to gauge chemo effectiveness and be able to switch to another chemo type or extend chemo treatments to obtain optimal results if needed.
Consider this advantageous.

This major operation has high morbidity, if chemo was not going to be effective unsure if surgery offered a risk/reward benefit and wanted to avoid an unnecessary surgical detriment.
Chemo first addressed this concern.

Quickly treating with chemo the known primary tumor and any occult micrometastases with the hope to reduce the chance of recurrence after surgery we viewed as helpful.

There are arguments for surgery first but being treated at Mayo with a neoadjuvant approach made the most sense to US for OUR unique situation and, we pray, offers us the best opportunity for healing.
Everyone is unique. YMMV.