Recent diagnosis: Have questions about treatment options?

I am getting diagnosed with pancreatic cancer after an abdominal CT last week. I’m 45 male, South Asian, and married with 8yo twins. I have a healthy lifestyle, run half marathons, and have no family history of cancer among my parents, grandparents or uncles/aunts. I’m still in denial. I started having back pain 1.5 months and abdomen pain 1 month back. The doctor prescribed an abdomen CT scan which found a mass on the pancreatic head 27mm * 24mm. By the time the diagnosis came out, I also developed jaundice (4.9 total bilirubin) although my bilirubin levels have always been elevated (in the range of 1.5 and 3 going back 11 years). They did an ERCP procedure to put in a stent in the bile duct and biopsy the mass. The biopsy results came back inconclusive.
The cancer marker (CA 19-9) measured 153 as of last week. So far, all doctors have said it’s cancer and most likely pancreatic cancer. It seems locally advanced from the CT and MRI. I’m shocked by the grim cure rate / survival rate.
I have seen two surgeons so far. The first surgeon at Univ of Pennsylvania says it’s borderline resectable —so he wants me to get up to 6 months of chemo before attempting surgery / Whipple procedure. The second surgeon at MSK (Memorial Sloan Kettering) ordered a repeat CT scan with focus on pancreas after which he feels comfortable that he can remove it right away and is asking me to go for surgery first.
I have a few questions and would really appreciate your help:
- Could this be anything else?
- Which approach sounds better for overall survival as well as short-term survival: Chemo first then surgery (U Penn) or surgery first (MSK)?
- MSK surgeon has given me surgery appointment for 3 weeks out which is his earliest available. Do you think it’s too risky to wait that long?
Thanks!