Pancreatic Cancer Q&A with Dr. Stauffer, Mayo Surgeon: May 29

Hello Dr.,
What percentage of the time does chemo actually obliterate an existing tumor or lesion, rather than just shrink it? So many of us are told we are “cancer free”, only a few months later to be told a “new” tumor or lesion has been identified on a scan. It makes for quite a roller coaster ride on this disease. If you don’t have the BRCA related genes, then our recurrence for disease is very high and I wish (after having been in that situation for just about 3 years now) that drs would just stop with “cancer free” and at least order the CA19-9 every 2 weeks for patients during this period.

Sorry, but I have another question, I had surgery (distal) in 2022 and liver lesion in 2023 that I got chemo for and then SBRT. 6 months after SBRT a new liver lesion, very small, occurred and my CA19-9 is about 284 now. My drs fear I might also have it elsewhere (abdominal, only) since they think my number is too high for just that one about 1.2cm. Would it be appropriate to do a ERCP to find other areas? My dr at HOPE in Irvine, CA says no, but I’m not sure about that, what’s your opinion?

I a wondering if there are surgeons at Mayo Clinic who have had a lot of experience doing Nanoknife procedure?

THANK YOU, BETTE DAVIS

Thank you Dr Stauffer for giving us the opportunity to ask questions. What is your opinion on Irreversible Electrporation in combination with chemo or immunotherapy? There is very little data available, but from the few we can find, it seems very promising. It makes the tumor cell membrane porous and allows chemo drugs to enter. Why there are not more trials on this and how often does Mayo Clinic perform IRE? Thank you!!

What are your thoughts on having SBRT performed on a handful of small liver lesions and doing chemo at the same time? Is SBRT ever an option while you are participating in a clinical trial that is testing a new drug (RMC-6236 or IMM-1-104, for example)?
Thank you for taking precious time out of your day to answer these questions..
Sandy

I was diagnosed with acinar cell carcinoma of the pancreas in December 2024 They discovered it in a routine CT scan to follow progression of stage 4 lung cancer diagnosed in December 2023. The lung cancer diagnosis was based on a mediastinoscopy as non-small cell adenocarcinoma. I have been receiving nivolumab as immunotherapy for 2 years, and had ipilimumab for 18 months.
This Friday I will be undergoing a biopsy of the tumors and polyps in both lungs with a bronchial IR biopsy using robotics. I am currently receiving abraxane and gemcitabine chemo for the pancreatic cancer in hopes of shrinking the tumor away from the SMA and from around the SMV, in order to be a candidate for surgery, or reducing the size of the tumor from 4.2 cm to under 4.0, to be a candidate for Nano-knife procedure. I have had 3 cycles (2 treatments each) of the chemo with no significant change. I am in the midst of my 4th cycle and am scheduled for 3 more. Are there better options/types of chemo for this and is there immunotherapy that has been developed for pancreatic cancer?

Is there immunotherapy on the near horizon for stage IV patients that can take the place of chemotherapy in trying to clear our system of Pcan?
It seems there must be a careful balance of chemo and other options to not “ruin” our bodies with the toxic drugs in chemo.

Thank you for your time!

Are there any studies that suggest
fasting will kill cancer cells?

45 year old male(husband)$ diagnosed with Pcan. Stage IV, metastatic to lungs and liver. Starting chemo treatments may 30(nalirifox) I have no hopes. His doctor said hes not a candidate for a surgery. It feels like doctors already put an expiration date on him.

@margaretpaluch I think you said you're in Chicago? Rush University Medical Center is a PCAN Center of Excellence you might want to go to for a second opinion. I know everyone is different, but I have the same diagnosis, and I'm not giving up hope. All the best to you and your husband.
Kerry