One other thing regarding the PET scan. A PET scan was a mandatory requirement before surgery was approved in my case. It was my understanding that if the PET scan had shown significant signs of metastasis I would have been offered chemo as palliative care instead of surgery and one doctor advised avoiding the pre-surgery PET scan if possible for this reason. Surgery appeared to be the only chance I had of surviving this. It turned out that the PET scan showed inconclusive activity in my thyroid and liver. The thyroid activity was viewed as a separate issue and I was conditionally approved for surgery. The lesion on the liver was biopsied while I was under awaiting the Whipple surgery. Fortunately, it proved benign and the surgery went ahead as planned. Clean margins but the 19 lymph nodes removed were all biopsied after surgery and 8 of them showed signs of cancer. Thus the recommendation to follow up aggressively with chemo and radiation. (The thyroid was biopsied at a later date and also proved benign. And, fortunately, all subsequent scans have shown NED.) Anyhow, I hope this helps answer your questions.