Liver transplant and CKD, now husband diagnosed with pancreatic cancer

My 70-year-old husband received the news last week that some tissue samples from an EUS came back as cancerous. He has a complex medical history having had bile duct cancer in 2020, a liver transplant Feb 2021, Chronic Kidney Disease and alot of other things prior to that. Since he has transplant, he has frequent blood work including the CA 19-9 done quarterly as well as some scans. His CA 19-9 started to climb last year, nothing was showing up on imaging. Since July of last year its gone from 81 to now its over 10,000. CT Scan done today shows no masses on lungs. The MRI in March didn't show much either, but the most recent EUS did see some changes in the dilation of the pancreatic duct. We live in Cleveland, OH and get medical care at the Cleveland Clinic. Today we met with the surgeon and next Wednesday will be meeting with the oncology dr. But it sounds like the plan is chemo for 2-3 months. Repeat labs and scans to see if things have responded and if he's a candidate for surgery. He also has lingering post shingles nerve pain since January 2024, so constant pain has really worn him down and he's very sedentary right now. Not a great place to be when starting the chemo journey. Our questions this week for oncology dr will be the drugs used for chemo and how often they are administered. Sounds like they plan to do chemo 2-3 months, then retest/scan to see if numbers have dropped and if he's a candidate for surgery. We've got a long road ahead of us! Wondering if scans may have missed seeing any masses or tumors with such a high CA 19-9 number its seems like maybe its been there awhile.