I had distal and spleenectomy in 2022. This is a complicated disease dependent on she, mutations, stage snd comorbities and previous health ststus otherwise you ste just comparing apples to oranges. I was 64 when I first started with symptoms had Kaiser. Stay away from them! I live on west coast so not a lot of choices here. Mayo is good as well several other hospitals on east coast. Go to a center where they had a lot of these procedures. At 65 changed insurance to Medicare advantage and that was a good choice but my surgeon though smart didn't have a lot of experience surgery and I had a leaking pancreatic duct after surgery which made it a long and complicated recovery and delayed my start of 5FU chemo by 1 month, I was 65 then and used to do a lot of walking before surgery and was pre diabetic before and didn't drink and ate fairly healthy but was overweight a bit. My mutations were KRASG12, TP53, snd ATM with variant based of unknown origin (somatic not inherited). However my dad had aggressive pancreatic cancer like mine so I'm nloodwoeyis being sent out to another facility for germline or inherited testing now since research is always providing new information. I did 5FU chemo for 6 months (2x per month) and tolerated it fine just some nausea and weakness but I continued walking and volunteering snd working my small consulting busines. My cancer antigen went down to 6. Was off chemo for 4 months and then it went to my liver and peritoneum. Peritoneal were very small and biopsy was negative but my intelligent drs assumed is was cancer even though they didn't grow for 1 year ) always err on side of caution, I was on GA gem abraxane from Jan 24 to Dec 24 to get rid of liver lesions. I did though more weakness and nausea on that. Only MRI showed liver lesions ( not CT or PET) when lesions are low 1.0 cm range. You will get hair loss, but can avoid or decrease neuropathy in feet or hands if you get the iced booties and mittens from Amazon and they are very inexpensive, but highly recommended. I had one stubborn 0.9 cm lesion left that I radiated MRIdean) at City of Hope gor 3 sessions (looking back maybe back was too few) but my cancer antigen diwn to 11 that was October 2024. I was still on GA until Dec 2024. In early January 2025 after genetic testing I was considered cancer free and was just placed on gemcitabine for maintenance. I took a 3 week break from that in late March and I could feel pain in the abdominal peritoneum snd assumed those nodules ( since I hadn't been on abraxane for 3 months and I have aggressive cancer, was growing though they wete too small to be seen on scans, but gtom the area of pain I knew that's what it was. I also had another lesion in my liver though it was a bit difficult to see on CT scan. My oncologist insisting I do the phase 3 RMC6236 clinical trial but thete was was only a 50/50 chance I would get the drug at hand and I worked way too hard to ensure my survival thus far snd for me, I wasn't willing to take the risk; not when I knew abraxane would work on the peritoneum nodules (nobody told me this( it was just anecdotal based on my own experience). I went back to Hoag dr who was willing to put me on gem/abraxane; but not right away. I did the Naliri chemo for almost 2 months which didn't work at all! I did histotripsy in July on the now 3 liver lesions snd it has worked so far. Begore histotripsy my cancer antigen was almost at 14000! After histotripsy and being on gem abraxane since early August my ca19-9 is below 70 or 40 (I'll get my new number this morning). However, I developed several UTIs in July that wss misdiagnosed through urgent care and then my urologist again too young and inexperienced wasn't able to get biopsy just urine sample that showed cancer cells by cytology and showed I had aggressive urolethial cells or bladder cancer snd wanted to put me on keytruda. But without a biopsy this didn't make sense to me do I switched my bladder care to city of Hope and found out this week afyer he did do a biopsy that was negative that cytology of cells isn't a definite and I don't probably have bladder cancer though we are waiting on a RNA blood test for sure. I was then sent to infectious disease dr at Hope since I had BK virus through bladder fluid but he ssid levels wete not high enough and so after suffering for 5 months with blood in my urine and a severely inflamed bladder, my infectious disease dr tells me gemcitabine is known for causing cystitis and thus hematuria!!! so now I'll speak to my pancreatic oncologist about decreasing my gem. Dint be afraid to consult with many drs or to switch drs if medical advice you get sounds sketchy. And pray a lot whatever faith you have in God. Good luck to you!!