So sorry your husband is facing a recurrence after 20 months. I know how discouraging that must be, especially after such good pathology following surgery.

The fact that he had negative margins and no lymph node involvement gave him a good start, although perineural invasion (cancer cells in the nerves) is unfortunately a known risk factor for recurrence.

It sounds like he initially had a good response to Gemzar (gemcitabine) and Abraxane, with his CA 19-9 dropping from 4,500 to 700 before it began to rise again. Now that he's back on 5-FU while waiting for "the pill," I hope that treatment can keep things under control until the targeted therapy becomes available.

I have been on maintenance 5-FU for more than six years. Everyone's cancer is different, but long-term disease control on 5-FU is possible for some of us. I hope your husband responds well again.

Please don't lose hope. New treatments and clinical trials continue to emerge, and targeted therapies are giving some patients options that weren't available just a few years ago.

Wishing you both strength and hoping the next treatment brings another good response.