The chest CT ordered by Roswell showed 2 lung nodules, but they did not believe any follow up is needed regarding these or anything else. They recommended a local GI, but it’s uncertain whether they will take on my case, as they need to review my records first. They also recommended a rheumatologist in light of my joint and muscle pain and weakness. I’m still not sure what to do. Roswell has essentially washed their hands of me since they’ve found no evidence of malignancy thus far. They agreed to see me again in 4 months, but that seems like a long time to wait when I fear that I’m in a state of cancer cachexia. I know Roswell believes they have ruled out malignancy, but I'm not reassured. They refused to do a biopsy because they didn't see a mass on the EUS, but from the literature I've come across, there are cases of diffuse pancreatic carcinomas that don't form a distinct tumor. I had reached out to the Cleveland Clinic in desperation and now have an appointment with one of their GI surgeons, which I hope means they are in agreement that a biopsy is the only way to definitively rule out cancer.

I know that there are many causes of pancreatic insufficiency, but blood work and imaging ruled out chronic and autoimmune pancreatitis, and cystic fibrosis would've been diagnosed at birth. At this point, to me, it seems like an Occam's razor situation; I'm also reminded of the phrase "if it looks like a duck, swims like a duck, and quack likes a duck, it probably is a duck." I have so many clinical signs and symptoms of pancreatic cancer and it's just terrifying.