Hello, my Mom's situation is similar to your Mom's situation. My Mom had the Whipple in July 2020. She was NED for 18 months and then had a recurrence in December 2021 in the peritoneum. She had a small surgery to remove the growths. A few months ago, my Mom's stomach began to get bigger all of a sudden. She had cytoreductive surgery last week, which revealed two large ovarian cysts/mets. Now that the ovaries and mets are out, she is feeling much better. My Mom doesn't have regular pancreatic cancer- she has IOPN cancer of the pancreas for which chemotherapy is not very effective. As a result, we are choosing the wait/watch approach, aggressive surgical resection, while also waiting for a promising clinical trial to open up that targets her genetic fusion.

I would recommend the following regarding the ovarian mets considering my family just went through this: 1) don't fall into the trap that all stage IV pancreatic cancer is the same. That's simply not true. The fact that your Mom was NED for three years shows that the cancer is not as aggressive as the average pancreatic cancer, which is really good. Every tumor has a unique genetic makeup; 2) the fact that the cancer went to the ovaries is better than other organs such as the liver or lungs because ovaries are not vital organs that your Mom needs to survive, which is another great thing; 3) the fact that she had such a long NED period is more reason for her to have her ovaries and the mets removed surgically as soon as possible. I'd recommend removing them and doing some rounds of chemo after to kill the remaining cells. Ovarian mets can start to cause symptoms really quickly, so the faster they're out, the better. My Mom started developing symptoms within a few months; 4) do complete genetic testing of her tumor to see if there are any genetic mutations that can be targeted through medicines and immunotherapy; 5) Make sure you are getting care at a top cancer institution and not at a local hospital. Please reach out if you have any questions. Hope this helps!