In most cases chemo and sometimes chemo plus radiation is prior to Whipple.

Is your diagnosis and plan from a major center of excellence, or local hospital system? Is the Whipple open or laparoscopic?

Second opinions from major pancreatic centers are always appropriate.

While not a medical professional, my sense is that speed of getting started on chemo could be important. Further, that staying on chemo to beat back the cancer cells that could be in your body at related locations us important.

One of my symptoms was lack of energy and strength. I accept that my abilities are limited. Just can't haul around those 40 lb bags of mulch and dirt or use a pick axe to dig a hole to plant my peonies. I am able to be fully independent in all activities of daily living, enjoy socializing with friends by taking walks. In the garden, I am doing projects that require less strength. I am pleased with the effects of my weeding and my planter boxes. I have thought about disability and death a lot. I am getting chemo "borderline resect able" with beneficial effects. I do worry about being debilitated and loss of independence and how surgery might go for me. I certainly will not be weeding my garden and mowing the lawn for a while. I try and find pleasure in the things I am able to do every day and take each day as it comes.

I'm surely no expert, as I'm just beginning my PC journey, and I don't qualify for the Whipple procedure. But I wanted to say I can relate to the energy and appetite issue. I haven't lost much weight, maybe 2-3 pounds, but the last few evenings I haven't mustered up the interest in a "real" dinner, opting instead for peanut butter toast and milk. Are you working with a palliative care MD? Mine has prescribed dronabinol to be taken before breakfast and dinner when I feel like I need it. I haven't yet wrested it out of the pharmacy, but I'm hoping it'll help with the dinner blahs. We're also relying heavily on easy-fix meals and frozen entrees, and we've shifted some heavier meals toward lunch, when I do feel more like eating. I've also begun drinking ginger ale (sweetened, not sugar-free) because it tastes good and gets more calories and fluid in me. Basically, I'm focusing primarily on calorie intake. Play to what sounds good in the moment and go for that.

This is exactly what I went through last October. My oncologist recommended 12 rounds of chemo. Then the surgeon at Mayo wants 3weeks of radiation. Then the Whipple. But I guess every person has a different diagnosis. My tumor is on the head of my pancreas and is sitting on a major blood vessel so they really want to shrink the tumor as much as possible before surgery. The surgeon says once you do the Whipple there’s no do over. He’s got to make sure he gets it all with good margins.