← Return to So sick after first round of chemo: What can I do to help?

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@mayoconnectuser1 , Although Whipple is a part of the process, there is a protocol called TNT (Total NEOadjuvant Therapy) in which all chemo is done before the Whipple, and none after. That's what I was on, and I'm not sure it was the right call, given my quick recurrence after Whipple.

The opposite of NEOadjuvant just being "adjuvant" with surgery first and all chemo after the surgery, and the obvious third alternative of doing chemo both before and after. I posted links in another recent thread of a YouTube debate between two prominent physicians about those approaches.

Given my experience, when a tumor is labeled resectable, my reaction now would be to get it out as soon as possible. This paper https://link.springer.com/article/10.1007/s00423-021-02362-y "State-of-the-art surgery for pancreatic cancer" from 2021 states, "During the last twenty years, it has been well established that all surgical approaches to pancreatic cancer need to be supplemented by adjuvant therapy" and then goes into more detail from there.

So I'm surprised they went TNT with me, but there are patients out there who have had better outcomes than I did with the same approach.

My advice/encouragement to the original poster @rvm is give it hell!!! If you got through the Whipple that easy, you can find a recipe that works and get through the chemo. I assume they reported successful resection with clean margins -- don't gamble with this second chance on life! You're so close to the end of the tunnel, you'll get there.

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Replies to "@mayoconnectuser1 , Although Whipple is a part of the process, there is a protocol called TNT..."

Yes, I am familiar with neoadjuvant and adjuvant protocalls, and the ongoing conversation regarding which is more appropriate.

I wish the outcome was significantly different between the two - hence my general sense that one should start chemo as soon as possible once diagnosed, and continue for as long as possible., with or without Whipple.