So much has happened since I did that original post! Quickly... The cancer center where I'm a patient is not listed as an NCI center of excellence, but after some recent mergers, it's now affiliated with an NCI center. (Does that make sense?) I can't complain about the care; it's been good. I did switch oncologists. My first one was extremely negative. My new oncologist is terrific. So far, I've had six rounds of modified Folfirinox. Last one was Wednesday 7/5. I got waylaid from the regularly scheduled round on 7/24 by what turned out to be a gallbladder attack (liver enzymes and white cell count were elevated, and I had extreme nausea). Long story short, I spent a week in the hospital and underwent a bile duct stent placement and gallbladder removal (laparoscopic). My next chemo is scheduled for Monday 8/21. I'm dismayed by the delay, but it's understandable, and I'm trying to use the time to recuperate and build strength so I'm ready to resume chemo. Best news of all: My CA 19-9 tumor marker has plummeted from 1736 in mid-March to 276 on 7/24. Still too high, but the cancer is (so far) responding to the chemo. Yay!