Thanks for asking. The day after I last made a comment on this thread I was admitted to a hospital here in Alaska following blood draws and a CT scan at my oncology office. My biliary stent was obstructed and liver enzymes were elevated... among other things. I had an ERCP that evening addressing the stent obstruction caused by tumor ingrowth. A covered metal was placed on top of the uncovered mesh stent. Blood cultures were positive for a gram negative bacteria, resulting in an additional three days of hospitalization. The blood infection is being treated with an antibiotic (initially IV and now orally) that will continue for another week. There will be no further chemo until the course of antibiotics is completed next week. At that time (in 7 days) I'm scheduled to begin the Gemcitabine/Abraxane regimen.
In the meantime I've requested a second opinion from my Mayo oncologist (Alberts) and have informed my Mayo surgeon (Kendrick) of my situation so I can best plan next steps. I'm wondering if there may be a better alternative(s) or simply to go ahead with the current plan to substitute one drug regimen for another. One possible example as an alternative is to go go straight to radiation therapy at Mayo an skip further neo-adjuvant chemo, but perhaps that would be ill advised. My CA19.9 levels have been trending downward (641 in late May to 289 in late July) and tumor size has shrunk by about 16% after 4 Folfirinox infusions. (Current mass size 2.9 x 1.9 x 2.5 cm).