@altc321 , As you most undoubtedly understand, "would not" and "could not" are two entirely different things. If you want a specific test, it shouldn't be too hard to obtain with some shopping around. Getting insurance to pay for it is a different subject, but I would be quite ticked off at my primary care doc if he refused to order a cheap, simple test, especially if he's already ordering other blood work for me at the same physical. If it's not part of his specialty (and he's not an oncologist, so it's not), my rationale for asking is that we're just collecting data. The lab will tell us if the result is abnormal, and if that's the case, he has discretion or justification to consider a referral. Heck, you can now get full-body MRIs without a referral: https://pancan.org/news/full-body-mri-what-you-need-to-know/ (and Google search can return a list of several providers).

As mentioned earlier, for people with no symptoms and no known risk factors, it's hard to know where to put any focus (or even consider extra testing at all). If you have a reason to specifically be interested in the pancreas, other data (like A1C history and diabetic status) can be good indicators, as well as the Galleri test from Grail. In my case, it was the liver enzymes being abnormally high because of the pancreas tumor blocking my common bile duct that tipped us off. The jaundice that accompanied it also appeared in my eyes a good while before it came out in the skin, but that's all still in the "too little too late" range for a preventative diagnosis. If I'd had the genetic testing (hereditary) in advance, I might have coupled that with my family history and started looking at the pancreas a few years earlier.

Hindsight is 20/20, and I hate to beat dead horses, but all signs point to proactive patients finding and getting what they need a bit sooner than those who aren't. Even that doesn't always solve the problem, given how fast my cancer returned after surgery and 3 DNA-based tests and a biopsy saying it wasn't there.

Anyway, I wish you the best, and wonder about the treatment you're currently getting. I talked to one patient last year whose only mets after surgery were in the lungs. She was getting them radiated when they popped up, and doing rather well.