Thank you for your thoughts about this and letting me know your testing schedule. I think a monthly test is still warranted, at least through my next scan in March -- in case the date needs to be moved up.

First, I am continuing with the cancer center that did the surgery and chemo on the mainland for scans and ctDNA tests for recurrence monitoring and expertise. The problem is, they can't order blood tests or any medication (should I need it) in my state (Hawaii), so I also need a local oncologist. There are no Pancreatic specialists locally available. There are many good oncologists for other cancers, but PDAC is rare here as far as cancers are concerned.

Second, I am 18 months from my last chemo and have been NED on all my scans except for a small spot on my liver they have been watching. My CA19-9 has ranged from 7-8, with a high of 20 prior to surgery (stage 1, nodes were clear). My first three ctDNA results were negative. I still have my port as they preferred I keep it in. My next scan is in March 2024. That will be my 2-year scan from my last chemo. I'm 77 and that's part of why they are cautious.

Recurrence is a concern, as you know. To hear a staff member from the local doctor say that I should let them know if I have any symptoms is a "red flag". Sure would be nice if there was an "early warning" system for this cancer! I think four months is too long for someone so close to surgery/treatment (regardless of initial tumor stage), but have no idea how other patients are monitoring their situations and if there is some sort of standard the major cancer centers tend to follow in terms of monitoring. If the consensus is more frequent testing, then I may be able to get some help getting more frequent tests.