@burta3 There is always hope.

In this group there are others better informed than me to answer your question, but since no one else has responded yet....

A good starting point is: https://pancan.org/news/choosing-the-best-pancreatic-cancer-doctor-and-hospital-for-you/ I urge you to read this if you haven't already.

One consideration among many is where you're located in Canada and your willingness to travel. (I live in Alaska and am being treated at the Mayo Clinic in Minnesota.) Some of the most renowned hospitals for pancreatic cancer treatment include the Mayo Clinic (MN), John Hopkins (MD), MD Anderson (TX) and Memorial Sloan Kettering (NY). There are others. Most, if not all of these hospitals, have helpful information available at their respective websites.

This is a very supportive and well informed group of folks who speak from their own pancreatic cancer experiences. Ask more questions. You'll get some answers.

I had a Whipple surgery for ampullary cancer (treated as pancreatic) at St. Joseph’s Hospital in Toronto by Dr. Shiva Jayaraman. I was stage 2 so surgery was an immediate option but it might be worth a consult with him. He was highly recommended to me.

My husband was diagnosed with stage 4 in October. Same scenario. He’s had 3 rounds of chemo. Had 13 days off during which he feels better and eating better. We start round 4 on Monday and the two following Mondays. He will have a CT scan 1st week of Jan to see if there’s any progress. Surgery was not an option for him. I don’t have any answers for you but we are staying positive despite the prognosis. We are with Cancer Specialists of North Florida which is part of MD Anderson. We are only a few miles from Mayo but Im just not sold on Mayo for various personal reasons. Stay positive!!

MD Anderson is located right next to Baptist Medical Center downtown Jacksonville. I’ve known others who were diagnosed through Baptist Medical Center and received treatments at MD Anderson so they do work together. They’re oncologists do work with oncologist through Baptist.

So, is there a link showing CSNF is connected with MDA?

Welcome @burta3. You will also be interested in this recent discussion to which I have moved your question. Click the link to read previous posts as well as the helpful posts you have received thus far
- Where is best place to go for second opinion for stage 4 pancreatic?
https://connect.mayoclinic.org/discussion/where-is-best-place-to-go-for-second-opinion-for-stage-4-pancreatic/
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I agree with @wjk, that your location and your mother's ability and desire to travel are important considerations when choosing a center of excellence for pancreatic cancer. In Canada, you have several premier options like the Princess Margaret Cancer Centre in Toronto, Tom Baker Cancer Centre in Calgary, BC Cancer Agency in Vancouver, etc. I'm tagging a few fellow Canadian members like @naomicanada @waiting84 @krfinlayson @nunz12 to share their experiences with getting care.

As you can expect, I recommend Mayo Clinic should you wish to consider care in the US.
The Mayo Clinic Comprehensive Cancer Center has held its National Cancer Institute (NCI) cancer center designation since 1973. All 3 campuses in Arizona, Florida and Minnesota are ranked among the Best Hospitals for cancer by U.S. News & World Report.

- Pancreatic Cancer Care at Mayo Clinic https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/care-at-mayo-clinic/mac-20355431

You can call Mayo Clinic to talk to an appointment coordinator to learn more about seeking care. To get started: http://mayocl.in/1mtmR63

And to address your other question: YES, there is hope. I'm sure you are reeling from this news and have many questions. I look forward to helping you get answers from others who have walked this path before you. Keep asking questions. 🙂

Of course it's incredibly upsetting to hear "Stage IV," but some people do have atypically good experiences -- so after you nail down getting the best care than you can, perhaps read some of their stories.

A man -- and ?former? medical researcher -- known on this board as @stageivsurvivor has written at length about his experiences; in short, he was diagnosed about 11 years ago, underwent surgery and 46 cycles of FOLFIRINOX (some modified), and is doing very well. He has also mentioned a woman who underwent 37 cycles and is in good shape, also about 11 years after diagnosis.
https://connect.mayoclinic.org/discussion/question-for-newly-diagnosed/?pg=2#comment-970218
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His insights are exceptionally useful, in part bc of his professional training. Here's a link to all of stageivsurvivor's comments on this site:
https://connect.mayoclinic.org/member/00-3a8075b911bad2ae280957/activity/comments/
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markymarkfl is another ultra-valuable source of info; I encourage you to read his comments, too. (I'm pretty sure that he's an engineer, and my sense is that he's able to digest scientific articles, and share results with us, bc of his intellect and education.)

Some short pieces about survivors:
https://letswinpc.org/category/survivor-stories/
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I wish you and your mother (and other loved ones who are involved) all the best -- and I hope that her diagnosis moves her to the head of the line.