Golly, I'm sorry to hear that. You are absolutely right: CT scans cannot see small lesions. (I was told anything less than 1.5 cm, but I've also seen 1 cm mentioned online.) What is your CA 19-9 now? Also, I wondered what you meant about doing palliative chemo only at an integrative cancer care place. Which locations are you looking at? Anyway, mostly, I wanted to say that you may not yet be out of luck. Yes, you're stage 4, but there is still much that can be done to bring the cancer under control. Best wishes to you!