New to this journey. I have not been diagnosed, but am being screened

If the CT and MRI already show areas suspicious for cancer in the gallbladder and several spots on the pancreas, you're really beyond “early screening” now. The priority is getting an accurate diagnosis and determining exactly where the cancer originated and whether the different lesions are related. I would strongly encourage getting evaluated at a major, high-volume pancreatic cancer center where pancreatic and biliary cancer specialists work together. A second opinion can be extremely valuable before making major treatment decisions. I would also encourage psychological counseling or oncology counseling for both the patient and family. A possible pancreatic or gallbladder cancer diagnosis can be overwhelming, and having professional emotional support while going through testing and waiting for answers can make a tremendous difference.

Then I would continue with the part about the planned endoscopic ultrasound (EUS) and biopsy being an appropriate next step. God bless

It’s a journey. Starts with an MRCP. Next EUS FNA with cytology on the fluids. Various blood tests like CEA, Lipase and CA 19 can establish markers to be followed. Depending on outcome it may be continued monitoring, surgery or interventions such as chemablation or RFA. If cancer is staged then another journey starts. Being treated by a center that does high volume pancreatic cancer treatments seems essential. I’m at the monitoring and early intervention stage so this is just my experience. I’ve found this platform invaluable.

I’m the caregiver for my husband. And without going into all we have and are going through, I will say this. What the two former comments (from mcchsrlesfrancis and ltg7622) said about going to a high-volume pancreatic center is very important!
. My husband I went to one after diagnosis at a local hospital. Of course they wanted to do the surgery there.
If we’d stayed, his surgery would’ve been a disaster based on where the tumor was. And the local surgeon was just a surgeon, not a specialist.
Good luck!

I 100% agree on the comments regarding finding a high volume and experienced specialist. I was diagnosed with 5 pNETs in 2019 and visited the local system to get a plan of treatment. They offered a total pancreatectomy with an estimated 6 month recovery time. I ended up going to a high volume center with a specialist surgeon and had the operation. I was in the hospital for 5 days and was up and about the following week. I went back to work remotely the week after and have been active ever since. The surgeon that performed the operation was quite clear that it is not about the surgery as much as it is the after care.
Take care and we're here to help!
- Matt

@hawkinsp Hi and welcome to Mayo Connect. You received some great advice from folks that have been there. So have I. Dealing with everything that is coming at you can be terrifying and overwhelming. How are you managing with it all?

When an EUS-FNA is done, it is important that the surgeon doing the procedure attempt obtaining sufficient sample quantity for doing Next Generation Sequencing (NGS) which determines what tumor genomics are in play-somatic mutations driving the cancer and if there is the presence of actionable biomarkers that can be targeted with immunotherapy. A standard EUS-FNA is insufficient quantity of cellular DNA to do NGS. So it it’s important this be discussed ahead of time to ensure adequate sample volume.

The results will help determine a customized treatment and can lead to finding a clinical trial using a targeted therapy approach. This should be considered first as some clinical trials stipulate the patient be treatment naïve in order to enroll.

@hawkinsp, how did the endoscopy go? Any update?