Pancreatic cancer recurrence at 2 years: Treatment change
I haven't checked in for a while…
My wife was diagnosed in July 2019 right after her 61st birthday. Had 9 rounds of Folfirinox, then 5 SBRT treatments in January 2020 and then surgery in March 2020 to take 60% of the pancreas, spleen, gall bladder, left adrenal and 23 lymph nodes. Surgery was at Johns Hopkins and all surgical pathology was negative. CA19-9 was below 30 post surgical.
Post surgery, she had CA19-9 every 8 weeks as well as scans. CA19-9 was increasing but no signs of a tumor so just continued to watch carefully. Then in February 2021 a golf ball sized tumor appeared on the left ovary despite no evidence on the prior scan just 8 weeks earlier. The CA19-9 jumped up past 2400. The ovaries were removed in March and chemo initiated in May after she recuperated.
Her current regimen is GAC, gemcitibane, paclitaxel and cisplaten on a 21 day cycle, 2 weeks on, 1 week off. After 1 treatment the CA19-9 dropped over 50% so we are hopeful it is effective. The problem is that the GAC side effects have been brutal and taking a severe physical and emotional toll.
We met with the oncologist yesterday and he has proposed that after the 3rd cycle, if the CA19-9 drops more and the scan is clear, he would remove the cisplaten from the remaining 3 planned cycles in order to make the side effects more bearable.
Does anyone have experience with this type of treatment change? I will probably seek a second opinion form her Johns Hopkins oncologist but would like to hear any personal experiences with any improvement in side effects without reduction of effectiveness.