Para-aorta lymph node positive for carcinoma cells

Posted by yliddy @yliddy, Jul 2 3:32pm

Following a distal pancreatomy, splenectomy last May 29 2024, stage 2b, I completed 11 cycles of Folfirnax in December. Considered NED through January 2025 , which was my 3rd clear CT scan. Fast forward 6/6/25, CT scan showed enlarged para-aortic lymph nodes, left side. Biopsy 6/27/25 positive. I’m seeing my oncologist tomorrow. Has anyone else experienced this type of recurrence? If so, is the recommendation Gembiticane/Abzar chemo, SBRT radiation, etc? I’m reading a lot of different options. Thanks in advance.

Interested in more discussions like this? Go to the Pancreatic Cancer Support Group.

joiedevivre | @joiedevivre | Jul 2 6:46pm

My husband had the same surgery as you did in Dec 2023 - clear margins and no cancer anywhere but in the pancreas. He was on 3 sessions of Folfirinox but CA19-9 markers climbed slowly. Onco switched him to Gem-Abraxane in March 2024. He was on it for 15 months until recurrence in May 2025 at resected edge of pancreas. His scans had been clear from surgery till May 2025. Onco’s recommendation was for chemo-radiotherapy - 25 daily sessions of radiotherapy with Capecitabine. The radiotherapy is VMAT but SBRT was an option. He has done 13 sessions and holding up well. Just expect that with radiotherapy in that area, your eating and digestion will get a bit messed up - bloating, not hungry, slight nausea, reflux etc. Fatigue is the worse side effect but we set aside these 5 weeks of doing nothing. SBRT is done in a shorter period. All the best!

yliddy | @yliddy | Jul 2 7:19pm

Thank you so much for the information. All the best to your husband!!!

joiedevivre | @joiedevivre | Jul 2 10:29pm

In reply to @yliddy "Thank you so much for the information. All the best to your husband!!!" + (show)

My husband's recurrence happened during chemo (Gem-Abraxane) so it is likely the cancer developed a resistance but you were not on chemo so you may be ok to go on Gem-Abraxane. Your onco may suggest SBRT first for localised and small area of recurrence. I was told SBRT involves 5 sessions. Ask your onco if you need to go on with some Gem-Abraxane after SBRT.

Turkey, Volunteer Mentor | @tomrennie | Jul 3 9:01am

In reply to @yliddy "Thank you so much for the information. All the best to your husband!!!" + (show)

Good luck with the oncologist today. Please let us know how it goes?

yliddy | @yliddy | Jul 3 9:04am

In reply to @joiedevivre "My husband's recurrence happened during chemo (Gem-Abraxane) so it is likely the cancer developed a resistance..." + (show)

Thank you. I’m on my way right now actually. Treating at MSKCC in NYC.

yliddy | @yliddy | Jul 3 1:17pm

So saw the doctor. We are going with chemo at this time Gemcitibane/Abraxane and we will look for any potential clinical trials. I don’t have any specific mutation namely SK111. 3 cycles of chemo, then CT scan and we are doing the ctDNA test. For now I feel good about the plan! Thanks everyone for your input.

Please sign in or register to post a reply.