Need more tests.
Hi. Thanks for the query. It is a difficult situation for friends and family and I know what you are going through. Regarding your query, I have read it in detail. The fact that your friend is being treated with chemotherapy
first means that it is an advanced stage. According to the details provided by you, it is probably a locally advanced pancreatic cancer. Size is not the only criterion for response assessment. First there will be some variation in size when measured by two different radiologists and this is known as inter observer variability and it can't be totally eliminated. Secondly, the fact that CA 19-9 is rising suggests that the tumor
is progressing. CTscanalone is not enough in this situation. We need more tests. One of them is a whole body PET-CT
. It is a good test in detecting distant metastasis especially in the liver
. The second test which is superior to CT scan
in determining local extent, especially vessel involvement and nodal status is EUS(endoscopic ultrasound
). Based on these tests we can come to a conclusion whether it is worth operating or not. In case the tumor is not operable, local radiation
can be given if it had not spread elsewhere and that will provide some relief.