Ain't No Sunshine When She's Gone

Terrified of the Road Ahead 

Venus and Mars surprised by Vulcan



Currently, I am sitting in the parking lot at YTN, reading medical journals on PDAC. I am curious what the journals suggest an elevated CA-19-9 level (the cancer marker) might mean. Jenny's is stable at 2349 (normal reading is >37). Hers was under 1000 at diagnosis, and crashed as low as the 300s in initial treatment, before beginning its ascent in late October.  It more than doubled from 331.2 in early October to 792.4 at the next session. It dropped below 1000 a couple times since then, but the trend isn't encouraging.  Amongst the literature I perused, I found  this, "Rising CA 19-9 values mean the tumor is growing." That statement is too strong.  Other things can cause the number to go up, an obstructed biliary duct, for instance. The worry for me is of all the examples listed as reasons CA19-9 may be elevated, none were things Jenny has. I'm not a medical doctor, so I don't know what the simplest or even the most likely explanation is. But the rising numbers scare the shit out of me.
Then, I came across this beauty:

Survival in Pancreatic Carcinoma Based on Tumor Size

Banke Agarwal et al. Pancreas. 2008 Jan.

Conclusions: A dramatic change in survival occurs as the size of pancreatic tumor increases from 20 mm or smaller to 30 mm or larger. To be effective, future strategies for early diagnosis of pancreatic cancer should aim at diagnosing most pancreatic cancers before they are 20 mm in size.
 
 The study identified and links overall survival length on the size of the tumor at diagnosis.  Unsurprisingly, the bigger it is when discovered, the worse your prognosis. Fact, Jenny's tumor, at the outset was measured in centimeters, not millimeters.  And, while the palliative chemo has thus far reduced its size, its still in the centimeters, not millimeters.

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