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Strong Chemotherapy Before Surgery May Help Certain Pancreatic Cancer Patients

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Strong Chemotherapy Before Surgery May Help Certain Pancreatic Cancer Patients

Pancreatic cancer is often treated with surgery if doctors believe the tumor can be removed. But survival can still be poor, especially for patients with high levels of a blood marker called CA19-9. This marker shows how aggressive the cancer may be.

A new study looked at patients with pancreatic cancer that could be removed with surgery and had CA19-9 levels above 500 U/mL. Researchers compared two groups: one had surgery right away, and the other had intensive chemotherapy first, then surgery.

The results were striking. Patients who received chemotherapy before surgery lived much longer—about 53 months compared to 23 months for those who had surgery first. They were also more likely to have surgery that fully removed the cancer and to have no cancer in their lymph nodes. Even in patients with very high CA19-9 levels (over 2000), chemotherapy first still improved survival.

This means that for patients with pancreatic cancer and very high CA19-9, starting with strong chemotherapy may give them a better chance of living longer and having better surgical results.

Doctors may now consider using CA19-9 not just as a test but as a guide for treatment decisions. Patients with high levels should discuss with their care team whether chemotherapy before surgery might be the best approach for them.

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Dr. Harsh J Shah

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Dr Harsh Shah - GI & HPB Oncosurgeon in India
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