Update: My Fight With Cancer - Alhamdulillah for Small Wins

As-salamu alaykum. I was diagnosed with a PNET on June 7 at 42, living in Bangkok with my wife and our 2-year-old son. It’s been a huge emotional ride for us: first they thought it was PDAC and we were told I might have less than a year, then we learned it’s a neuroendocrine tumor and were told I might have 3–5 years. Alhamdulillah for clarity, even if the road’s been hard. Since June I’ve had two rounds of chemo and two rounds of PRRT with Lutetium because my cancer cells have the right receptors for it. I also had an RFA to remove pancreatic tumors, which mostly succeeded in taking out the primary tumors. Everything’s happened fast. Updated Oct 24 - latest results and how things look: Liver function: - ALP: ... → 126 → 176 → 259 (increase may point to a vascular issue in the liver) - ALT: 322 → 170 → 37 → 41 → 83 (rise shows mild liver stress) - AST: 53 → 68 → 67 → 69 → 107 (mild liver stress) - GGT: 813 → 603 → 478 → 999 → 1,674 (big spike, could be vascular or treatment-related) Cancer markers: - CA 19-9: 2,384 → 743.8 → 629.3 → 738 (still much better than baseline) - CEA: 11.1 → 7.4 → 6.1 → 6.7 (also improved from baseline) Scans and interpretation: This blood work didn’t include cancer markers, and we’ve ruled out ascites and clear vascular blockages in the liver. Right now the team thinks the elevated liver numbers are likely from the treatments themselves - they can push up enzymes in the short term. Another possibility is that effective treatment has caused scarring and inflammation, which is changing how blood flows in the liver. What’s next: I’ll be discussing a proton therapy option with a specialist in Thailand. They have one of the region’s leading proton centers. The reason I might be a candidate is that my disease is being controlled with PRRT + SSA, and the tumor biology looks favorable for targeted work. Proton therapy is non-surgical, very focused, and tends to spare nearby healthy tissue - that’s important because we don’t want to overstress the liver and risk failure. It’s expensive and may take 10–15 sessions to reduce or debulk tumors, but if we can add it to PRRT + SSA it could really help control progression and possibly restore some liver function. I was cleared to try creatine and hyperbaric oxygen for fatigue and recovery; I’ve started hyperbaric oxygen therapy but decided not to take creatine because I don’t want to add extra load to the liver right now. My next PRRT + SSA cycle is planned for the second week of November. Between now and then I’m focusing on getting stronger, eating well, and doing what I can to improve my chance of responding. Up until now the plan has mostly been palliative - to keep quality of life - but if proton therapy is feasible alongside PRRT + SSA there might be a route toward no evidence of disease or longer remission. I haven’t had the full discussion with the doctor yet, so I’m trying not to get my hopes too high until I know more. In sha Allah we’ll know more in a couple weeks. I’ve been documenting not only treatments but the emotions, small victories, and tough days. If anyone else is going through something similar, you’re not alone. I’m sharing my daily journey so others may learn from what I’m experiencing and maybe find some comfort. If you want to follow along, I post updates on my YouTube channel. JazakAllahu khairan for the prayers and support.