Also note often sloan kettering and md anderson (and my nci center in NH) and maybe columbia in ny and some others will do chemo and, or chemo-radiatio prior to a whipple which can not only increase numbers that qualify but increase survival--NEOadjuvant treatment. One huge advantage is some will then have it shrink around ? portal vein/artery which would have some surgeons close up and not do surgery if around it and this can make that difference, maybe downgrading stage. This option depends on evalutation, scans too. Sloan is 2nd rated cancer center in US. Ask number of patients seen yearly, number of whipples, whether do neoadjuvant treatment and trials, if can do whipple if cancer around pancreatic vein....