CT Results not good this time!

For the first time since her diagnosis I missed an appointment with my sister. I drove my aging parents 1500 miles to Florida for a couple of months of sunshine and warmth.
While I was gone my sister had an appointment and got her latests CT results. Something had developed in the 3 or 4 months since her last one.

“Findings…
there is a 5.4 x 8.0 cm multilobulated septated cystic mass in the right hemipelvis adjacent to surgical clips..There is soft tissue nodularity adjacent to it.
The sigmoid colon directly abuts the mass and its wall is eccentrically thickened.
the known peritoneal carcinomatosis with soft tissue stranding in the omentum is stable.
there is minimal distention of the right ureter, but no associated right hydronephrosis. A ureteric stent is in place in the left ureter. Previous hysterectomy noted. the ovaries are not identified.
There are no enlarged retroperitoneal or pelvic sidewall lymph nodes.
Stable apperance of the liver with chronic biliary duct dilatation in the left lobe. Unremarkable gallblader, spleen, pancreas, adrenal glands, aorta, kidneys, and IVC.
No ascites..
In the chest, there are no enlarged hilar, mediastinal or axillary lymph nodes. No pericardial or pleural effusions. Multiple faint bilateral subcentimeter pulmonary nodes are unchanged. No new parenchymal adnormality.
No suspicious bone lesions.
OPINION:
Cystic septated mass in the right hemipelvis at the site of previous surgical clips with adjacent soft tissue nodularity is suggestive of probable local recurrence of disease. Stable peritoneal carcinomatosis..”

I’m not very happy with the size of this “mass” and can’t seem to wrap my head around how this could possibly have gotten this large in that short a time. The last CT we questioned as it indicated she had her gallbladder removed – which she hadn’t. So the doc ordered a new one. THis is what they found this time.
I’m thinking that this is pretty fast growth? She is currently still on the same Chemo regiment of Gemcitabine and Oxlaplatin every third week. Her ca19-9 markers are on the rise again as well. She was 711 in Sept of last year and is over 2000 now.
Her oncologist has referred her to Princess Margaret hospital in Toronto for thier Investigative Drug program, we’re waiting to hear if they will see her and if they can offer her any options.

Any thoughts?