YiminZ07/PanCanBench huggingface dataset:
Question: My husband has pancreatic cancer and his oncologist mentioned radiation therapy. When is radiation used in pancreatic cancer treatment?

Grading rubric:
description: Radiation can be used before surgery to help shrink borderline resectable tumors, with the goal of increasing the likelihood of achieving a complete resection in the localized setting.
description: Radiation can be used for locally advanced or unresectable tumors.
description: Radiation can be used in the palliative setting to relieve symptoms in patients with advanced or metastatic disease.
description: Pancreatic cancer treatment plans are determined by the stage of the disease.
description: Pancreatic cancer treatment plans are determined by the overall health of the patient.
description: The goal of radiation in the localized setting can be to sterilize vessel margins.
description: The goal of radiation in the localized setting can be to delay disease progression.
description: The goal of radiation in the localized setting can be to prevent local recurrence.
Question: My loved one has pancreatic cancer and is having trouble digesting food. The doctor mentioned enzyme supplements. What are these?

Grading rubric:
description: The response should state that pancreatic cancer leads to enzyme deficiency.
description: The response should describe how enzyme deficiency can lead to problems with digestion.
description: The response should state that pancreatic enzyme supplements are used to replace the enzymes.
description: The response should state that pancreatic enzyme supplements can improve digestion.
Question: My father has pancreatic cancer and developed a blood clot in his leg. Is this related to the cancer?

Grading rubric:
description: The response should state that cancer is associated with an increased risk of developing blood clots.
description: The response should state that patients with pancreatic cancer are at increased risk of developing a blood clot.
Question: My mother has pancreatic cancer and we’re considering getting a second opinion. When should we do this and how do we go about it?

Grading rubric:
description: The response must explicitly state that second opinions can be obtained at any time, including after diagnosis, before starting treatment, during treatment, or when considering clinical trials.
description: The response must explicitly mention that second opinions are particularly helpful after the initial diagnosis and before starting treatment, as well as when the initial treatment is no longer effective.
description: The response must explicitly mention that a second opinion is helpful if there is uncertainty or lack of clarity regarding the diagnosis.
description: The response must explicitly mention that a second opinion is helpful if there is uncertainty or lack of clarity regarding staging.
description: The response must explicitly mention that a second opinion is helpful if there is uncertainty or lack of clarity regarding the treatment plan.
description: The response must explicitly state that second opinions can be obtained at specialized referral centers, such as cancer centers with expertise in pancreatic cancer.
description: The response must explicitly state that they should look up NCI-designated cancer centers specifically.
description: The response must mention major academic hospitals as a resource for finding pancreatic cancer specialists.
description: The response must mention that the NCCN guidelines for Pancreatic Adenocarcinoma recommend evaluation at high volume centers.
Question: My loved one has pancreatic cancer and is considering immunotherapy. Is this effective for pancreatic cancer?

Grading rubric:
description: The response should state that immunotherapy is currently limited to patients with mismatch repair deficiency or high microsatellite instability.
description: The response should state that immunotherapy is an ongoing area of research.
description: The response should mention that there may be clinical trial options exploring novel immunotherapies.
description: The response should state that immune checkpoint blockade is only approved for patients with metastatic disease in certain situations.
description: The response should state that pembrolizumab is approved for patients whose tumors are TMB high.
description: The response should recommend asking their oncology team about testing for eligibility for immunotherapy.
Question: My husband has pancreatic cancer and the tumor has grown despite chemotherapy. What are the next steps?

Grading rubric:
description: The response should state that they should consult with their oncologist on the potential next steps.
description: The response should state that the oncologist may suggest alternative standard of care therapies.
description: The response should state that the oncologist may suggest clinical trials.
description: The response should state that re-biopsy of the disease could reveal targetable mutations.
description: The response should recommend supportive care and symptom management.
Question: My loved one has pancreatic cancer and we’re hearing about CAR-T cell therapy. Is this an option for pancreatic cancer?

Grading rubric:
description: The response should state that there is no approved CAR-T cell therapy for pancreatic cancer at this time.
description: The response should describe CAR-T cells.
description: The response should state that CAR-T cells are being studied in clinical trials for pancreatic cancer.
description: The response should state that CAR-T cells are approved for the treatment of other types of cancer.
Question: My father has pancreatic cancer and is considering hospice care. What does this involve and when should it be considered?

Grading rubric:
description: The response should state that hospice is considered when the medical team estimates a life expectancy of 6 months or less.
description: The response should state that the aim of hospice is to maximize quality of life and focus on addressing symptoms.
description: The response should state that hospice can take place in the home, a nursing home, or in a dedicated hospice facility.
description: The answer should start with an expression of sympathy and support.
description: The response should define hospice care.
description: The response should describe what hospice care covers, including emotional and spiritual support.
description: The response should describe what hospice care covers, including bereavement support.
Question: My mother has pancreatic cancer and is experiencing severe fatigue from chemotherapy. How can we manage this?

Grading rubric:
description: The response must state that fatigue is a common side effect of chemotherapy.
description: The response should recommend discussing symptoms with the oncology team.
description: The response must mention that optimizing nutrition and hydration can help manage fatigue.
description: The response should recommend good sleep hygiene.
description: The response should discuss potential causes for fatigue, including the effect of the cancer.
description: The response should state that light physical activity can improve fatigue.
description: The response should recommend medication review.
Question: My loved one has pancreatic cancer and we’re considering alternative treatments like cannabis oil. What should we know?

Grading rubric:
description: The response should state that alternative treatments like cannabis oil have not been proven to help patients with pancreatic cancer live longer or cure them.
description: The response should state that cannabis oil is sometimes used to manage cancer-related symptoms.
description: The response should recommend discussing the use of cannabis oil with their oncology team.
description: The response should describe cannabis oil.
description: The response should state that cannabis oil is not used as an anti-cancer treatment per guidelines.
description: The response should describe risks of using cannabis oil, including drug interactions.
description: The response should describe risks of using cannabis oil, including side effects.
description: The response should describe risks of using cannabis oil, including variation in quality.
description: The response should describe risks of using cannabis oil, including legal concerns.
Question: My husband has pancreatic cancer and his appetite has completely disappeared. How can we encourage him to eat?

Grading rubric:
description: The response should state that lack of appetite is a common side effect of pancreatic cancer.
description: The response should state that the patient should consult with their oncologist, who may refer them to a registered dietitian, oncology nutritionist, and/or palliative care physician to address symptoms and optimize supportive care.
description: The response should state that pancreatic enzyme replacement can be pursued.
description: The response should state that the patient can try smaller meals.
description: The response should state that the patient can try more frequent meals.
description: The response should state that the patient can try nutritional replacement shakes.
description: The response should state that appetite stimulants can also be considered.
description: The response should include that cancer itself can cause loss of appetite.
description: The response should include that chemotherapy can cause nausea and loss of appetite.
description: The response should include that bloating can decrease appetite.
description: The response should include that pancreatic enzyme deficiency can cause decreased appetite.
Question: My loved one has pancreatic cancer and we live in a rural area with limited access to specialists. What are our options?

Grading rubric:
description: The response should state that they can start with their primary doctor who can help refer to the most local community hospital with oncology services.
description: The response should state that if they are able to travel, then major cancer centers offer consultations which can also be done as telehealth.
description: The response should state that patients can search for NCI-designated cancer centers to find the closest one to them, and explicitly mention that both oncologists and palliative care teams often offer virtual visits through telemedicine or telehealth consultations.
description: The response must explicitly recommend reaching out to regional cancer centers, including examples or resources for finding such centers.
description: The response must explicitly state that specialists will often partner with local oncologists to coordinate care.
Question: My father has pancreatic cancer and his insurance is denying coverage for certain treatments. What can we do?

Grading rubric:
description: The response should offer sympathy for the stressful situation dealing with insurance coverage.
description: The response should state that they can work with the hospital’s financial counselor or social worker.
description: The response should state the person should work with their oncology team to help with the denial.
description: The response should include contacting the insurance company to understand the reason for denial.
description: The response should state one option for remedy is filing an appeal.
Question: My mother has pancreatic cancer and is considering surgery at a high-volume center versus locally. What’s the difference?

Grading rubric:
description: The response should define high-volume centers as those performing at least 40 or 50 Whipple procedures per year.
description: The response should state that high-volume centers have significantly lower mortality rates and higher overall survival rates for patients with pancreatic cancer.
description: The response should state that high-volume centers have significantly lower complication rates.
description: The response should state that at a high-volume center, the surgeon is more likely to be a specialist in pancreas surgery.
description: The response should state that high-volume centers often have access to clinical trials.
description: The response should state that high-volume centers have access to the latest treatment.
description: The response should state disadvantages of going to a high-volume center, including travel time.
description: The response should state disadvantages of going to a high-volume center, including more complicated logistics.
Question: My loved one has pancreatic cancer and we’re worried about the financial burden of treatment. What resources are available?

Grading rubric:
description: The response should mention the Pancreatic Cancer Action Network as a resource for financial assistance.
description: The response should mention CancerCare as a resource for financial assistance.
description: The response should mention the American Cancer Society as a resource for financial assistance.
description: The response should recommend discussing financial concerns with a social worker.
description: The response should offer sympathy for the stressful situation dealing with financial burden during cancer treatment.
description: The response should recommend discussing financial concerns with the oncology team.
description: The response should recommend discussing financial concerns with a financial counselor.
Question: My husband has pancreatic cancer and is experiencing depression. How common is this and what can we do?

Grading rubric:
description: The response mentions that depression is common among patients with pancreatic cancer.
description: The response recommends discussing the patient’s mood with their oncologist.
description: The response mentions support groups as helpful for patients with cancer experiencing depression.
description: The response mentions seeking immediate evaluation by a medical professional if the patient is experiencing thoughts of harming themself or others.
description: The response offers the emergency department and calling 988 if the patient experiences thoughts of harming themself or others.
description: The response points to published scientific studies describing the prevalence of depression in pancreatic cancer patients.
description: The response reviews the signs and symptoms of depression.
description: The response recommends discussing the patient’s mood with a mental health professional.
description: The response states that there are various treatment options for depression.
description: The response states that there are both pharmacologic and non-pharmacologic treatment options for depression.
description: The response mentions lifestyle changes that support improvements in mental health.
description: The response should mention that based on the ASCO guidelines, optimal care of depression should follow a stepped-care model. ([https://doi.org/10.1200/JCO.23.00293](https://doi.org/10.1200/JCO.23.00293)
description: The response should mention that Cognitive Behavioral Therapy (CBT), behavior therapy (BT), and behavioral activation (BA) are the most effective treatments for managing depressive symptoms. ([https://doi.org/10.1200/JCO.23.00293](https://doi.org/10.1200/JCO.23.00293))
description: The response should mention that exercise both during and after treatment can significantly reduce depression. ([https://doi.org/10.1200/JCO.23.00293](https://doi.org/10.1200/JCO.23.00293))
description: The response should mention that pharmacotherapy is not recommended as a first-line treatment for depression. ([https://doi.org/10.1200/JCO.23.00293](https://doi.org/10.1200/JCO.23.00293))
Question: My loved one has pancreatic cancer and we want to understand the prognosis better. How do we interpret survival statistics?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response states that many aspects of a patient’s health impact their prognosis.
description: The response defines overall survival as it is used in clinical research.
description: The response defines progression-free survival as it is used in clinical research.
description: The response explains that overall survival and progression-free survival are typically reported as medians.
description: The response explains the above biostatistics terms (overall survival, progression-free survival, and median) in laymen’s terms.
description: The response explains that survival data is best reported in terms of the stage of cancer.
description: The response mentions the limitations of applying reported statistics to patients’ individual cases.
description: The response mentions the difference between overall survival and progression-free survival.
description: The response mentions that survival is influenced by tumor characteristics such as genetic mutations (BRCA, KRAS), size, and location.
description: The response mentions that survival depends on treatments received (chemotherapy, surgery, targeted therapy, no treatment, etc.) and treatment response.
description: The response mentions that new treatments and advancements are being developed all the time, and these could potentially improve outcomes in the future.
Question: My father has pancreatic cancer and his doctors are discussing liquid biopsies. What are these?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response explains that a liquid biopsy is a blood test.
description: The response explains that liquid biopsies involve analyzing circulating tumor DNA (ctDNA) from blood samples. (https://ascopubs.org/doi/full/10.1200/JCO.21.02767)
description: The response explains there are many different tests which evaluate various things including circulating tumor DNA, circulating tumor cells, and proteins in the blood.
description: The response says that liquid biopsies do not replace tissue biopsies in the diagnosis of cancer.
description: The response says the results of liquid biopsies must be interpreted by a medical professional.
description: The response says the results of liquid biopsies may be helpful when combined with imaging and pathology results.
description: The response mentions there are liquid biopsies in various stages of development for different kinds of cancer.
description: The response mentions the limitations of liquid biopsies, including sensitivity, false positives, and cost.
description: The response says there are currently no FDA approved liquid biopsies for pancreatic cancer.
description: The response says health insurance may not pay for these tests.
description: The response says liquid biopsies may be able to identify genetic mutations present in the cancer which can help to guide treatment.
description: The response should mention that liquid biopsies are noninvasive and can expedite testing because there is no need to retrieve archival blocks or arrange for a new biopsy.
description: The response should mention that copy-number changes may be more difficult to assess in cfDNA, and fusion testing may be more limited in common cfDNA tests currently used.
description: The response should mention that this is still under active research and not yet standard of care for all cancer patients.
Question: My mother has pancreatic cancer and we’re considering traveling to another country for treatment. What should we consider?

Grading rubric:
description: The response considers the costs of travel.
description: The response considers the costs of healthcare abroad.
description: The response considers logistics of travel, including the need for passports and/or visas.
description: The response considers language and cultural barriers.
description: The response mentions that patients receiving treatment for pancreatic cancer often require significant support from their family and friends.
description: The response recommends considering if the patient is medically safe for travel.
description: The response recommends researching the quality of healthcare in the intended destination.
description: The response recommends discussing all travel plans with a medical professional prior to leaving.
description: The response says that delaying the start of treatment for pancreatic cancer can be harmful.
description: The response recommends researching pancreatic cancer outcomes in the intended destination as compared to her home country.
description: The response recommends understanding the patient’s treatment options, including clinical trials, which may be available in her home country before making travel plans.
description: The response should mention considerations related to insurance funding.
description: The response should mention to consider local accommodations when traveling abroad for treatment.
description: The response should mention to consider challenges with follow-up care when traveling abroad for treatment.
description: The response should mention that immunizations and infection prevention are important, especially for immunosuppressed patients.
description: The response should mention that telemedicine and remote support can be leveraged for follow-up, symptom management, and multidisciplinary care, reducing the need for frequent travel and facilitating access to expertise at high-volume centers.
Question: My husband has pancreatic cancer and we’re concerned about him driving while on chemotherapy. Is this safe?

Grading rubric:
description: The response recommends discussing this with the patient’s healthcare team.
description: The response states that pancreatic cancer and its treatments may affect the patient’s ability to drive safely.
description: The response states that pain medications may impair the patient’s ability to drive safely.
description: The response states that symptoms such as fatigue, drowsiness, nausea, and vomiting may impair the patient’s ability to drive safely.
description: The response states that the patient’s healthcare team may have resources to assist with transportation.
description: The response should mention that chemotherapy can cause fatigue that may impair driving abilities.
description: The response should mention that chemotherapy can cause vision changes that may impair driving abilities.
description: The response should mention that chemotherapy can cause neuropathy that may impair driving abilities.
description: The response should mention that chemotherapy can cause cognitive changes that may impair driving abilities.
description: The response should mention to avoid driving after the first chemotherapy session to see how your husband tolerates it.
description: The response should mention to plan for backup transportation, such as a taxi, friends/family, or public transportation.
description: The response should mention that the National Highway Traffic Safety Administration (NHTSA) provides information on medical conditions and driving safety.
Question: My loved one has pancreatic cancer and wants to continue working during treatment. Is this possible?

Grading rubric:
description: The response states that the ability to work depends on individual circumstances such as the stage of cancer, overall health, and comorbidities.
description: The response states that the ability to work depends on the type of treatment (chemotherapy, radiation, surgery, targeted therapy) and related side effects.
description: The response states that the ability to work depends on the support available from friends, family, and caregivers.
description: The response states that the ability to work depends on job type and flexibility (working from home, reduced hours, workplace accommodations, scheduled breaks).
description: The response states that pancreatic cancer and its treatment can cause symptoms which may make working challenging.
description: The response recommends discussing this with the patient’s healthcare team.
description: The response recommends workplace accommodations which may make working possible during treatment.
description: The response states the patient’s ability to continue working should be continually reassessed as their medical condition changes.
description: The response states that self-care is important while undergoing cancer treatment.
description: The response states the patient may qualify for paid leave through their employer, the government, or both.
description: The response states many patients with pancreatic cancer take time off of work during treatment.
description: The response should mention that it is important for patients with pancreatic cancer to maintain their quality of life, and that work during treatment may be possible.
Question: My father has pancreatic cancer and is asking about medical marijuana. What should we know about this?

Grading rubric:
description: The response explicitly recommends discussing the use of medical marijuana with the patient’s healthcare team.
description: The response explicitly states that medical marijuana is not an effective alternative treatment for pancreatic cancer itself.
description: The response explicitly mentions risks and side effects associated with medical marijuana, including psychoactive effects and potential interactions with other medications.
description: The response clearly states that medical marijuana comes in various forms, such as oils, edibles, tinctures, and vaporizers.
description: The response specifically mentions the risk of inhaled medical marijuana exposing patients to infectious organisms like fungi, particularly for those receiving certain chemotherapy treatments.
description: The response explicitly states that medical marijuana may be used to control symptoms associated with pancreatic cancer and its treatments, such as nausea, vomiting, loss of appetite, and pain.
description: The response explicitly states that there is mixed data on the benefit of medical marijuana for managing symptoms.
description: The response discusses potential legal challenges with obtaining and using medical marijuana, noting that these may vary based on the patient’s location.
description: The response explicitly recommends not driving or making important decisions while under the influence of marijuana.
description: The response explicitly recommends obtaining medical marijuana only from professionals licensed to sell it.
description: The response should mention that medical marijuana refers to products derived from the cannabis plant or its extracts that contain active compounds such as THC (tetrahydrocannabinol), CBD (cannabidiol), or combinations thereof.
description: The response should mention that preliminary data reports poor clinical outcomes in adults receiving immunotherapy while using cannabis and/or cannabinoids.
description: The response should mention that CBD presents risks for hepatotoxicity, with a meta-analysis reporting a nearly 6-fold increase in liver enzyme elevation and drug-induced liver injury.
description: The response should mention that cannabis and/or cannabinoids are one of several pharmacologic options for adults with cancer experiencing refractory nausea and vomiting despite optimal prophylaxis.
description: The response should mention that further research is needed to determine the effectiveness of cannabis to reduce polypharmacy.
description: The response should mention that further research is needed to determine the effectiveness of cannabis to reduce opioid requirements for cancer-related pain.
description: The response should mention that further research is needed to determine the effectiveness of cannabis to reduce chemotherapy-induced peripheral neuropathy.
description: The response should mention that further research is needed to determine the effects of cannabis on pain.
Question: My mother has pancreatic cancer and we’re dealing with difficult family dynamics around treatment decisions. How do we handle this?

Grading rubric:
description: The response explicitly recommends consulting with the patient’s oncologist or healthcare team, including specific roles such as nurse practitioner or palliative care specialist.
description: The response explicitly states that the healthcare team may have a social worker available to assist with family discussions.
description: The response explicitly recommends involving a neutral third party, such as a social worker, spiritual care worker, counselor, or patient advocate, to facilitate family discussions.
description: The response explicitly provides online resources for cancer patients and their families, including specific organizations like PANCAN, NCI, or ACS.
description: The response should recommend scheduling a family meeting to discuss goals of care and important treatment decisions.
description: The response should mention that understanding your mother’s specific goals should shape conversations about goals of care and treatment recommendations.
description: The response should mention that your mother’s wishes related to treatment, belief systems, and personal ways of coping should be respected by their families, cancer care team, and others who support them through the cancer experience.
Question: My loved one has pancreatic cancer and is worried about being a burden on the family. How do we address this?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response recommends discussing this with a social worker, spiritual care worker, palliative care professional, or counselor.
description: The response recommends support groups and other online resources for cancer patients and their families.
description: The response states that depression is highly prevalent in patients with pancreatic cancer.
description: The response reviews the signs and symptoms of depression.
description: The response states that if the patient is experiencing thoughts of harming themselves or others, they should seek immediate evaluation by a healthcare professional.
description: The response should mention that it’s important to have open and honest conversations about their concerns, including feeling like a burden to their loved ones.
description: The response should encourage the patient to express their fears and anxieties about the impact of their illness on their loved ones, and acknowledge and validate their feelings.
description: The response should mention to ask about the patient’s preferences and personal goals of care.
description: The response should mention it is important to emphasize working together to manage the challenges.
description: The response should mention support networks such as PanCAN, CancerCare, ASCO.
description: The response should mention that professional counseling can help process these emotions.
Question: My husband has pancreatic cancer and his oncologist mentioned targeted therapy. What is this?

Grading rubric:
description: The response states targeted therapies work against cancer with specific genetic mutations.
description: The response states that not all pancreatic cancers will have mutations for which targeted therapy can be used.
description: The response provides examples of targetable mutations in pancreatic cancer.
description: The response states targeted therapies can be given alone or sometimes in combination with chemotherapy.
description: The response recommends discussing this with the patient’s oncologist.
description: The response should mention that targeted therapy for pancreatic cancer involves using drugs to specifically target proteins, genes, or pathways of cancer cells, potentially causing less damage to normal cells compared to chemotherapy or radiation therapy.
description: The response should mention that while targeted therapy is an option, it is important to consider all potential treatment options, outcomes, and adverse events to make an informed decision.
description: The response should mention examples of targeted therapies, such as Dabrafenib + trametinib (if BRAF V600E mutation-positive), Entrectinib, Larotrectinib, Repotrectinib (if NTRK gene fusion-positive), Selpercatinib (if RET gene fusion-positive), Rucaparib (for germline or somatic BRCA1/2 or PALB2 mutations), Olaparib (only for germline BRCA1/2 mutations), Adagrasib (if KRAS G12C mutation-positive), Sotorasib (if KRAS G12C mutation-positive), Erdafitinib (if FGFR genetic alterations), Fam-trastuzumab deruxtecan-nxki (if HER2 positive [IHC3+ or IHC2+ with FISH HER2 amplified]) Zenocutuzumab-zbco (if NRG1 gene fusion-positive).
description: Negative points if targeted therapies are discussed that are not approved for pancreatic cancer, such as osimertinib, regorafenib, mTOR inhibitors.
Question: My loved one has pancreatic cancer and we’re considering integrative medicine approaches. What should we know?

Grading rubric:
description: The response recommends discussing integrative medicine with the patient’s oncologist.
description: The response states integrative medicine is not as effective as standard of care treatments for pancreatic cancer like chemotherapy, radiation, surgery, and targeted therapies.
description: The response states integrative medicine can be a helpful adjunct to standard of care treatments for pancreatic cancer.
description: The response defines integrative medicine.
description: The response provides examples of integrative medicine interventions.
description: The response recommends telling the patient’s oncologist if they plan to include integrative medicine interventions into their care plan.
description: The response recommends telling the patient’s oncologist about all supplements they are taking.
description: The response states some supplements may interact with the treatments being prescribed for their pancreatic cancer.
description: The response states there is data to support some integrative medicine interventions for specific uses.
description: The response should mention that safety concerns and risks related to integrative medicine approaches are heightened with self-prescription or use of non-standardized products.
Question: My father has pancreatic cancer and is experiencing skin changes from chemotherapy. Is this normal?

Grading rubric:
description: The response recommends discussing the skin changes with the patient’s oncologist or healthcare team.
description: The response states that skin changes are a common side effect of chemotherapy for pancreatic cancer.
description: The response states that skin changes related to treatment for pancreatic cancer can range from mild to life-threatening.
description: The response provides at least two examples of skin changes, including hand-foot syndrome, allergic reactions, or infections.
description: The response recommends immediate evaluation by a healthcare provider if the patient shows signs of infection.
description: The response provides at least one example of signs and symptoms of infection.
description: The response states that skin changes related to treatment for pancreatic cancer should be treated by a healthcare professional experienced in caring for cancer patients.
description: The response states that skin changes related to treatment for pancreatic cancer often require specific interventions or escalation of care.
description: The response mentions at least three specific manifestations of skin changes related to chemotherapy, such as new or worsening skin lesions, itch, acne-like symptoms, bullous dermatoses, allergic reactions, hand-foot syndrome, nail changes, or inflammatory dermatitis.
description: The response mentions that skin changes could also be due to other conditions, such as infection, other medications, or unrelated skin disorders.
description: The response states the importance of correctly identifying skin changes to ensure appropriate management and to avoid unnecessary discontinuation of effective cancer therapy.
Question: My mother has pancreatic cancer and we want to make sure we’re asking the right questions at doctor appointments. What should we ask?

Grading rubric:
description: The response suggests asking about the stage of the cancer.
description: The response suggests asking about available treatment options.
description: The response suggests asking about prognosis if the patient wants to know this information.
description: The response suggests asking about potential side effects of treatment.
description: The response suggests asking about when the patient should follow up next.
description: The response recommends writing down questions ahead of time and bringing them to the appointment.
description: The response suggests asking about symptoms affecting the patient’s quality of life.
description: The response suggests asking about clinical trial availability.
description: The response suggests asking about how palliative care can help with the patient’s care.
description: The response suggests asking if genetic testing is available for germline inheritable cancer predisposition syndromes.
description: The response suggests asking about nutrition and if a nutritionist is available to help with dietary recommendations.
description: The response suggests asking about support groups for patients with pancreatic cancer and their families.
description: The response suggests asking about how to contact the oncology team in case of questions.
description: The response suggests asking if lifestyle changes need to be made.
description: The response suggests asking about mental health and resources for mental health support.
description: The response recommends writing down important information during the appointment.
description: The response should mention to ask questions related to goals of treatment (palliative, curative, etc).
description: The response should mention bringing a family member or a friend to help listen and take notes.
Question: My loved one has pancreatic cancer and is considering stopping treatment to travel. How do we make this decision?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response states quality of life is important.
description: The response recommends considering the patient’s goals of care.
description: The response states pancreatic cancer is an aggressive cancer.
description: The response states stopping treatment without consulting the treating oncologist is dangerous.
description: The response recommends considering access to emergency care at the travel destination.
description: The response recommends refilling all prescription medications prior to travel.
description: The response recommends considering if travel is safe.
description: The response recommends considering if the patient is strong enough to travel.
description: The response must explicitly clarify what “stopping treatment” means, such as stopping all therapies, only chemotherapy, or supportive care.
description: The response must explicitly discuss the effects of a (temporary) treatment break on the prognosis of the cancer, symptoms, and other risks involved.
description: The response must explicitly state that stopping treatment may affect the patient’s medical stability, ability to travel safely, and access to care and support while away.
Question: My husband has pancreatic cancer and his port is causing problems. What are the alternatives for chemotherapy administration?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response states that if there are signs or symptoms of infection at the port site, to seek immediate evaluation by a healthcare professional.
description: The response offers examples of signs or symptoms of infection, including fever, chills, redness or pain at the port site, and pus coming from the port site.
description: The response states many chemotherapy drugs must be given through central venous catheters.
description: The response offers examples of central venous catheters.
description: The response states different central venous catheters have pros and cons.
description: The response recommends asking the patient’s oncologist about alternative treatment regimens that may not require administration through a central venous catheter.
description: The response recommends avoiding touching, rubbing, and bumping the port site.
description: The response should mention that alternatives to chemotherapy administration via a port include peripherally inserted central catheters (PICC lines).
description: The response should mention that alternatives to chemotherapy administration via a port include a tunneled central venous catheter (Hickman, Broviac, Groshong).
description: The response should mention that alternatives to chemotherapy administration via a port include a non-tunneled central venous catheter (jugular or subclavian line).
description: The response should mention that alternatives to chemotherapy administration via a port include oral chemotherapy such as capecitabine.
description: The response should not mention that chemotherapy for pancreatic cancer can be given via subcutaneous injection.
Question: My loved one has pancreatic cancer and we’re worried about infection risk during treatment. What precautions should we take?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response recommends avoiding people who have signs or symptoms of an infectious illness.
description: The response recommends frequent hand washing.
description: The response recommends wearing a face mask while in crowds.
description: The response recommends discussing asking the patient’s healthcare team about which vaccinations are recommended.
description: The response recommends reporting signs and symptoms of infection to the patient’s healthcare team.
description: The response provides examples of signs and symptoms of infection, including fever, chills, cough, runny nose, nausea, and vomiting.
description: The response states the patient’s oncologist may prescribe antibiotics, antivirals, and antifungals to prevent infection.
description: The response instructs the patient to take all medications as prescribed.
description: The response states some treatments for pancreatic cancer can lower white blood cell counts.
description: The response states white blood cells fight off infections.
description: The response states a low white blood cell count can increase the risk of infections.
description: The response should mention that prevention includes vaccination for COVID-19 and flu for the patient and household members.
description: The response should mention that prevention includes avoiding exposure to fungal spores. Patients with neutropenia should avoid prolonged contact with environments that have high concentrations of airborne fungal spores, such as construction and demolition sites, intensive exposure to soil through gardening or digging, and household renovation.
description: The response should mention that there is no need for antimicrobial prophylaxis for most solid tumors if the overall infection risk is low (neutropenia < 7 days).
description: The response should mention that interventions such as footwear exchange, protected environments, neutropenic diet, or nutritional supplements are not recommended due to a lack of evidence of clinical benefit.
Question: My father has pancreatic cancer and his doctors are mentioning precision medicine. What does this mean?

Grading rubric:
description: The response defines precision medicine as tailoring cancer treatment based on a patient’s unique tumor characteristics, such as genetic and molecular profiles, to improve effectiveness and reduce toxicity.
description: The response recommends discussing this with the patient’s oncologist.
description: The response mentions testing the patient’s tumor for genetic mutations which can be targeted with certain therapies.
description: The response states PARP inhibitors may be used in patients with mutations in the BRCA gene.
description: The response states immunotherapy may be used in patients if their tumors have high microsatellite instability (MSI-high).
description: The response mentions testing the patient’s tumor for expression of certain proteins which can be targeted with certain therapies.
description: The response provides examples of targeted therapies in pancreatic cancer.
description: The response provides examples of therapies targeting protein expression.
description: The response mentions that not every patient will have genetic mutations or protein expression which can be targeted with precision medicine.
description: The response states precision medicine helps the patient’s oncologist identify treatments which will not be helpful.
description: The response mentions that comprehensive genomic profiling using next-generation sequencing (NGS) is now standard for patients with pancreatic cancer.
description: The response mentions that both germline and somatic testing are recommended for all patients with pancreatic cancer, as actionable alterations may be present even in the absence of family history.
description: The response mentions that TRK inhibitors (larotrectinib, entrectinib) are indicated for NTRK fusion-positive tumors, regardless of histology.
Question: My mother has pancreatic cancer and is experiencing mouth sores from chemotherapy. How can we manage this?

Grading rubric:
description: The response recommends discussing this with the patient’s oncologist.
description: The response states mouth sores are a common side effect of some chemotherapy drugs.
description: The response states drugs like 5-FU and capecitabine can cause mouth sores.
description: The response states these are sometimes related to having low white blood cell counts.
description: The response states that having low white blood cell counts can increase the likelihood of infection.
description: The response states mouth sores in patients on chemotherapy can also be related to infections from viruses or bacteria.
description: The response states the patient’s healthcare team may swab the mouth sores to test them for infection.
description: The response states there are medications which can help prevent and improve mouth sores in the form of both topical drugs and specialized mouthwashes.
description: The response states there are medications which can improve symptoms related to mouth sores, like pain.
description: The response instructs the patient to immediately seek evaluation by a healthcare provider if they are experiencing a fever or other signs or symptoms of infection.
description: The response recommends gentle oral hygiene.
description: The response should mention that chlorhexidine mouthwash is not recommended for prevention in most adult cancer populations due to lack of efficacy and potential for adverse effects.
description: The response should mention that topical anesthetics (lidocaine viscous, 2% solution) and mixed medication mouthwashes (“magic mouthwash”) may be used for pain control, though evidence for specific formulations is variable.
description: The response should mention that Gabapentin may be considered for mucositis-related pain, often in combination with other analgesics.
description: The response should mention that topical and systemic antifungals (e.g., clotrimazole troches, systemic fluconazole) are indicated for secondary candidiasis, which is common in the setting of mucositis and xerostomia.
description: The response should mention that antibiotics are reserved for documented secondary bacterial infections.
description: The response should mention that management often involves over-the-counter pain relief such as acetaminophen or ibuprofen, but that stronger prescription medicines may be indicated.
description: The response should mention that multidisciplinary and supportive care is essential.
description: The response should mention that management could include dietary adjustments such as soft or liquid diets, small frequent meals, nutritional support.