YiminZ07/PanCanBench huggingface dataset:
Question: My husband has pancreatic cancer and we’re trying to plan for the future. What legal documents should we have in place?

Grading rubric:
description: The response should recommend discussing legal planning with a qualified professional.
description: The response should include that laws can vary state to state.
description: The response should include a description of an advance healthcare directive or living will.
description: The response should include a description of a medical power of attorney.
description: The response should include a description of a durable power of attorney for finances.
description: The response should include a description of a last will and testament.
description: The response should mention that POLST forms translate preferences into actionable medical orders for emergency settings.
description: The response should mention that these documents ensure that care aligns with the patient’s values and preferences, especially if the patient loses decision-making capacity due to disease progression or treatment effects.
description: The response should mention that it is essential to have ongoing, structured conversations about goals of care, as patient preferences may change over time.
Question: My loved one has pancreatic cancer and we’re dealing with significant medical bills. What financial assistance is available?

Grading rubric:
description: The response should recommend discussing their concerns with the oncology team.
description: The response should recommend discussing their concerns with a social worker.
description: The response should recommend discussing their concerns with a financial counselor.
description: The response should state that patient advocacy organizations can help and include information on the Pancreatic Cancer Action Network (PanCAN).
description: The response should state that patient advocacy organizations can help and include information on CancerCare.org.
description: The response should state that patient advocacy organizations can help and include information for the American Cancer Society.
description: The response should mention that patients with pancreatic cancer who are facing significant medical bills have access to several financial assistance options.
description: The response should mention that financial assistance options include patient assistance programs (PAPs) from independent charity foundations, pharmaceutical company programs, and direct grants from nonprofit organizations.
description: The response should mention that these programs may provide co-payment assistance, help with insurance premiums, and sometimes support for non-medical expenses such as transportation or housing.
description: The response should mention that eligibility is generally based on annual household income (often up to 400–500% of the federal poverty level), insurance status, and physician endorsement.
Question: My mother has pancreatic cancer and we’re considering relocating to be closer to a major cancer center. What should we consider?

Grading rubric:
description: The response should recommend considering proximity to the treatment center.
description: The response should recommend considering housing options near the cancer center.
description: The response should recommend considering transportation to and from the cancer center.
description: The response should recommend considering financial considerations.
description: The response should include insurance coverage.
description: The response should recommend considering the social support system near the cancer center.
description: The response should provide information for the Pancreatic Cancer Action Network (PanCAN) Patient services.
description: The response should provide information for the American Cancer Society (ACS) page on finding a doctor.
description: The recommendation should provide a link to the NCI website for finding an NCI-designated cancer center.
description: The response should state that the NCCN Panel (version 2.2025) recommends that decisions about diagnosis and management involve multidisciplinary teams at high-volume centers with appropriate high-volume imaging studies.
description: The response explicitly mentions patient preferences, goals of care, or quality of life as central to the decision.
description: The response explicitly addresses open communication about expectations, prognosis, or the impact of relocation on daily life.
description: The response explicitly mentions continuity of care, transferring medical records, coordinating with the current care team, or ensuring uninterrupted access to medications/supportive services.
description: The response explicitly mentions access to multidisciplinary care and/or clinical trials as important factors.
description: The response explicitly recommends discussing the case with an oncologist.
Question: My loved one has pancreatic cancer and is experiencing severe anxiety about upcoming scans. How can we help manage this?

Grading rubric:
description: The response should recommend discussing the anxiety with their oncology team.
description: The response should include considering relaxation techniques prior to the scan.
description: The response should recommend asking the oncology team about what will happen during the scan.
description: The response should include talking to a mental health professional.
description: The response should include talking to a social worker.
description: The response should discuss medical interventions to help with anxiety.
description: The response explicitly states that severe anxiety related to upcoming scans is highly prevalent or very common among patients with pancreatic cancer or cancer in general.
description: The response explicitly mentions at least two of the following resource types for managing treatment-related anxiety: psychotherapy, psychoeducation, supportive therapy, or integrative modalities.
description: The response explicitly identifies Cognitive Behavioral Therapy (CBT) as the first-line or primary intervention for treatment-related anxiety in pancreatic cancer or cancer patients, and attributes this recommendation to a major oncology guideline.
description: The response explicitly mentions mindfulness-based interventions (MBIs) or mindfulness-based stress reduction (MBSR) as recommended for anxiety in cancer patients, and attributes this recommendation to a major oncology guideline.
description: The response explicitly states that pharmacologic therapy may be considered for severe anxiety or when first-line psychological interventions are insufficient, and that this is a secondary option with weaker evidence, as per a major oncology guideline.
Question: My husband has pancreatic cancer and we’re trying to maintain normalcy for our family. What strategies work best?

Grading rubric:
description: The response should include open communication with the family.
description: The response should include maintaining daily routines.
description: The response should include continuing to do activities that bring enjoyment.
description: The response should include letting the support system help.
description: The response should include ensuring self-care for the patient.
description: The response should include ensuring self-care for the support system.
description: The response should mention that pancreatic cancer imposes profound emotional, social, and practical upheaval on both the patient and family, disrupting established routines, roles, and relationships.
description: The response should mention that early integration of supportive and palliative care is recommended.
description: The response should mention that referrals to registered dietitians and symptom management specialists can help minimize disruptions to family life.
description: The response should mention that caregiver and family support resources can provide education, emotional support, and practical assistance.
description: The response should mention that the literature notes persistent gaps in support for caregivers and families affected by pancreatic cancer.
description: The response should recommend that the user discuss this case with an oncologist.
Question: My loved one has pancreatic cancer and we’re considering getting genetic counseling. What does this involve?

Grading rubric:
description: The response should recommend discussing genetic counseling with the oncology team or healthcare provider in the context of pancreatic cancer care.
description: The response should accurately describe the role of a genetic counselor as a trained professional who helps individuals and families understand the genetic aspects of disease, provides information, guidance, and support for informed decision-making, and assists with risk assessment and testing.
description: The response should mention that genetic counseling involves a structured evaluation of personal and family cancer history.
description: The response should mention that genetic counseling involves education about hereditary cancer syndromes.
description: The response should mention that genetic counseling involves a discussion of the risks, benefits, and limitations of genetic testing.
description: The response should mention that genetic counseling addresses the psychological and ethical aspects of genetic information, including communication of results to family members and consideration of reproductive implications.
description: The response should mention that the American Society of Clinical Oncology recommends that this process be conducted with providers experienced in hereditary cancer syndromes.
description: The response should mention that the American Society of Clinical Oncology recommends that germline genetic testing be offered early in the disease course, ideally using a multigene panel that includes genes linked to pancreatic cancer risk such as BRCA1, BRCA2, and others.
Question: My father has pancreatic cancer and is experiencing peripheral neuropathy. What treatments are available for this?

Grading rubric:
description: The response should state that neuropathy is a common side effect from certain chemotherapy drugs.
description: The response should recommend discussing medication side effects with their oncology team.
description: The response should state that neuropathy from chemotherapy can be managed by dose reduction.
description: The response should state that neuropathy from chemotherapy can be managed by schedule modification.
description: The response should state that neuropathy from chemotherapy can be managed by switching to an alternate regimen.
description: The response should state that neuropathy from chemotherapy can be managed using supportive medications, including gabapentin.
description: The response should state that neuropathy from oxaliplatin can be managed using supportive medications, including SNRIs.
description: The response should state that neuropathy from oxaliplatin can be managed using supportive medications, including pregabalin.
description: The response should include physical therapy.
description: The response should include occupational therapy.
description: The response should mention that peripheral neuropathy could arise from chemotherapy (notably platinum agents), direct tumor involvement, or paraneoplastic syndromes.
description: The response should mention that peripheral neuropathy significantly impairs quality of life and functional status.
description: The response should mention that management should be individualized, balancing efficacy, side effects, and patient-specific factors.
description: The response should mention that Duloxetine is the only agent with moderate evidence-based recommendation for the treatment of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients.
description: The response should mention that the typical starting dose of duloxetine is 30 mg daily, titrated to 60 mg daily as tolerated, with slow tapering recommended to avoid withdrawal symptoms.
description: The response should mention that other pharmacologic options include tricyclic antidepressants (nortriptyline, amitriptyline), gabapentin, and pregabalin, which are supported by guidelines for cancer-related neuropathic pain but have inconclusive evidence.
description: The response should mention that topical agents such as lidocaine and capsaicin patches may be considered for localized neuropathic pain, though evidence is limited.
description: The response should mention that opioids are not preferred for chronic neuropathic pain due to risk of tolerance, dependence, and adverse effects.
description: The response should mention that interventional approaches, notably neurolytic celiac plexus block, are effective for refractory pain in pancreatic cancer.
Question: My mother has pancreatic cancer and we’re trying to understand the difference between curative and palliative treatment. Can you explain?

Grading rubric:
description: The response should define curative treatment as interventions with the intent to eradicate the disease and achieve long-term survival.
description: The response should include that curative treatment can include surgery.
description: The response should mention that in curative treatment, surgery is often followed by adjuvant chemotherapy to reduce recurrence risk.
description: The response should define palliative treatment as focusing on improving quality of life when cure is not possible.
description: The response should mention that palliative treatment is the case for the majority of patients with locally advanced unresectable or metastatic disease.
description: The response should include that the primary goal of palliative treatment is to prolong survival, control symptoms, and maintain quality of life.
description: The response should include that palliative treatment can include chemotherapy.
description: The response should include that palliative treatment can include radiation for local control or pain.
description: The response should include that palliative treatment can include pain management.
description: The response should mention that palliative approaches include endoscopic or surgical procedures to relieve biliary or gastric outlet obstruction, and comprehensive supportive care for pain, nutrition, and psychosocial needs.
description: The response should mention that the American Society of Clinical Oncology emphasizes early integration of palliative care for all patients with advanced disease to address symptom burden and support patient and family well-being.
description: The response should recommend that the user discuss this case with an oncologist.
Question: My loved one has pancreatic cancer and is considering experimental treatments abroad. What should we research?

Grading rubric:
description: The response should recommend understanding the costs.
description: The response should recommend discussing treatment decisions with your oncology team.
description: The response should recommend understanding the stage of pancreatic cancer.
description: The response should recommend understanding the type of cancer.
description: The response should recommend understanding the reputation of the clinic.
description: The response should recommend understanding the qualifications of the providers.
description: The response should recommend understanding the details of the experimental treatments, including types of drugs.
description: The response should recommend understanding the evidence supporting the treatment.
description: The response should recommend understanding the potential side effects of the experimental treatments.
description: The response should recommend understanding the safety of the drugs.
description: The response should recommend understanding the legal protections of the country.
description: The response should recommend understanding the availability of medical records.
description: The response should recommend understanding the logistics of traveling abroad for treatment.
description: The response should mention considering your loved one’s health and travel suitability, as long travel can be taxing.
description: The response should mention considering if the other country has specialized high-quality pancreatic cancer care.
description: The response should mention considering visa barriers when traveling abroad for treatment.
description: The response should mention considering local accommodations when traveling abroad for treatment.
description: The response should mention considering cultural barriers when traveling abroad for treatment.
description: The response should mention considering challenges with follow-up care when traveling abroad for treatment.
description: The response should mention considering social support challenges when traveling abroad for treatment.
Question: My husband has pancreatic cancer and we’re dealing with treatment-related infections. How can we prevent these?

Grading rubric:
description: The response should describe why treatments for pancreatic cancer can increase the risk of infections, including immunosuppression due to chemotherapy.
description: The response should recommend hand hygiene.
description: The response should recommend avoiding sick contacts.
description: The response should recommend being up to date on age-appropriate vaccinations.
description: The response should recommend discussing the infections with the oncology team.
description: The response should recommend food safety.
description: The response should recommend adherence with prophylactic medications if prescribed.
description: The response should mention avoiding exposure to fungal spores, especially for patients with neutropenia, by avoiding environments with high concentrations of airborne fungal spores.
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 loved one has pancreatic cancer and we want to understand more about immunotherapy combinations. What research is being done?

Grading rubric:
description: The response describes the combination of immune checkpoint blockade with chemotherapy as a current research strategy in pancreatic cancer.
description: The response describes the combination of immune checkpoint blockade with radiation as a current research strategy in pancreatic cancer.
description: The response describes the combination of immune checkpoint blockade with other novel agents (e.g., targeted therapies, immune modulators, or agents targeting the tumor microenvironment) as a current research strategy in pancreatic cancer.
description: The response explicitly defines immunotherapy as a treatment that uses the body’s immune system to attack cancer.
description: The response states that pembrolizumab is approved for pancreatic cancer with MSI-high tumors.
description: The response states that pembrolizumab is approved for pancreatic cancer with dMMR (deficient mismatch repair) tumors.
description: The response states that pembrolizumab is approved for pancreatic cancer with TMB-high (tumor mutational burden-high) tumors.
description: The response specifically mentions clinicaltrials.gov as a resource for finding immunotherapy clinical trials.
description: The response specifically mentions the PanCan clinical trial finder as a resource for finding immunotherapy clinical trials.
description: The response describes immune checkpoint blockade as a current strategy for studying immunotherapy in pancreatic cancer.
description: The response describes adoptive cellular therapy (e.g., CAR-T cell therapy or modified T-cells) as a current research strategy in pancreatic cancer.
description: The response should mention that current research on immunotherapy combinations for patients with pancreatic cancer is focused on overcoming the immunosuppressive tumor microenvironment (TME) and enhancing antitumor immune responses.
description: The response should mention that neoadjuvant immunotherapy combinations are being tested to prime the immune system before surgery, with early results suggesting potential improvements in disease-free and overall survival.
description: The response should mention that cancer vaccines are under investigation as an immunotherapy approach for pancreatic cancer.
description: The response should recommend that the user discuss this case with an oncologist.
Question: My father has pancreatic cancer and is considering participating in a research study. What questions should we ask?

Grading rubric:
description: The response should recommend understanding the goal of the study.
description: The response should recommend understanding the phase of the trial.
description: The response should recommend understanding the eligibility requirements of the trial.
description: The response should recommend understanding the potential side effects of the treatments.
description: The response should recommend understanding if there are additional tests required to participate in the trial.
description: The response should recommend understanding if there are travel costs associated with the trial.
description: The response should recommend understanding the evidence supporting the trial.
description: The response should recommend understanding the kind of treatment.
description: The response should recommend understanding the visit schedule of the trial.
description: The response explicitly states that research studies are designed to determine if a new medical strategy, treatment, or device is safe and/or effective for humans.
description: The response explicitly states that clinical trials are essential for improving, optimizing, or advancing current and/or future cancer therapies.
description: The response includes the question: “How will participation impact current treatment and care?”
description: The response includes the question: “What are the implications for family members, especially if genetic testing is involved?”
description: The response recommends discussing the case with an oncologist or relevant healthcare professional to review trial details and discuss pros and cons.
Question: My mother has pancreatic cancer and we’re trying to manage her pain without becoming dependent on opioids. What alternatives exist?

Grading rubric:
description: The response should describe non-opioid medications for pain control, including acetaminophen.
description: The response should describe non-opioid medications for pain control, including NSAIDs.
description: The response should describe non-opioid medications for neuropathic pain, including gabapentin.
description: The response should describe non-opioid medications for neuropathic pain, including anti-depressants.
description: The response should include procedures that can help with pain related to pancreatic cancer, including nerve blocks.
description: The response should include procedures that can help with pain related to pancreatic cancer, including radiation therapy.
description: The response should include non-pharmacologic therapies, including acupuncture.
description: The response should include non-pharmacologic therapies, including psychological support.
description: The response should recommend discussing symptom management with the oncology team.
description: The response should describe non-opioid medications for neuropathic pain, including pregabalin, duloxetine, nortriptyline, and amitriptyline.
description: The response should mention that topical agents, including lidocaine and capsaicin patches, can be considered for localized neuropathic pain.
description: The response should mention that corticosteroids are reserved for specific indications such as spinal cord compression or inflammatory pain.
description: The response should mention that antioxidant supplementation may reduce painful attacks in select cases, though evidence is limited and should be considered adjunctive.
description: The response should mention that interventional and procedural approaches are particularly relevant in pancreatic cancer.
description: The response should mention that neurolytic celiac plexus block is supported by randomized trials for opioid-sparing pain relief.
description: The response should include non-pharmacologic therapies, including physical therapy.
description: The response should recommend discussing symptom management with a palliative care specialist.
description: The response should mention that cognitive-behavioral therapy and stress management are effective adjuncts.
description: The response should mention that areas that need further research include the long-term comparative effectiveness of nonopioid and integrative modalities.
description: The response should mention that effective pain management in pancreatic cancer requires regular assessment and individualized planning.
Question: My loved one has pancreatic cancer and we’re concerned about the psychological impact on our teenage children. What support is available?

Grading rubric:
description: The response explicitly recommends discussing psychological concerns about the children with the oncology team.
description: The response explicitly recommends professional counseling and mentions mental health professionals (e.g., therapist, counselor, psychologist, psychiatrist).
description: The response explicitly recommends support groups for teens with a parent with cancer.
description: The response explicitly recommends involving school counselors for support.
description: The response explicitly recommends support groups for teens with a parent with cancer and specifically mentions cancersupportcommunity.org as a resource.
description: The response explicitly recommends support groups for teens with a parent with cancer and specifically mentions PanCAN (Pancreatic Cancer Action Network) patient services as a resource.
description: The response should mention that informal support from family, friends, and teachers is highly valued by adolescents.
description: The response should mention that technology-based resources, such as online support communities and apps, can supplement in-person support and are increasingly used by adolescents for connection and information.
Question: My husband has pancreatic cancer and his oncologist mentioned circulating tumor DNA testing. What is this?

Grading rubric:
description: The response defines circulating tumor DNA (ctDNA) as DNA from cancer cells or tumors found in the blood, and can be used as a biomarker for diagnosis, monitoring, or recurrence.
description: The response explicitly states that ctDNA can be used for mutation testing in cancer.
description: The response explicitly states that ctDNA can provide prognostic information about recurrence risk or detect minimal residual disease after treatment.
description: The response explicitly states that ctDNA can be used to monitor response to treatment.
description: The response states that, per NCCN guidelines, ctDNA is only recommended for mutation testing in pancreatic cancer if a biopsy sample is not available.
description: The response mentions that ctDNA testing is noninvasive and can expedite testing because there is no need to retrieve archival blocks or arrange for a new biopsy.
description: The response mentions 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 mentions that ctDNA may miss low-level cancers or not detect all mutations, and there may be false negative or false positive results.
description: The response mentions that not all hospitals offer ctDNA testing and that not all insurances cover them.
description: The response mentions that ctDNA testing is still under active research and not yet standard of care for all cancer patients.
description: The response recommends that the user discuss this case with an oncologist.
Question: My loved one has pancreatic cancer and we’re trying to coordinate care between multiple hospitals. How do we manage this effectively?

Grading rubric:
description: The response explicitly recommends designating a single point person (e.g., care coordinator, family member, or friend) to coordinate care and serve as the primary contact for health-related matters.
description: The response explicitly recommends discussing care coordination with the oncology team or oncologist.
description: The response explicitly recommends keeping an organized, centralized medical record of all relevant documents (e.g., test results, treatment plans, medication lists, doctor notes).
description: The response explicitly recommends discussing or arranging the transfer of medical records with each hospital involved.
description: The response explicitly recommends carrying or maintaining an up-to-date medication list.
description: The response explicitly mentions nurse navigators or patient navigators as resources for care coordination.
description: The response should mention that effective coordination of care between multiple hospitals for a patient with pancreatic cancer requires addressing several systemic and logistical challenges.
description: The response should mention that the lack of shared electronic health records is a significant barrier.
description: The response should mention that the lack of shared electronic health records impedes seamless information exchange, and the risk of inconsistent recommendations when care is split between high-volume centers and community hospitals.
description: The response should mention to facilitate doctor-to-doctor communication.
description: The response should mention to ask for a summary note after every visit and share it with all the providers.
description: The response should mention to use PanCAN or NCI for personalized advice on coordinating care, finding specialists, and accessing clinical trials.
Question: My father has pancreatic cancer and is experiencing significant weight loss despite eating. What interventions might help?

Grading rubric:
description: The response should state that weight loss can occur due to impaired absorption due to pancreatic enzyme deficiency.
description: The response should state that pancreatic exocrine insufficiency leads to deficiencies in fat-soluble vitamins or micronutrients and explicitly recommends pancreatic enzyme replacement.
description: The response should state that appetite stimulants can sometimes be helpful.
description: The response should state that appetite stimulants may be considered for refractory cases or due to potential side effects.
description: The response should state that the patient should discuss their weight loss with their oncology team.
description: The response should state that there can be many causes of losing weight in patients with pancreatic cancer.
description: The response should state that losing weight can be due to the cancer itself.
description: The response should state that weight loss can occur as a side effect of chemotherapy.
description: The response should state the patient should try and get sufficient protein intake.
description: The response should state the patient should try and get sufficient calorie intake.
description: The response should state that nutrition/protein supplements can be helpful.
description: The response does not explicitly state the patient should discuss changes to their diet with their oncology team.
description: The response should discuss concerns with a palliative care specialist.
description: States that patients with pancreatic cancer are at high risk of malnutrition, cachexia, and weight loss, and explicitly mentions the need for early and ongoing nutritional assessment/intervention.
description: Explicitly recommends prompt referral to a registered dietitian or nutritionist for individualized evaluation/counseling, or states that nutritional support is a cornerstone of care.
description: Clearly states that early and aggressive nutritional intervention is essential to reduce further weight/muscle loss, improve tolerance to oncologic therapies, and optimize survival or quality of life.
description: Explicitly states that enteral nutrition (tube feeding) should be prioritized over parenteral nutrition (IV feeding) when oral intake is inadequate, and mentions at least one benefit of enteral nutrition.
description: Recommends oral nutritional supplements and specifically mentions omega-3 fatty acids as beneficial for supporting body weight or lean body mass.
description: Recommends discussing the case with an oncologist or dietitian/nutritionist.
Question: My mother has pancreatic cancer and we’re considering massage therapy during treatment. Is this safe?

Grading rubric:
description: The response should recommend discussing massage therapy with the oncology team.
description: The response should recommend using a massage therapist who has experience with oncology patients.
description: The response should recommend avoiding massage if the person has a fever.
description: The response should recommend avoiding massage if the person has an infection.
description: The response should recommend avoiding massage if the person has excessive pain.
description: The response should recommend avoiding massage if the person has a clot or deep vein thrombosis.
description: The response should recommend avoiding massage over the tumor.
description: The response should recommend avoiding massage over sensitive areas.
description: States that massage therapy is generally considered safe for patients undergoing treatment for pancreatic cancer when performed by trained professionals, and explicitly mentions that serious adverse events are extremely rare.
description: States that evidence from randomized controlled trials or meta-analyses shows massage therapy can reduce pain, anxiety, and fatigue, and may improve quality of life in cancer patients, and explicitly mentions that the certainty of evidence is low and benefits are typically moderate.
description: Advises consulting the oncology team or healthcare provider before starting massage therapy, and mentions bleeding risk (e.g., low platelets) as a specific safety concern.
description: Advises consulting the oncology team or healthcare provider before starting massage therapy, and mentions unstable bone lesions as a specific safety concern.
Question: My loved one has pancreatic cancer and we want to understand more about personalized medicine approaches. What’s available?

Grading rubric:
description: The response should describe personalized medicine approaches in pancreatic cancer, including tumor genetic testing.
description: The response should mention that precision medicine, or personalized oncology, tailors 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 should include somatic testing for patients with locally advanced pancreatic cancer who are candidates for systemic therapy.
description: The response should include somatic testing for patients with metastatic pancreatic cancer who are candidates for systemic therapy.
description: The response should mention 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 should include germline testing for inherited pancreatic cancer syndromes.
description: The response should include germline testing is recommended for all patients with confirmed pancreatic cancer.
description: The response should state that mutations found by somatic testing can sometimes be targeted with medications.
description: The response should mention that based on genetic testing and molecular profiles, targeted therapies can be given.
description: The response should state that patients with certain germline mutations are candidates for targeted therapies.
description: The response should mention that FDA-approved targeted therapies include PARP inhibitors (e.g., olaparib) for patients with germline BRCA1/2 mutations, typically as maintenance therapy following platinum-based chemotherapy.
description: The response should mention that TRK inhibitors (larotrectinib, entrectinib) are indicated for NTRK fusion-positive tumors, regardless of histology.
description: The response should mention that immune checkpoint inhibitors (pembrolizumab, dostarlimab) are approved for dMMR/MSI-H PDAC, a rare but important subset.
description: The response should mention that sotorasib is an emerging agent for KRAS G12C-mutated pancreatic cancer.
description: The response should include that clinical trials may be testing drugs targeting certain mutations.
description: The response should recommend that the user discuss this case with an oncologist.
Question: My husband has pancreatic cancer and we’re dealing with treatment-related diarrhea. How can this be managed?

Grading rubric:
description: The response should state that diarrhea is a common side effect from certain chemotherapy drugs.
description: The response should state that diarrhea can be managed with anti-motility agents such as loperamide.
description: The response should mention that dietary modifications include the elimination of lactose-containing products and high-osmolar supplements.
description: The response should mention that loperamide is given starting at 4 mg followed by 2 mg every 4 hours or after each unformed stool, not exceeding 16 mg per day.
description: The response should state that diarrhea from chemotherapy can be managed by dose reduction.
description: The response should state that diarrhea from chemotherapy can be managed by schedule modification.
description: The response should state that diarrhea from chemotherapy can be managed by switching to an alternate regimen.
description: The response should state that diarrhea can be associated with pancreatic enzyme deficiency.
description: The response should state that diarrhea associated with pancreatic enzyme deficiency can be improved with pancreatic enzyme supplementation.
description: The response should mention that in patients with exocrine pancreatic insufficiency, pancreatic enzyme replacement therapy (PERT) should be initiated and titrated to symptom control, as this can significantly reduce steatorrhea and improve nutritional status.
description: The response should discuss symptoms with the oncology team.
description: The response should mention that if diarrhea progresses to grade 3 or 4 or persists after 24–48 hours of loperamide, aggressive management is recommended.
description: The response should mention that aggressive management includes intravenous fluids for dehydration, octreotide, and empiric antibiotics if infection is suspected.
description: The response should mention that octreotide is initially given as 100–150 μg subcutaneously three times daily, with escalation up to 500 μg if needed.
description: The response should mention that stool studies and laboratory evaluation for infectious etiologies should be performed in severe cases.
Question: My loved one has pancreatic cancer and is considering stopping work to focus on treatment. What should we consider?

Grading rubric:
description: The response should recommend discussing the treatment plan with their oncology team.
description: The response should recommend understanding the prognosis.
description: The response should recommend understanding the goals of treatment.
description: The response should recommend considering the impact of stopping work on health insurance.
description: The response should recommend considering the impact of stopping work on income.
description: The response should recommend understanding the expected physical effects of treatment.
description: The response should recommend understanding the expected mental effects of treatment.
description: The response should recommend considering employer-sponsored medical leave.
description: The response explicitly mentions at least two common symptoms of pancreatic cancer, such as pain, fatigue, dietary issues, or weight loss, and states that these symptoms can impair daily functioning and/or the ability to work.
description: The response states that multiple factors should be systematically evaluated to support informed, patient-centered decision-making when considering stopping work for pancreatic cancer treatment.
description: The response states that discussions should elicit or consider the patient’s personal values, goals, and/or preferences, including the importance of quality of life versus life extension.
description: The response explicitly mentions that financial and practical considerations are critical in the decision to stop working.
description: The response recommends referral to, or consultation with, financial counselors or social workers to help navigate financial challenges, access resources, or manage cancer care costs.
description: The response states that patients should be informed about disability benefits, workplace accommodations, and/or community support programs that may help with financial or practical challenges.
Question: My father has pancreatic cancer and his doctors mentioned tumor profiling. What does this involve?

Grading rubric:
description: The response should describe tumor profiling as involving comprehensive molecular analysis of tumor tissue and often blood to identify genetic, transcriptomic, and proteomic alterations.
description: The response should state that a tumor biopsy can be used for tumor profiling.
description: The response should state that circulating tumor DNA can be used for tumor profiling.
description: The response should state that tumor biopsies can be tested for mutations in the DNA.
description: The response should state that tumor biopsies can be tested for mutations in the RNA.
description: The response should state that tumor biopsies can be tested for the presence of certain proteins.
description: The response should state that circulating tumor DNA can be tested for mutations in DNA.
description: The response should mention that tumor profiling helps identify alterations that may be actionable for therapy selection or clinical trial enrollment.
description: The response should mention that routine molecular tumor profiling is now feasible and recommended for all patients with pancreatic cancer, regardless of stage or surgical eligibility. Based on the NCCN Guidelines Version 2.2025, Clinical Presentation and Workup pathway for pancreatic adenocarcinoma, stating that patients with clinical suspicion of pancreatic cancer or evidence of dilated pancreatic/bile duct should undergo pancreatic protocol CT or MRI (abdomen) for evaluation. A multidisciplinary consultation is recommended after imaging. Workup includes chest and pelvis CT, endoscopic ultrasonography (EUS), MRI for indeterminate liver lesions, PET/CT or PET/MRI for high-risk features, and ERCP with stent placement if biliary obstruction is present. Laboratory evaluation should include liver function tests and baseline CA 19-9 after biliary drainage. If diagnosis is confirmed, perform genetic testing for inherited mutations. For metastatic disease, confirm with biopsy from a metastatic site, and perform molecular profiling of tumor tissue and complete staging with chest and pelvis CT. Depending on findings, categorize as resectable (PANC-2), borderline resectable (PANC-4), locally advanced (PANC-5), or metastatic disease (PANC-10). If no mass or diagnosis is confirmed, refer to a high-volume center for evaluation.
description: The response should mention that approximately 20–28% of patients have actionable findings, and those who receive matched therapies based on tumor profiling have significantly improved progression-free and overall survival compared to those who do not.
description: The response should mention that actionable alterations include BRCA1/2 mutations, NTRK, BRAF, FGFR2, RET, NRG1, and ALK fusions, and mismatch repair deficiency (dMMR/MSI-H).
description: The response should recommend that the user discuss this case with an oncologist.
Question: My mother has pancreatic cancer and we’re trying to understand the role of inflammation in her condition. How is this managed?

Grading rubric:
description: The response should describe the connection between chronic inflammation of the pancreas and the risk of pancreatic cancer.
description: The response should state that inflammation plays a central or significant role in pancreatic cancer pathogenesis, progression, or clinical outcomes.
description: The response should include that there is no treatment for targeting inflammation in pancreatic cancer per NCCN guidelines (version 2.2025).
description: The response should include that inflammation is implicated in many cancers and include symptoms.
description: The response should explicitly mention that strategies to manage inflammation in pancreatic cancer are being researched or investigated in clinical or translational research.
description: The response should explicitly mention that strategies involving cytokine signaling are being researched, investigated, or studied for managing inflammation in pancreatic cancer.
description: The response should explicitly recommend that the user discuss this case with an oncologist.
Question: My loved one has pancreatic cancer and we’re considering art therapy. Are there benefits to this during treatment?

Grading rubric:
description: The response describes at least three specific benefits of art therapy for cancer patients, such as emotional expression, stress reduction, coping skills, mood improvement, self-esteem, social connection, or mindfulness/relaxation.
description: The response explicitly states that art therapy is not an anti-cancer therapy, does not treat cancer itself, or is not a substitute for medical cancer treatment.
description: The response provides the name “American Art Therapy Association” and states or implies that this organization can be used to find a qualified art therapist.
description: The response clearly recommends that the user discuss the use of art therapy with an oncologist or healthcare provider involved in the cancer treatment.
Question: My husband has pancreatic cancer and we’re dealing with insurance denials for certain medications. What can we do?

Grading rubric:
description: The person should contact the insurance company to understand the reason for the denial.
description: The person should file an appeal as an option to remedy the denial.
description: The person should work with their oncology team to help with the denial.
description: The person should work with their oncology team to understand the denial.
description: Patient assistance programs should be considered.
description: The response explicitly defines prior authorization as a process in which insurers require approval before a medication is covered.
description: The response states that prior authorization denials or delays are common in oncology care and mentions at least one impact.
description: The person should contact the oncologist to request a referral to a financial navigator or social worker.
description: The appeal process involves submitting a formal appeal with supporting evidence.
description: If appeals are unsuccessful, alternative access strategies should be pursued, such as patient assistance programs or manufacturer co-pay cards.
description: The response names at least one patient advocacy organization that can help connect the user with resources.