YiminZ07/PanCanBench huggingface dataset:
Question: My father has pancreatic cancer and we’re dealing with treatment-related kidney problems. How are these managed?

Grading rubric:
description: The response should describe how pancreatic cancer chemotherapy treatment can cause injury to the kidneys.
description: The response must explicitly mention that platinum drugs (e.g., cisplatin, oxaliplatin) can directly injure the kidney.
description: The response should describe how other pancreatic cancer treatments, such as surgery or radiation, can cause injury to the kidneys.
description: The response should mention that urinary tract infection should be ruled out, as some cancer treatments can put patients at increased risk for infection.
description: The response should describe that patients undergoing systemic treatment for pancreatic cancer should have their kidney function monitored frequently to evaluate for toxicity.
description: The response must clearly state that the first step is to identify the offending agent and reduce or hold the drug.
description: The response should describe ways that renal toxicity related to pancreatic cancer treatment is monitored and managed, such as serial lab tests of renal function to understand if it is improving over time.
description: The response should describe ways that renal toxicity related to pancreatic cancer treatment is managed, such as dose reduction of systemic treatment, particularly the offending drugs.
description: The response should describe ways that renal toxicity related to pancreatic cancer treatment is managed, such as administration of intravenous fluids or other medications to support the kidneys.
description: The response must explicitly mention that IV fluids can be used to provide hydration.
description: The response should describe ways that renal toxicity related to pancreatic cancer treatment is managed, such as thorough evaluation of other medications or supplements a patient is taking to ensure there are no harmful interactions.
description: The response must explicitly mention that alleviating obstruction (e.g., via stenting or nephrostomy) can help recover renal function.
description: The response must explicitly state that dehydration and obstruction (e.g., biliary or urinary) can lead to kidney injury.
description: The response should recommend that the patient consult with their oncology team and oncology pharmacist prior to starting new medications or supplements while undergoing pancreatic cancer treatment to avoid harmful interactions.
description: The response should mention that sometimes dialysis may be indicated if there is a severe kidney injury related to cancer treatment.
description: The response should recommend staying well hydrated and with adequate nutrition intake while undergoing pancreatic cancer treatment to preserve energy and organ functions.
Question: My mother has pancreatic cancer and we want to understand more about tumor evolution. How does cancer change over time?

Grading rubric:
description: The response should describe the role of genetic mutations in cancer.
description: The response should explain how cancer treatment applies selective pressure on cancer cells, allowing those that harbor certain characteristics that confer resistance to therapy a survival advantage.
description: The response should explain that after certain treatments, tumor cells susceptible to that treatment will have died while those resistant to the treatment survive, making the residual cancer fundamentally different from the original cancer.
description: The response should describe how genetic mutations can cause cancer cells to resist certain treatments.
description: The response should describe the heterogeneous cellular make-up of pancreatic cancer at baseline.
description: The response should describe the mesenchymal-epithelial transition, including triggers for this phenomenon.
description: The response should describe methods for evaluating tumor evolution over time, including circulating tumor DNA and/or traditional biopsy of the primary tumor or metastatic lesion.
description: The response should state that tumor evolution is when the cancer changes and adapts over time.
Question: My loved one has pancreatic cancer and we’re considering complementary therapies like aromatherapy. Are these safe during treatment?

Grading rubric:
description: The response should define complementary therapies, including supportive and integrative therapy.
description: The response should define aromatherapy.
description: The response should mention that any substances that are ingested or applied to the body can cause a reaction, such as an allergic reaction, and may be difficult to tell if the patient’s reaction is from the complementary therapy or the cancer treatment itself. For this reason, these complementary therapies should be used with caution.
description: The response should inform patients that complementary therapies do not treat cancer.
description: The response should inform patients that some complementary therapies may help with symptoms related to their cancer diagnosis, such as stress or insomnia.
description: The response should recommend the patient inquire with their oncology team if there are practitioners of complementary therapies that they trust, or can place a referral to.
description: The response should provide website links to informational pages from cancer societies such as NCI or PanCAN.
description: The response should strongly recommend that the patient discuss any complementary therapies they are considering with their oncology team to ensure there are no harmful interactions with their cancer treatment.
description: The response must explicitly state that aromatherapy is safest when used through inhalation and that oils must be appropriately prepared.
description: The response must explicitly state that essential oils on the skin should be used with caution due to the risk of worsening skin irritation from chemotherapy or radiation.
Question: My husband has pancreatic cancer and we’re trying to understand the role of metabolism in cancer. How does this affect treatment?

Grading rubric:
description: The response should define metabolism in humans.
description: The response should describe the Warburg Effect.
description: The response should include information about glucose, amino acid, and lipid metabolism in cancer cells, specifically in pancreatic cancer.
description: The response should state that changes in metabolism can alter sensitivity to cancer treatment.
description: The response should not recommend specific diets for the management of cancer.
description: The response should not indicate that restrictive diets, such as the ketogenic diet or intermittent fasting, should be started by patients with pancreatic cancer.
description: The response should recommend that the patient discuss diet with their oncologist and request a referral to a nutritionist if they are interested in learning more.
description: The response should state that there is not any current evidence for dietary interventions to alter the metabolism of the cancer and improve treatment.
Question: My loved one has pancreatic cancer and we’re dealing with treatment-related eye problems. Should we be concerned?

Grading rubric:
description: The response should list causes of eye problems related to cancer and/or cancer treatment, including chemotherapy-induced optic neuropathy, immunotherapy-related inflammation, bleeding, cataracts, dry eye, metastatic disease to the brain or eye, and infections.
description: The response must explicitly state that chemotherapy can lead to eye dryness and irritations.
description: The response must explicitly state that the use of steroids can lead to an increase in cataracts or glaucoma.
description: The response must explicitly state that immunosuppressed patients are more likely to have infections in their eyes.
description: The response should mention that the patient’s eye symptoms may not be related to cancer or cancer treatment, and they should seek out an eye exam by a qualified practitioner.
description: The response should recommend that the patient document characteristics of their symptoms, such as severity and date of onset.
description: The response should list “red flag” eye symptoms that should prompt immediate presentation to medical care, such as vision loss or severe pain.
description: The response must explicitly state that any eye symptoms should be discussed with their oncology team.
description: The response should recommend that the patient possibly request a referral to an ophthalmologist, based on reported symptoms.
description: The response must explicitly state that eye drops can be used to mitigate symptoms of dry eyes.
Question: My father has pancreatic cancer and his doctors mentioned neoantigens. What are these and how do they relate to treatment?

Grading rubric:
description: The response should define neoantigens in cancer as proteins expressed on the surface of cancer cells, used by the immune system to differentiate cancer from healthy tissue.
description: The response should mention ongoing research involving neoantigens in cancer, including cancer vaccines, immunotherapy, and CAR-T trials.
description: The response should state that there are no FDA-approved treatments targeting neoantigens at this time.
description: The response should recommend that the patient discuss the role of neoantigens in their cancer care with their oncology team.
description: The response should recommend considering referral to be considered for clinical trials for pancreatic cancer treatment in their area.
Question: My mother has pancreatic cancer and we’re trying to understand the role of autophagy. How does this cellular process affect cancer?

Grading rubric:
description: The response must define autophagy, including its normal role in cellular turnover, specifically mentioning degradation and recycling of cellular components, and maintaining cellular homeostasis by removing damaged organelles and protein aggregates.
description: The response must describe the dual role of autophagy in cancer, including both tumor suppression and promotion, with context on how these roles change during cancer progression.
description: The response should state that autophagy can be protective against cancer by removing damaged or dysregulated proteins.
description: The response must describe the role of autophagy in pancreatic adenocarcinoma, specifically addressing its upregulation and contribution to cancer cell survival and treatment resistance.
description: The response should state that cancerous cells can utilize autophagy to promote survival, growth, and therapy resistance.
description: The response must explain if the autophagy process can be targeted with cancer treatment, providing at least one reference with a PMID if available.
description: The response should state that blocking autophagy has been explored as an area of research but there are no current standard of care treatments targeting autophagy in pancreatic cancer.
description: The response must mention specific drugs targeting autophagy, reference existing evidence in the scientific literature, and clearly state if any treatment strategy is FDA approved.
description: The response must reference at least one scientific literature source with a PubMed identification number (PMID).
Question: My loved one has pancreatic cancer and we’re considering telehealth support groups. Are these as effective as in-person groups?

Grading rubric:
description: The response should describe the different types of support groups that exist for cancer patients and family members of cancer patients.
description: The response should address whether there is evidence that a telehealth support group is inferior to an in-person support group.
description: The response should provide references and sources for evidence regarding the effectiveness of telehealth versus in-person support groups.
description: The response should state that in-person and telehealth groups each have their advantages and disadvantages and either may be as effective based on an individual’s needs and preferences.
description: The response should state that telehealth groups can be more accessible and convenient.
description: The response should state that some may feel that in-person groups will lead to better emotional connection.
description: The response should include a way for the patient or family member to input their location to generate a list of local support group resources.
description: The response should list organizations to contact that might be able to provide support resources.
description: The response should recommend that the patient ask their oncology team for assistance in finding support groups.
description: The response should describe that increased stress is normal when dealing with a cancer diagnosis and treatment, or as a family member of a cancer patient.
Question: My husband has pancreatic cancer and we’re dealing with treatment-related sleep problems. What can help improve sleep quality?

Grading rubric:
description: The response should mention the effect of caffeine on sleep.
description: The response should mention the effect of alcohol on sleep.
description: The response should mention the effect of illegal drugs on sleep.
description: The response should describe strategies to improve sleep that are evidence-based.
description: The response should provide references for evidence-based sleep improvement interventions.
description: The response should include insights into things in everyday life that may be interfering with a patient’s ability to sleep.
description: The response should provide insights into how cancer-related symptoms can interfere with sleep.
description: The response should emphasize the importance of appropriate management of cancer-related or cancer-treatment related symptoms to prevent interference in everyday life, including sleep.
description: The response should describe common symptoms that people with pancreatic cancer might experience.
description: The response should direct the patient to discuss any symptoms of cancer or cancer treatment with their oncology team.
description: The response should emphasize the importance of mental health and the impact of stress on sleep.
description: The response must explicitly state that sleep hygiene is an important first step.
description: The response must mention a consistent relaxing bedtime routine starting 30 to 60 minutes before bedtime.
description: The response must clearly state that stimulant use, such as nicotine, should be avoided in the afternoon and evenings.
description: The response must explicitly recommend optimizing the sleep environment by keeping the room dark, cool, and quiet.
description: The response must mention that supportive therapies, such as melatonin or other sleep aids, can be considered if deemed safe by the medical team.
Question: My loved one has pancreatic cancer and we want to understand more about cancer cachexia. How is this different from regular weight loss?

Grading rubric:
description: The response should define cancer-related cachexia.
description: The response should describe how cachexia occurs in patients with pancreatic cancer.
description: The response should delineate cancer cachexia from regular weight loss.
description: The response should state that cachexia can occur independently of dietary changes.
description: The response should state that cachexia involves muscle loss.
description: The response should include information about prognosis in patients experiencing cancer cachexia.
description: The response should provide evidence-based recommendations to patients experiencing cancer cachexia.
description: The response should recommend that the patient discuss their concerns about cancer cachexia with their oncology team and/or a nutritionist.
description: The response should state that cachexia is difficult to manage.
description: The response should state that cachexia can be mitigated by nutritional support, medications, and physical therapy.
Question: My father has pancreatic cancer and his doctors mentioned epithelial-mesenchymal transition. What is this?

Grading rubric:
description: The response must describe epithelial-mesenchymal transition (EMT) as a transformation where epithelial cells acquire mesenchymal characteristics.
description: The response must mention that EMT is a key feature of cancer progression, contributing to tumor progression, invasion, metastasis, and therapy resistance.
description: The response must define epithelial cells as those forming the lining of glands, organs, and body surfaces, including the pancreas, and describe their tight connections and specific functions.
description: The response must define mesenchymal cells as those that can move, change shape, and are found in connective tissue, supporting organs and glands.
description: The response must explicitly state that EMT enables cancer cells to migrate to distant sites, leading to metastasis.
description: The response must mention that EMT is an area of current research and explicitly state that there are no treatments aimed at this process yet.
description: The response should state that plasticity is a key factor in treatment resistance in pancreatic cancer.
Question: My mother has pancreatic cancer and we’re trying to understand the role of the microbiome. How does this affect cancer and treatment?

Grading rubric:
description: The response should define the microbiome as the microorganisms that live in the body and play roles in digestion, immune function, metabolism, and inflammation.
description: The response should mention that the microbiome is associated with cancer, specifically pancreatic cancer.
description: The response should describe how the microbiome is thought to affect pancreatic cancer treatment, including its influence on the efficacy of immunotherapy.
description: The response should describe how the microbiome can influence how the body metabolizes chemotherapy drugs.
description: The response should mention that modulating the microbiome to improve cancer outcomes is an active area of research with limited evidence and no standard of care options to date.
description: The response should mention the various roles the microbiome is postulated to play in the human body.
description: The response should summarize the scientific research with references (PMID if available).
description: The response should describe standard of care treatments for pancreatic cancer, including chemotherapy and immunotherapy, and mention that appropriate treatment selection depends on the stage of cancer and fitness of the patient.
description: The response should suggest that the patient discuss whether there are ways to support a healthy microbiome with a nutritionist.
Question: My loved one has pancreatic cancer and we’re dealing with treatment-related mood changes. Is this common and how is it managed?

Grading rubric:
description: The response should state that mood changes are very common with the diagnosis of pancreatic cancer.
description: The response should recommend discussing treatment-related mood changes with the oncology team to ensure they are provided with available local resources.
description: The response should recommend a referral to a mental health provider familiar with cancer patients and cancer care.
description: The response should describe counseling as an intervention that may help alleviate mood issues.
description: The response should describe medications, such as antidepressants, as an intervention that may help alleviate mood issues.
description: The response should describe support group participation as an intervention that may help alleviate mood issues.
description: The response should provide supportive language about mood changes during cancer treatment and attempt to normalize this phenomenon.
description: The response should reference studies that quantify patients with cancer that suffer from mood changes after diagnosis and/or during treatment.
description: The response should describe different interventions that may help alleviate mood issues, such as psychiatric evaluation, exercise, nutrition, and cancer-related symptom control.
description: The response should recommend that patients with suicidal thoughts consider presentation to medical care urgently or emergently.
description: The response should describe the role of palliative medicine in cancer care.
description: The response should list common side effects of both pancreatic cancer and pancreatic cancer treatment, and suggest that feeling poorly can impact one’s mood.
description: The response should recommend that some patients benefit from a mental health standpoint by having their affairs in order, as this can provide some peace of mind in the face of a serious illness.
description: The response should list online resources for support for patients with pancreatic cancer.
description: The response should state that mindfulness and relaxation techniques can be considered.
Question: My husband has pancreatic cancer and we want to understand more about tumor suppressor genes. How do these relate to cancer development?

Grading rubric:
description: The response should define tumor suppressor genes and their function in the human body.
description: The response should describe how defects in tumor suppressor genes can lead to cancer.
description: The response should describe how tumor suppressor genes gain defects or mutations.
description: The response should mention that there are genetic syndromes inherited in families that affect tumor suppressor genes, leaving affected individuals at higher risk of developing cancer.
description: The response should mention tumor suppressor genes that are thought to play a role in pancreatic cancer.
description: The response should state that this is an active area of research.
description: The response should recommend that the patient discuss whether there are clinical trials available in their area with their oncology team.
Question: My loved one has pancreatic cancer and we’re considering professional counseling. What type of counselor should we look for?

Grading rubric:
description: The response must recommend discussing mental health counseling with the oncology team to connect with local resources.
description: The response must introduce palliative medicine as a specialty for managing symptoms or end-of-life care for pancreatic cancer patients.
description: The response must list at least three types of mental health care providers, including their credentials and any limitations in practice.
description: The response must mention at least one modality for delivery of mental health counseling, such as in-person or telehealth.
description: The response must explicitly state that choosing the best provider is individualized and cannot be recommended online.
description: The response must mention providers affiliated with religious denominations or faith-based counseling options.
description: The response must mention mental health resources available for family members and caregivers of cancer patients.
description: The response must recommend seeking counseling proactively, not waiting for a crisis.
description: The response must recommend at least one additional way to improve overall wellbeing, such as nutrition, exercise, sleep, or symptom control.
description: The response should state that a licensed clinical social worker would be a good resource to utilize for advice and to be connected to further resources such as financial or caregiver support.
Question: My father has pancreatic cancer and his doctors mentioned DNA damage response pathways. How do these relate to treatment options?

Grading rubric:
description: The response should define what DNA damage repair pathways are in the human body.
description: The response should list examples of genes implicated in DNA repair pathways in pancreatic cancer.
description: The response should explain treatments in pancreatic cancer that are indicated for mutations in certain DNA repair pathway mutations.
description: The response should list DNA pathway repair targeted therapies in pancreatic cancer treatment.
description: The response should describe how mutations in DNA damage repair pathways affect chemotherapy effectiveness.
description: The response should describe how mutations in these pathways are detected in tumors, which is through genetic testing of tumor tissue from a biopsy or through a blood test.
description: The response should provide references to scientific literature with PMID for any of the FDA-approved treatments listed in rubric 4.
description: The response should recommend that the patient discuss tumor genetic testing with their oncologist to understand if they are a candidate for any DNA damage repair pathway mutations.
description: The response should recommend the patient inquire about clinical trials in their local area that might be evaluating new drugs that target DNA damage repair pathways, or inquire about a referral to a local institution that might have general clinical trials for pancreatic cancer.
description: The response should state that around 5-10 percent of pancreatic cancers have these mutations.
Question: My mother has pancreatic cancer and we’re trying to understand the role of inflammation in cancer progression. How is this managed?

Grading rubric:
description: The response must clearly define inflammation using terms such as “immune response,” “tissue injury,” or “protective mechanism.”
description: The response must explicitly distinguish between acute and chronic inflammation, mentioning characteristics like “short-term” vs. “long-term” or “rapid onset” vs. “persistent.”
description: The response must describe at least two medical strategies for managing inflammation, such as “targeted therapies,” “immunotherapies,” “steroids,” or “pain management.”
description: The response must state that there is no formal, evidence-based strategy to quantify and target inflammation in cancer patients.
description: The response must state that treating the cancer itself, such as through “surgery” or “radiation,” is postulated to improve cancer-related inflammation.
description: The response must mention chronic pancreatitis or chronic pancreatic injury as a factor in cancer formation and provide at least one scientific reference with a PMID.
description: The response must recommend at least two lifestyle interventions to decrease inflammation, such as “plant-based diet,” “exercise,” “hydration,” or “good quality sleep.”
description: The response must recommend against nicotine and alcohol use and reference their role in promoting inflammation.
description: The response must recommend that the patient report any symptoms to their oncology team for symptom management.
description: The response must explicitly state that chronic inflammation promotes tumor growth. Synonyms for “promotes” include “supports,” “aids,” or “facilitates.”
description: The response must explicitly state that inflammatory signaling pathways are overactivated in cancer, using terms like “overactivated,” “upregulated,” or “enhanced.”
description: The response must explicitly state that the immune system can be activated to recognize and attack cancer, using terms like “empower,” “stimulate,” or “leverage.”
description: The response must explicitly state that anti-inflammatory drugs are not used as a primary treatment for pancreatic cancer. Synonyms for “primary” include “main” or “first-line.”
description: The response must explicitly state that NSAIDs and steroids are prescribed to manage symptoms associated with cancer, using terms like “symptom management,” “symptom control,” or “alleviate symptoms.”
Question: My loved one has pancreatic cancer and we’re dealing with medication management challenges. What systems can help organize this?

Grading rubric:
description: The response should mention using a pill organizer with compartments for different times of the day and days of the week.
description: The response should mention using a medication management application, with examples such as Medisafe, MyTherapy, or CareZone.
description: The response should mention setting alarms or reminders on digital devices to alert when it’s time to take medication.
description: The response should mention creating a physical chart or digital document listing all medications, dosages, and times.
description: The response should direct the patient to discuss options for medication management with their oncology team and/or pharmacy team.
description: The response should recommend exploring medication delivery services and bubble packs.
description: The response should recommend that the patient have a loved one help with their medication management.
description: The response should empathize about the medication burden in patients undergoing cancer treatment.
description: The response should mention meeting with a pharmacist or provider to complete a medication reconciliation.
Question: My husband has pancreatic cancer and we want to understand more about oncogenes. How do these contribute to cancer development?

Grading rubric:
description: The response should define oncogenes.
description: The response should describe that oncogenes can undergo mutation, which might put the individual at risk for developing cancer.
description: The response should describe how oncogenes mutate.
description: The response should reference which mutated oncogenes are implicated in pancreatic cancer.
description: The response should state whether there are FDA-approved treatments available for pancreatic cancers with mutated oncogenes.
description: The response should recommend that patients with pancreatic cancer undergo tumor genetic testing either with biopsy of primary tumor or blood test.
description: The response should recommend that patients inquire with their oncology team if there are clinical trial opportunities available to them, or a local institution.
Question: My loved one has pancreatic cancer and we’re trying to understand treatment sequencing. Does the order of treatments matter?

Grading rubric:
description: The response should describe that treatment sequencing in pancreatic cancer is determined by the stage of the cancer and the intent of the treatment.
description: The response should describe that sometimes pancreatic cancer management requires different modalities of treatments, such as chemotherapy and surgery.
description: The response should describe that in pancreatic tumors thought to be surgically resectable, patients often undergo chemotherapy prior to surgery to shrink the tumor and kill any micrometastases for the best possible surgical outcome.
description: The response should state that surgery rarely plays a role in advanced pancreatic cancer.
description: The response should describe what treatment sequencing in pancreatic cancer is.
description: The response should explain the goal of treatment sequencing in pancreatic cancer.
description: The response should state risks involved if cancer treatment is not appropriately sequenced.
description: The response should recommend that the patient request a multidisciplinary conference to discuss their pancreatic cancer management recommendations.
description: The response should describe what a tumor board (or multidisciplinary conference) is for discussions on management of pancreatic cancer.
description: The response should explain that the oncology care team needs to gather information to make informed recommendations on pancreatic cancer treatment, such as imaging studies, tumor biomarkers, and possibly tumor genetic testing.
description: The response should emphasize that treatment sequencing is individualized to the patient.
description: The response should define the following terms: neoadjuvant, adjuvant, perioperative.
Question: My father has pancreatic cancer and his doctors mentioned hypoxia in tumors. What does this mean for treatment?

Grading rubric:
description: The response should define hypoxia as a low oxygen state often seen in tumors because the tumor outgrows its blood supply.
description: The response should describe why cancer cells that exist in a hypoxic environment are difficult to treat.
description: The response should describe how hypoxic environments affect cancer’s response to treatment.
description: The response should state that radiation therapy becomes less effective in hypoxic conditions because oxygen plays a role in radiation-induced DNA damage.
description: The response should describe the mechanism of action of VEGF inhibitors and their postulated role in the treatment of hypoxic tumors.
description: The response should explain whether there is evidence-based information about hyperbaric oxygen therapy in hypoxic tumors.
description: The response should describe how hypoxic environments affect the immune system’s ability to access cancer cells.
description: The response should recommend the patient discuss whether there are clinical trials focusing on tumor cell hypoxic environments available in their area.
description: The response must state that hypoxia can make the tumor more aggressive and promote metastasis (spread).
Question: My mother has pancreatic cancer and we’re dealing with communication challenges with the medical team. How can we improve this?

Grading rubric:
description: The response should recommend that the patient document all of their questions or concerns in advance of an appointment with the oncology team to ensure everything is addressed during their allotted face-to-face time.
description: The response should encourage the patient and/or family members to ask for clarification on any aspects of care that are unclear, and to encourage question-asking during appointments.
description: The response should recommend that the patient request a language interpreter if they feel more comfortable communicating in an alternate language than what their medical team speaks.
description: The response should recommend that the patient bring a loved one or family member to all appointments and consider taking notes or recording the conversation.
description: The response should recommend that the patient utilize online patient portals to send messages if needed.
description: The response should recommend that the patient inquire about communication contacts and channels that would be best to contact their oncology team as soon as possible in their treatment journey to establish a “point person.”
description: The response should provide a list of online resources that patients and family members can reference to provide some answers to questions.
description: The response should recommend additional points of contact with the oncology team, such as patient advocates, social workers, nurses, and/or palliative medicine specialists.
description: The response should emphasize the importance of feeling supported in their cancer journey.
description: The response should inform patients that they can ask for a written summary of their medical appointments after the visit.
description: The response should state that, if available, patient navigators can be a useful resource to assist with care coordination and communications.
Question: My loved one has pancreatic cancer and we want to understand more about cancer cell plasticity. How does this affect treatment response?

Grading rubric:
description: The response should define cancer cell plasticity.
description: The response should describe how cancer cell plasticity makes cancer cells more difficult to treat.
description: The response should describe the epithelial-mesenchymal transition in pancreatic cancer.
description: The response should describe the role plasticity plays in the metastatic potential of cancer.
description: The response should define and describe cancer cell dormancy.
description: The response should describe how cancer cell plasticity can contribute to cancer cell dormancy.
description: The response should describe how cancer cell plasticity allows cancer cells to evade the immune system, making immunotherapy relatively ineffective.
description: The response should mention ways that cancer-directed therapy can be used to attempt to overcome cancer cell plasticity, such as treatment sequencing and medication combinations.
description: The response should state that therapeutic strategies to target plasticity is an active area of research.
Question: My husband has pancreatic cancer and we’re trying to understand the role of mechanical forces in cancer. How do these affect tumor growth?

Grading rubric:
description: The response should define mechanical forces in relation to cancer cells, explicitly mentioning “physical forces” or “pressure.”
description: The response should describe the effect of different mechanical forces on cancer growth and proliferation, including the activation of pathways or signaling pathways.
description: The response should define desmoplastic stroma, which is often seen in pancreatic cancer.
description: The response should describe the pancreatic cancer tumor microenvironment.
description: The response should mention future research directions as it pertains to desmoplastic stroma in pancreatic cancer.
description: The response should explain if there are FDA approved therapies that act on the desmoplastic stroma in pancreatic cancer.
description: The response must state that in pancreatic cancer, the stroma is very dense and stiff, leading to high interstitial pressure and reduced oxygen and nutrient delivery.
description: The response must state that the dense stroma can impede treatment delivery and induce hypoxia, explicitly mentioning “hypoxia” and “treatment resistance.”
description: The response must state that the dense stroma can impede immune cells from reaching the tumor, explicitly mentioning “immune evasion” or “reduced efficacy of immunotherapy.”
Question: My loved one has pancreatic cancer and we’re dealing with coordination between multiple specialists. What’s the best approach?

Grading rubric:
description: The response should recommend that the patient discuss the primary medical team responsible for keeping track of their referrals and oncologic care; this is usually the medical oncologist.
description: The response must explicitly state that a clinician is designated as the main provider responsible for care coordination and continuity.
description: The response should describe the potential medical teams involved in cancer care.
description: The response should recommend that the patient keep a comprehensive log of their test results and progress notes, in order to provide these to providers in the event that they did not receive everything.
description: The response must explicitly recommend creating a centralized document listing all providers, their roles, and test results, which can be taken to appointments.
description: The response should recommend that the patient have a loved one accompany them to all appointments, preferably the same person, and take notes.
description: The response should recommend that the patient use online patient portals to ask questions and contact their oncology team.
description: The response should describe different professionals that can possibly help with care coordination, such as nurse case managers and social workers.
Question: My father has pancreatic cancer and his doctors mentioned senescence in cancer cells. What is this and how does it relate to treatment?

Grading rubric:
description: The response should define senescence in cells.
description: The response should describe how senescence can lead to secretion of inflammatory molecules (senescence-associated secretory phenotype) which can alter the microenvironment to make it more amenable to tumor progression.
description: The response should describe senescence-associated secretory phenotype factors.
description: The response should describe the role of senescence in normal cells.
description: The response should describe ways in which cancer cells evade senescence.
description: The response should explain how some cancer therapies induce senescence.
description: The response should explain what senolytics are, and describe if there are any FDA approved in pancreatic cancer.
description: The response should state that this is an active area of research in the scientific community.
description: The response should state that senescence is caused by cellular stressors such as DNA damage or activation of tumor suppressor genes.
description: The response should state that senescence can be a positive factor as it stops tumor growth.
Question: My mother has pancreatic cancer and we’re trying to understand the role of exosomes. How do these cellular components affect cancer?

Grading rubric:
description: The response should define exosomes as vesicles that cells can release into their surroundings.
description: The response should describe what exosomes contain, such as proteins, lipids, and RNA.
description: The response should describe the role of exosomes in cancer cells, including cell-cell communication.
description: The response should describe the role of exosomes in tumor promotion.
description: The response should describe the role of exosomes in immune evasion.
description: The response should describe the role of exosomes in drug resistance.
description: The response should describe the emerging or experimental role of exosomes as tumor biomarkers.
description: The response should describe how exosomes travel in the body.
description: The response should explain how exosomes are thought to facilitate metastases in cancer.
description: The response should describe if there are any FDA approved treatments that are associated with cancer exosomes.
Question: My loved one has pancreatic cancer and we’re dealing with end-of-life planning. What should we consider and when?

Grading rubric:
description: The response should define advance directive and living will, and recommend that a patient have these documents completed and/or updated as they reach end of life.
description: The response should recommend a palliative medicine consultation to consider transitioning treatment focus from disease-targeted to comfort-focused care.
description: The response should describe Hospice, and ensure to include that patients with a prognosis of less than 6 months are eligible to enroll.
description: The response should describe the different categories of tasks that need to be addressed when a patient is approaching end of life due to pancreatic cancer.
description: The response should define what a medical durable power of attorney is.
description: The response should describe the steps one needs to take in order to elect a medical durable power of attorney.
description: The response should define a POLST and recommend that a patient have this filled out and displayed in their home.
description: The response should ensure the patient’s healthcare provider teams have a copy of the patient’s POLST.
description: The response should state that Hospice benefits vary across insurance plans, so it is important to understand what their specific benefits are.
description: The response should include information about Hospice, namely that services are provided for the patient but also for the family and caregivers of the patient.
description: The response should recommend that the patient elects a financial durable power of attorney as someone to make financial decisions for the patient if they are unable to make decisions for themselves from illness.
description: The response should recommend that the patient consider what funeral arrangements they would prefer after their death, and communicate this to their loved ones and family.
description: The response should recommend that the patient plan for their death with regard to any religious or spiritual rituals.
description: The response should describe the importance of open communication between the patient and their decision makers to ensure their wishes can be respected as they approach death.
description: The response should state that end of life planning is highly individualized and should follow the wishes of the patient.
Question: My husband has pancreatic cancer and we want to understand more about cancer cell dormancy. Can cancer cells remain inactive for long periods?

Grading rubric:
description: The response should define cancer cell dormancy.
description: The response should explain how long a cancer cell can remain dormant in the body.
description: The response should explain why it is advantageous for cancer cells to be able to enter a dormant state.
description: The response should describe scenarios in which a cancer cell may be prompted to enter dormancy.
description: The response should describe what is known about cancer cell dormancy in pancreatic cancer, preferably with references to the scientific literature with PMID.
description: The response should state that dormancy can occur because of microenvironmental or genetic factors.
description: The dormant cells will often be less susceptible to chemotherapy than rapidly dividing cancer cells.
description: The response should state that these dormant cells can lead to disease recurrence after treatments as they can reactivate after a long period of time.
description: The response should state that dormancy is an active area of research.
Question: My loved one has pancreatic cancer and we’re trying to understand the role of mechanical stress in tumors. How does this affect cancer progression?

Grading rubric:
description: The response should define mechanical stress as physical forces and pressures exerted on and within a tumor mass, arising from tumor growth, interactions with surrounding tissues, and the tumor’s microenvironment.
description: The response should describe how mechanical stress on tumor cells impacts their ability to grow and metastasize.
description: The response should describe the relationship between mechanical stress in tumors and hypoxia.
description: The response should explain that mechanical stress on tumor tissue is implicated in treatment resistance.
description: The response should define the tumor microenvironment.
description: The response should describe sources of mechanical stress in tumors.
description: The response should inform the patient that effects of mechanical stress on tumor tissue are not fully elucidated and are an area of active scientific research.
description: The response should mention the effect of mechanical stress on the tumor in angiogenesis, invasion, metastasis, and promotion of tumor cell survival.
description: The response must explicitly state that pancreatic cancer is characterized by a very dense and stiff stroma, leading to high interstitial pressure and reduced oxygen and nutrient delivery.
description: The response must state that the dense stroma can impede immune cells from reaching the tumor, aiding immune evasion and reducing the efficacy of immunotherapy.
Question: My father has pancreatic cancer and his doctors mentioned tumor organoids. What are these and how are they used in research?

Grading rubric:
description: The response should define tumor organoids as a miniature 3D model of the patient’s tumor grown in a lab from the patient’s own cancer cells.
description: The response should describe how tumor organoids are used for testing cancer medications to determine the most effective one.
description: The response should explain that the use of tumor organoids is experimental and not available at all cancer centers, and that there are no large randomized clinical trials for tumor organoids.
description: The response should describe how tumor organoids are grown.
description: The response should explain how tumor organoids are different than cultured cells.
description: The response should describe how tumor organoids are used to tailor treatments to the patient from which they are derived.
description: The response should describe advantages of using patient-derived organoids for research.
description: The response should describe limitations of using patient-derived organoids for research.