YiminZ07/PanCanBench huggingface dataset:
Question: I was just diagnosed with pancreatic cancer and I have questions on options of treatment. I would greatly appreciate it if you could get back to me as soon as possible. Thank you.

Grading rubric:
description: The response should state that the treatment of pancreatic cancer depends on the stage of the cancer.
description: The response should include surgery as a preferred option for resectable tumors.
description: The response should state that chemotherapy is the backbone of treatment for metastatic or unresectable pancreatic cancer.
description: The response should include radiation as a potential treatment option for localized disease.
description: The response should include the concept of resectability.
description: The response should specify the main chemotherapy regimens used are FOLFIRINOX or Gemcitabine + Nab-Paclitaxel.
description: The response should include immunotherapy and that its role is currently limited to patients with mismatch repair deficiency or high microsatellite instability.
description: The response should include targeted therapy such as PARPi for patients with BRCA mutations.
description: The response should introduce the concept of clinical trials and their role in the management of pancreatic cancer.
description: The response should emphasize that symptom management is an important part of the care of patients with pancreatic cancer and should highlight the importance of supportive care, including evaluation by a palliative care specialist and nutritional support.
description: The response should state that the treatment of pancreatic cancer depends on the location of the cancer.
description: The response should state that the NCCN Panel recommends that decisions about diagnosis and management involve multidisciplinary teams at high-volume centers with appropriate high-volume imaging studies.
description: The response should recommend discussing the treatment of pancreatic cancer with an oncologist.
Question: My friend has just been told they have a tumor extending from their pancreas that is wrapped around the celiac artery. I am trying to help them find pancreatic cancer specialists in the area.

Grading rubric:
description: The response must provide a direct link to a list of NCI-designated cancer centers.
description: The response must discuss the concept of resectability in pancreatic cancer, stating that involvement of major blood vessels like the celiac artery generally precludes safe resection and requires evaluation at a specialized center.
description: The response must emphasize the need for evaluation by a multidisciplinary clinic, including surgical, medical, and radiation oncology.
description: The response must clearly state that neoadjuvant treatment may be proposed to shrink the tumor to a resectable size, but some tumors may remain unresectable and only amenable to systemic therapy or radiation.
description: The response must explicitly state that some specialized centers can offer vascular reconstruction for tumors involving major blood vessels.
description: The response must offer to search for high-volume pancreatic cancer programs by preferred location, asking for specific location details to tailor recommendations.
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.
Question: I need a recommendation for tumor removal. I am currently receiving treatment at a cancer center. Under a clinical trial for radiation and chemotherapy treatment for several months now. Stage 3. The surgical team does not feel comfortable performing surgery.

Grading rubric:
description: The response should include an overview of the criteria for resection of the tumor and why patients are deemed not to be good candidates for surgery.
description: The response should indicate that the case should be discussed at a multidisciplinary tumor board.
description: The response should indicate that the patient could seek a second opinion at another specialized center.
description: The response should provide a list of specialized centers that offer second opinions.
description: The response should recommend that the person discuss surgery with the current oncology team.
description: The response should recommend the person ask their current oncology team if there are specific metrics they need to achieve to be eligible for surgery.
Question: I wanted to know if there are any online support groups for family members of pancreatic cancer patients.

Grading rubric:
description: The response should list PANCAN Online Community as an option.
description: The response should include the American Cancer Society (ACS) online community as an option.
description: The response should include CancerCare Online Support Groups as an option.
description: The response should include various Facebook support groups.
description: The response should affirm that there are many online support groups for families of pancreatic cancer patients.
description: The response should recommend talking to your family member’s oncology about support groups.
Question: I have had pancreatitis for years. Due to not being able to afford medical insurance, I have not had the proper treatment or checkups. I am concerned about pancreatic cancer.

Grading rubric:
description: The response should indicate that while chronic pancreatitis is a risk factor for pancreatic cancer, it is still not common to develop pancreatic cancer even in patients with pancreatitis.
description: The response should offer support for having experienced the symptoms of chronic pancreatitis.
description: The response should describe the potential signs and symptoms of pancreatic cancer, which could include unintentional weight loss, jaundice, steatorrhea, new onset diabetes, and worsening of abdominal symptoms.
description: The response should outline at least three options for obtaining medical attention without insurance or for low-income adults, such as Federally Qualified Health Centers, community health clinics, Medicaid, or ACA marketplace plans, and should include specific examples or resources when possible.
description: The response should indicate that a consultation with a physician who may obtain labs, perform a physical exam, and obtain imaging studies such as a CT scan would be warranted.
description: The response should offer information on how to sign up for Medicaid and provide more specific instructions and information about eligibility depending on the state the person resides in.
description: The response explicitly recommends discussing financial concerns with a doctor, including at least one practical suggestion (e.g., payment plans, charity care).
Question: My loved one recently got diagnosed with pancreatic cancer. Please help me as I am feeling helpless and overwhelmed.

Grading rubric:
description: The answer should provide support and note that it is normal to feel overwhelmed under the circumstance.
description: The answer should provide links to websites that give more information on pancreatic cancer that are written at the level of patients and their families.
description: The response should provide information about online support groups for pancreatic cancer patients and caregivers, including those offered by the Pancreatic Cancer Action Network (PanCAN), the American Cancer Society (ACS), and CancerCare.
Question: My loved one has stage IV pancreatic cancer and their chemotherapy stopped working. Are there any experimental treatments or clinical trials available?

Grading rubric:
description: The answer should provide a link to ClinicalTrials.gov for information on clinical trial options.
description: The answer should offer to search for treatment options by location.
description: The response should explicitly suggest obtaining a second opinion from another oncologist or major cancer center and provide a list of leading cancer centers that offer second opinion consultations.
description: The answer should provide an overview of active areas of research in pancreatic cancer.
description: The answer should provide support and acknowledge the difficulty of the situation.
description: The response must explicitly recommend discussing clinical trial options and eligibility with the oncologist.
Question: My loved one was recently diagnosed with stage IV pancreatic cancer. Both my family and the patient are completely overwhelmed and don’t know where to start.

Grading rubric:
description: The answer should provide support and acknowledge that feeling overwhelmed under the circumstances is understandable and valid.
description: The answer should provide an overview of what a Stage IV diagnosis entails.
description: The answer should identify members of the patient care team that the patient should have to support them, including a medical oncologist and palliative care physician.
description: The answer should outline the general approach to the treatment of stage IV pancreatic cancer, emphasizing that the cornerstone is chemotherapy with palliative intent.
description: The response should emphasize the importance of support and community for both patients and caregivers, and should mention the Pancreatic Cancer Action Network (PanCAN), the American Cancer Society (ACS), and CancerCare as key resources for online support groups.
description: The response must explicitly recommend discussing the diagnosis and next steps with the patient’s oncologist.
Question: My loved one is in her third year with pancreatic cancer. We are looking for suggestions on vitamins and supplements that might help.

Grading rubric:
description: The answer must recommend discussing vitamins and supplements with the oncology team.
description: The answer must recommend maintaining a healthy and balanced diet.
description: The answer must explicitly state that any diet or high-dose vitamins claiming to cure cancer should be avoided.
description: The answer must mention the benefit of pancreatic enzyme replacement therapy for pancreatic cancer patients.
description: The response must specify that due to malabsorption in pancreatic cancer, supplementation of fat-soluble vitamins (A, D, E, and K) is recommended, and should note that lab-confirmed vitamin deficiencies can be improved with appropriate vitamin supplements under the direction of a doctor.
description: The answer must state that pancreatic enzyme deficiency is common in patients with pancreatic cancer.
Question: My loved one was diagnosed two months ago with stage IV and was given 3-6 months. They have had two chemo treatments and the side effects are terrible. Should we continue?

Grading rubric:
description: The response should recommend that the patient discuss their goals of care and potential treatment side effects with their oncology team.
description: The response should state that the decision to continue with chemotherapy treatments is highly personal.
description: The response should state that changes to the chemotherapy dose can improve side effects.
description: The response should state that changes to the chemotherapy schedule can improve side effects.
description: The response should state that changes to supportive medications can improve side effect symptoms.
description: The response should recommend the patient ask for a referral to a palliative care specialist.
description: The response should start with an expression of sympathy and support.
description: The response should state that deferring further cancer-directed treatment and pursuing palliative care and hospice would be a valid approach.
Question: My loved one has pancreatic cancer with liver metastases. The oncologist mentioned that there are genetic mutations that might affect treatment. What should we ask about?

Grading rubric:
description: The answer should specify that somatic testing can be done on the tumor.
description: The answer should specify that germline testing is appropriate.
description: The answer should discuss testing for BRCA mutations.
description: The answer should discuss the role of utilizing PARP inhibitors in pancreatic cancer.
description: The answer should include an overview of testing for microsatellite instability and MSI status, which can be a marker for response to immunotherapy.
description: The answer should include other potential targetable mutations such as HER2/ERBB2 amplification and NTRK.
description: The answer should specify that clinical trials may be available for less commonly targeted mutations.
Question: My family history of pancreatic cancer is quite extensive. My father died from it, as did his father. Should I be getting screened?

Grading rubric:
description: The answer should recommend that the patient consult a genetic counselor.
description: The answer should state that there is no widely accepted protocol for pancreatic cancer screening.
description: The answer should state that high-risk patients can undergo screening imaging studies, such as CT or MRI, after discussion with physicians.
description: The response should describe hereditary syndromes that increase the risk of pancreatic cancer and note that germline BRCA mutations are a significant genetic risk factor.
description: The answer should recommend testing for selected mutations such as BRCA and CDKN2A.
Question: My loved one has been on chemotherapy for 6 months and the CA 19-9 levels are not going down. Does this mean the treatment isn’t working?

Grading rubric:
description: The response should state that doctors use imaging results to determine response to therapy.
description: The response should state that CA 19-9 is one part of what determines response to therapy.
description: The response should state that CA 19-9 levels are not always correlated with tumor size or disease status, and note that some patients do not secrete CA 19-9 at all.
description: The response should state that if CA 19-9 is reflective of cancer activity, it would be expected to decrease with effective chemotherapy.
description: The response should define CA 19-9.
description: The response should state that doctors use changes in symptoms to determine response to therapy.
description: The response should recommend discussing the CA 19-9 test results with their oncologist.
Question: My father had the Whipple procedure and now has diabetes. Is this normal? How do we manage this?

Grading rubric:
description: The response should state that it is not an unexpected outcome as removing pancreas tissue will also take the islet cells which produce insulin.
description: The response should describe the incidence of post-Whipple diabetes, noting it can vary based on how much of the pancreas is removed and the specific patient population, occurring in 15-20% to up to 50% of patients.
description: The response should state the control of diabetes is achieved through regulating glucose intake via dietary modifications and medications that can help control blood sugars.
description: The response should state that the father of the question writer should be evaluated by an endocrinologist.
description: The response should state that the father may ultimately require insulin injections to regulate his blood sugars.
Question: My loved one has pancreatic cancer and is losing weight very rapidly despite trying to eat. What can we do?

Grading rubric:
description: The response must explicitly state that anorexia and weight loss are common symptoms of pancreatic cancer.
description: The response must mention pancreatic enzyme replacement as an intervention and suggest discussing it with the healthcare team.
description: The response must recommend consulting a registered dietitian specializing in oncology for personalized nutritional advice.
description: The response must advise consuming nutrient-dense foods and eating smaller, more frequent meals, and explicitly emphasize the importance of maintaining adequate protein and calorie intake.
description: The response must suggest nutritional supplementation with high-calorie meal replacement shakes and explicitly state that nutrition or protein supplements can be helpful.
description: The response must explicitly state that the patient should discuss their weight loss with their oncology team.
description: The response must explicitly mention chemotherapy as a potential cause of weight loss.
Question: My mother was diagnosed with pancreatic cancer and the doctor mentioned that she has jaundice. What does this mean and how is it treated?

Grading rubric:
description: The answer must specify that jaundice is due to an increase in bilirubin in the blood.
description: The answer must state that jaundice refers to a yellowing of the skin and eyes due to elevated bilirubin levels.
description: The answer must state that jaundice can arise in pancreatic cancer due to blockage of the bile duct from tumor growth.
description: The answer must state that ERCP (Endoscopic Retrograde Cholangiopancreatography) is used to visualize the blocked duct and place a stent to relieve the blockage.
description: The answer must state that other options to relieve the obstruction include percutaneous biliary drainage or surgery.
description: The answer must state that another potential cause for jaundice is metastatic disease in the liver.
description: The answer must state that treating the cancer with chemotherapy can shrink the tumor and help address the jaundice.
Question: My husband has pancreatic cancer and is experiencing severe pain. What are the options for pain management?

Grading rubric:
description: The answer should state that pain medications, including opioids, can be used for pain management.
description: The answer should describe procedures, such as a celiac plexus block, that can help alleviate pain.
description: The answer should express sympathy for the diagnosis and symptoms.
description: The answer should state that adjunctive non-opioid medications, such as amitriptyline and gabapentin, can be used.
description: The answer should state that steroids, such as dexamethasone, can also be used.
description: The answer should state that radiation can be used for local treatment and pain control.
description: The answer should state that complementary therapies, such as acupuncture and massages, can also be pursued.
description: The answer should state that the patient should be seen by a palliative care specialist.
description: The response should recommend discussing pain management with their oncology team.
Question: My loved one has pancreatic cancer and we’ve been told the tumor is “unresectable.” What does this mean exactly?

Grading rubric:
description: The answer should state that resectability is determined by the surgeons’ assessment of their ability to safely remove the entire tumor.
description: The answer should state that tumors are deemed not resectable if they involve surrounding major blood vessels such as the SMA, SMV, CA, PV.
description: The answer should state that invasion of nearby organs can also lead to a tumor not being able to be resected.
description: The answer should state that sometimes tumors that are not initially able to be resected can be shrunk (downstaged) with chemotherapy and/or radiation and later removed.
description: The answer should offer sympathy for the loved one’s diagnosis.
Question: My family member with pancreatic cancer is considering stopping treatment and focusing on quality of life. How do we make this decision?

Grading rubric:
description: The response should state that the decision to continue with or stop chemotherapy treatments is highly personal.
description: The response should state that the decision should be made weighing the expected benefit of more therapy with the current side effects.
description: The response should recommend that the patient discuss their goals of care with their oncology team and suggest meeting with their oncologist and a palliative care physician to help guide decision-making.
description: The response should recommend the patient ask for a referral to a palliative care specialist.
description: The response should describe palliative care.
description: The response should describe hospice care.
description: The response should offer sympathy and state that it is a very difficult decision to try to make.
Question: My father has pancreatic cancer and was told he has a KRAS mutation. What does this mean for his treatment?

Grading rubric:
description: The response should state that KRAS mutations are frequently implicated in pancreatic cancer as a major driver of tumorigenesis.
description: The response should state that the first line of treatment would remain the standard of care with chemotherapy regimens such as FOLFIRINOX and gemcitabine/abraxane.
description: The answer should state that there are several KRAS mutations (G12C, G12D, G12V) and specify which one is present in the patient’s case.
description: The response should state that targeted therapy to the KRAS mutation is an active area of research.
description: The response should state that some KRAS mutations can be targeted with drugs.
description: The response should state that there may be clinical trials for certain KRAS mutations.
description: The response should state the patient should discuss their KRAS mutation with their oncologist.
Question: Are there studies for pancreatic cancer evaluating infusion of high vitamin C doses in conjunction with chemotherapy?

Grading rubric:
description: The response must mention recent trials evaluating the use of high-dose vitamin C in combination with chemotherapy for the treatment of pancreatic cancer.
description: The response must state that high-dose vitamin C has not been proven to improve outcomes in pancreatic or any other cancer.
description: The response should mention the proposed mechanism of action of high-dose vitamin C in conjunction with chemotherapy, noting that it can act as a pro-oxidant by generating hydrogen peroxide (H₂O₂), which may enhance the killing of cancer cells.
description: The response must state that there is limited published data showing high-dose vitamin C is well tolerated and shows a trend toward efficacy, but studies are limited and not sufficiently powered.
description: The response should mention possible toxicities of taking high doses of vitamin C.
description: The response should mention drug-drug interactions of vitamin C.
description: The response should note that vitamin C is not FDA approved.
description: The response should note that vitamin C is not recommended by the NCCN guideline.
description: The response should note that if a patient wishes to use high doses of vitamin C in conjunction with chemotherapy, they should consult with an oncologist regarding the treatment of pancreatic cancer.
Question: Yesterday it was confirmed that my loved one has pancreatic cancer. It is believed to be stage IV and has spread to the liver. However, they were not able to confirm cancer in the liver based on the biopsy. How can this be confirmed?

Grading rubric:
description: The response should state that a biopsy is the only way to confirm the diagnosis of metastatic cancer.
description: The response should state that imaging such as CT or MRI is done to evaluate for the presence of metastatic disease.
description: The response should state that tumor markers can be supportive of a diagnosis.
description: The response should state that the team may suggest that the patient undergo another biopsy.
description: The response should state that on occasion the team will decide to treat as metastatic if the tumor markers and imaging are consistent with metastatic disease so as to not delay treatment if a repeat biopsy is not feasible.
Question: Does eating vegan stall cancer progression?

Grading rubric:
description: The response should state that there is no good evidence to suggest that eating vegan can stall cancer progression.
description: The response should include changes in digestion that can occur with pancreatic cancer that may affect diet, including pancreatic enzyme insufficiency.
description: The response should include changes in digestion that can occur with pancreatic cancer that may affect diet, including insulin-dependent diabetes.
description: The response should include changes in digestion that can occur with pancreatic cancer that may affect diet, including biliary obstruction.
description: The response should include changes in digestion that can occur with pancreatic cancer that may affect diet, including high protein and calorie needs during treatment.
description: The response should include that nutrition support is often needed for patients with pancreatic cancer.
description: The response should recommend discussion of diet with their oncology team.
description: The response should recommend discussion of diet with an oncology nutritionist.
Question: How do oncologists choose between gemcitabine and nab-paclitaxel and FOLFIRINOX?

Grading rubric:
description: The response should state that medical fitness is scored by the oncologist using the ECOG or Karnofsky performance status.
description: The response should state that typically patients who are more medically fit will be offered FOLFIRINOX, whereas those who are more frail but still candidates for treatment will be offered gemcitabine and nab-paclitaxel.
description: The response should state that generally FOLFIRINOX is reserved for patients with an ECOG score of 0-1, whereas gemcitabine and nab-paclitaxel can be given to ECOG 2 patients.
description: The response should state the reason that FOLFIRINOX is reserved for patients with good performance status is that it is more intensive and is associated with higher rates of severe side effects such as neutropenia, fatigue, and diarrhea.
description: The response must explicitly list the individual drugs in FOLFIRINOX (5-FU, leucovorin, irinotecan, oxaliplatin) and clarify that nab-paclitaxel is combined with gemcitabine.
description: The response must state that there are no head-to-head trials comparing gemcitabine/nab-paclitaxel and FOLFIRINOX.
description: The response must mention age as a factor influencing the choice of regimen.
description: The response must mention comorbid conditions as a factor in selecting a regimen.
Question: What makes pancreatic cancer resectable?

Grading rubric:
description: The response should state that resectability is determined by the ability of the surgeon to safely remove the entire tumor and not leave any behind (R0 resection).
description: The response should state that involvement of major blood vessels such as the SMA, SMV, CA, PV are often implicated when a tumor is deemed to not be resectable.
description: The response should state that for pancreatic cancer to be resectable, there must not be any distant metastases.
description: The response should state that occasionally tumors that contact the veins (PV/SMV) and have less than 180 degrees of involvement can still be resected provided it can be safely removed and the vessel can be reconstructed as needed.
description: The response should state that some tumors are deemed to be borderline resectable and that the patient will be recommended to undergo treatment with chemotherapy and/or radiation in order to attempt to down-stage the tumor and make it amenable to resection.
description: The response should include imaging modalities that help determine resectability, including a CT scan.
description: The response should include imaging modalities that help determine resectability, including an MRI.
description: The response should include imaging modalities that help determine resectability, including a PET scan.
description: The response should include imaging modalities that help determine resectability, including an endoscopic ultrasound.
Question: What are the risk factors for pancreas cancer if my father died of it?

Grading rubric:
description: The response should state that family history of pancreas cancer is associated with increased risk.
description: The response should state that a family history of pancreas cancer is due to inherited gene mutations such as BRCA.
description: The response should state that smoking is a significant modifiable risk factor.
description: The response should state that chronic pancreatitis is a risk factor.
description: The response should state that heavy alcohol use can lead to increased risk of pancreas cancer through pancreatitis.
description: The response should identify genetic risk factors, including Lynch syndrome.
description: The response should identify genetic risk factors, including Peutz-Jeghers syndrome.
description: The response should identify genetic risk factors, including Familial atypical multiple mole melanoma.
description: The response should identify genetic risk factors, including hereditary pancreatitis.
description: The response should include non-hereditary risk factors, including age.
description: The response should include non-hereditary risk factors, including diabetes.
description: The response should include non-hereditary risk factors, including obesity.
description: The response should include non-hereditary risk factors, including diet.
description: The response should include non-hereditary risk factors, including exposure to certain industrial chemicals.
description: The response should state that if you have a strong family history, discuss with your doctor about screening or genetic testing.
Question: What genetic tests are recommended for a patient with a family history of hereditary disease?

Grading rubric:
description: The response should state that the patient should undergo genetic counseling.
description: The response should state that the type of genetic testing depends on the specific family history or hereditary condition.
description: The response should state that single genes can be tested if there is a known condition associated with a specific genetic disorder.
description: The response should state that a panel of genes can be tested for multiple genes.
description: The response should provide examples of single gene disorders such as Huntington’s Disease, Cystic Fibrosis, and Sickle Cell.
description: The response should provide examples of panel testing for hereditary cancer and cardiomyopathy.
Question: My loved one was diagnosed one year ago. They just finished their 15th round of chemotherapy. I am interested to learn more about clinical trials.

Grading rubric:
description: The response should describe the types of clinical trials.
description: The response should state that clinical trials are divided into three different phases.
description: The response should state that phase 1 is the first time the drug is tested in humans and is aimed at establishing the safety and dosage.
description: The response should state that phase 2 tests the effectiveness of the drug and continues to establish its safety.
description: The response should state that phase 3 tests the efficacy of the drug in a larger group of patients and compares it to the current standard of care.
description: The response should describe eligibility criteria for clinical trials, including stage of disease.
description: The response should state that there can be risks associated with participating in a trial, including potential side effects and lack of efficacy.
description: The response should recommend discussing clinical trial options with their oncology team.
description: The response should include clinicaltrials.gov as a resource for finding clinical trials.
description: The response should offer support for the diagnosis and how difficult it can be to complete 15 rounds of chemotherapy.
Question: How do I find clinical trials for pancreatic cancer in my area?

Grading rubric:
description: The response must include ClinicalTrials.gov as a resource for finding clinical trials.
description: The response must provide instructions on using the search by location function on ClinicalTrials.gov.
description: The response must mention the National Cancer Institute (NCI) website and describe using it to search for trials.
description: The response must mention and provide a link to the Pancreatic Cancer Action Network (PanCAN) clinical trial finder tool.
description: The response should recommend contacting advocacy organizations for information on clinical trials, including PanCAN.
description: The response should recommend contacting advocacy organizations for information on clinical trials, including the American Cancer Society.
description: The response should recommend that the patient discuss clinical trial options with their oncology team and consult with a local healthcare provider or oncologist to explore available trials at nearby cancer centers, as well as contact major cancer centers for additional information on clinical trials.
Question: What are the risk factors associated with pancreatic cancer?

Grading rubric:
description: The response should state that family history of pancreatic cancer is associated with increased risk.
description: The response should state that BRCA1/BRCA2 mutations are genetic risk factors for pancreatic cancer.
description: The response should state that smoking is a significant modifiable risk factor for pancreatic cancer.
description: The response should state that chronic pancreatitis is a risk factor for pancreatic cancer.
description: The response should state that heavy alcohol use can lead to increased risk of pancreatic cancer through pancreatitis.
description: The response should identify Lynch syndrome as a genetic risk factor for pancreatic cancer.
description: The response should identify Peutz-Jeghers syndrome as a genetic risk factor for pancreatic cancer.
description: The response should identify Familial atypical multiple mole melanoma as a genetic risk factor for pancreatic cancer.
description: The response should identify hereditary pancreatitis as a genetic risk factor for pancreatic cancer.
description: The response should include age as a non-hereditary risk factor for pancreatic cancer.
description: The response should include diabetes as a non-hereditary risk factor for pancreatic cancer.
description: The response should include obesity as a non-hereditary risk factor for pancreatic cancer.
description: The response should include diet as a non-hereditary risk factor for pancreatic cancer.
description: The response should include exposure to certain industrial chemicals as a non-hereditary risk factor for pancreatic cancer.
description: The response should state that if you have a strong family history, discuss with your doctor about screening or genetic testing.
Question: How do I locate a pancreatic cancer specialist in my area?

Grading rubric:
description: The response should recommend asking for a referral from their primary doctor or oncologist.
description: The response should recommend using the PanCAN patient services to find a pancreatic cancer specialist.
description: The response should recommend using the American Cancer Society patient services to find a pancreatic cancer specialist.
description: The response should state that they can reference the NCI website to look for designated cancer centers that have pancreatic cancer specialists on staff.
description: The response should include information about the nearest cancer center.
description: The response should recommend checking with their health insurance provider about in-network pancreatic cancer specialists.
Question: What Is CA 19-9?

Grading rubric:
description: The response should define CA 19-9.
description: The response should state that CA 19-9 is a tumor marker produced by cancer cells and measurable in the blood, and describe its use in pancreatic cancer, noting that it can serve as a marker for the disease.
description: The response must include that CA 19-9 can be elevated in other conditions.
Question: What do the Numbers of a CA 19-9 Test Mean?

Grading rubric:
description: The response should state that reference ranges can vary by lab.
description: The response should state that normal levels are typically less than 37 U/mL but do not rule out cancer.
description: The response should state that levels from 37 to 100 U/mL can be associated with non-cancer conditions such as pancreatitis and bile duct disorders.
description: The response should state that moderate elevation (100-1000 U/mL) can be concerning for cancer.
description: The response should state that levels greater than 1000 U/mL can be suggestive of advanced cancer.
description: The response should describe the use of CA 19-9 in pancreatic cancer, including that it can be a marker of pancreatic cancer.
description: The response should include that CA 19-9 can be elevated in other conditions.
description: The response should include that CA 19-9 can be used for monitoring the effectiveness of pancreatic cancer treatment.
description: The response should include that CA 19-9 can be used for detecting recurrence of pancreatic cancer.
description: The response should include that CA 19-9 can be used in other cancers.
description: The response should include that CA 19-9 can be elevated in liver disease.
description: The response should include that CA 19-9 can be elevated in gallstones.
description: The response should include that CA 19-9 can be elevated with elevated bilirubin.
description: The response should include that CA 19-9 is not produced by all pancreatic cancers.
Question: What Other Conditions Can Cause Elevated CA 19-9 Levels?

Grading rubric:
description: The response should state that CA 19-9 can be elevated with pancreatitis.
description: The response should state that CA 19-9 can be elevated with liver diseases like cirrhosis or hepatitis.
description: The response should state that CA 19-9 can be elevated with cholestasis or biliary diseases.
description: The response should state that CA 19-9 can be elevated with inflammatory bowel disease or gastrointestinal diseases.
description: The response should state that CA 19-9 can be elevated with infections or other inflammatory conditions.
description: The response should include that CA 19-9 can be a marker of pancreatic cancer.
description: The response should include that CA 19-9 can be used in other cancers.
description: The response should include that CA 19-9 is not produced by all pancreatic cancer.
Question: How do I manage weight loss for my loved one during the treatment of pancreatic cancer?

Grading rubric:
description: The response should recommend discussing weight loss with the oncology team.
description: The response should state that pancreatic enzyme replacement can be taken to help with the absorption of nutrients from foods.
description: The response should state that nutritional strategies can be employed, such as focusing on small, frequent meals and nutrient-rich foods, and should recommend including calorie-dense and protein-rich foods in the diet.
description: The response should state that medications for managing nausea can be helpful.
description: The response should state there are many causes of weight loss in patients with pancreatic cancer, including weight loss related to chemotherapy side effects.
description: The response should state there are many causes of weight loss in patients with pancreatic cancer, including weight loss related to pancreatic enzyme deficiency.
Question: What are the symptoms of pancreatic cancer?

Grading rubric:
description: The response should state that a symptom of pancreatic cancer can include unintentional weight loss.
description: The response should state that a symptom of pancreatic cancer can include jaundice.
description: The response should state that a symptom of pancreatic cancer can include new onset diabetes.
description: The response should state that a symptom of pancreatic cancer can include abdominal pain.
description: The response should state that pancreatic cancer can be difficult to detect early.
description: The response should state that pancreatic cancer does not cause symptoms until the disease is advanced.
description: The response should state the reason for jaundice is the blockade of bile ducts.
description: The response should state that loss of appetite can be a symptom.
description: The response should state that abdominal bloating or indigestion can be a symptom.
description: The response should state that foul-smelling stools or steatorrhea can be a symptom.
description: The response should reference the American Cancer Society information page on symptoms of pancreatic cancer.
Question: Is pancreatic cancer a hereditary disease?

Grading rubric:
description: The response should state that most pancreatic cancer cases are sporadic and not hereditary.
description: The response should state that there are hereditary conditions that can lead to pancreatic cancer.
description: The response should state that a strong family history is a significant risk factor.
description: The response should identify hereditary pancreatic cancer syndromes, including familial pancreatic cancer syndrome.
description: The response should identify hereditary pancreatic cancer syndromes, including BRCA1/BRCA2 mutations.
description: The response should identify hereditary pancreatic cancer syndromes, including Lynch syndrome.
description: The response should identify hereditary pancreatic cancer syndromes, including Peutz-Jeghers syndrome.
description: The response should identify hereditary pancreatic cancer syndromes, including Familial atypical multiple mole melanoma.
description: The response should identify hereditary pancreatic cancer syndromes, including hereditary pancreatitis.
description: The response should state that if you are concerned about your risk of pancreatic cancer, you should consult an oncologist.
description: The response should state that if you are concerned about your risk of pancreatic cancer, you should consult a genetic counselor.
Question: What information can you provide on surveillance for pancreatic cancer?

Grading rubric:
description: The response must explicitly state that routine screening is not recommended for the general population.
description: The response must mention MRI as a surveillance modality for high-risk individuals.
description: The response must specify that surveillance typically starts around age 50 and continues annually.
description: The response must explicitly state that the evidence for screening/surveillance is not well established and mention the risk of overdiagnosis leading to unnecessary stress and procedures.
description: The response should state that people at high risk may benefit from screening.
description: The response should define people at high risk of pancreatic cancer to include those with a significant family history of pancreatic cancer.
description: The response should define people at high risk of pancreatic cancer to include those with a known genetic syndrome.
description: The response should define people at high risk of pancreatic cancer to include those with a history of chronic pancreatitis.
description: The response should include EUS as a screening modality to detect pancreatic cancer.
description: The response should recommend people discuss the risks and benefits of screening with a doctor.
description: The response should recommend people discuss the risks and benefits of screening with a genetic counselor.
Question: What are the treatments for patients with pancreatic cancer?

Grading rubric:
description: The response should include surgery as a potential treatment modality for resectable pancreatic cancer.
description: The response should specify that chemotherapy is the backbone of treatment for metastatic or unresectable pancreatic cancer, with main regimens being FOLFIRINOX or Gemcitabine + Nab-Paclitaxel.
description: The response should include radiation as a potential treatment option for localized pancreatic cancer.
description: The response should state that the treatment of pancreatic cancer depends on the stage of the disease.
description: The response should state that the treatment of pancreatic cancer depends on the co-morbidities of the patient.
description: The response should state that the treatment of pancreatic cancer depends on the functional status of the patient.
description: The response should include immunotherapy, noting its role is currently limited to patients with mismatch repair deficiency or high microsatellite instability.
description: The response should include targeted therapy such as PARPi for patients with BRCA mutations.
description: The response should introduce the concept of clinical trials and their role in the management of pancreatic cancer.
Question: What are the stages of pancreatic cancer?

Grading rubric:
description: The response should state that stage 0 is a pre-cancer state, also known as pancreatic intraepithelial neoplasia or carcinoma in situ.
description: The response should state that stage 1 cancer is when the cancer is confined to the pancreas and has not spread to lymph nodes or distant sites.
description: The response should note that stage 1a is when the tumor is 2cm or smaller.
description: The response should note that stage 1b is when the tumor is larger than 2cm.
description: The response should state that stage II is when the cancer is growing into nearby tissues and into lymph nodes.
description: The response should state that stage III is when the cancer is locally advanced and involves surrounding structures.
description: The response should state that stage IV is when the cancer has spread to other organs or sites.
description: The response should include a description of the T, N, M staging system.
description: The response should include that pancreatic cancer is categorized by resectability.
Question: My loved one has been on FOLFIRINOX for several months and is experiencing severe neuropathy. Are there alternatives?

Grading rubric:
description: The response must state that neuropathy is a common side effect from the oxaliplatin in FOLFIRINOX.
description: The response must state that the oncologist can ‘hold’ or temporarily stop oxaliplatin to manage neuropathy.
description: The response must state that neuropathy from oxaliplatin can be managed by dose reduction.
description: The response must state that neuropathy from oxaliplatin can be managed by schedule modification.
description: The response must state that neuropathy from oxaliplatin can be managed by switching to an alternate regimen.
description: The response must state that neuropathy from oxaliplatin can be managed by switching to an alternate regimen, including gemcitabine-based therapy.
description: The response must state that neuropathy from oxaliplatin can be managed using supportive medications, including gabapentin.
description: The response must state that neuropathy from oxaliplatin can be managed using supportive medications, including SNRIs.
description: The response must state that neuropathy from oxaliplatin can be managed using supportive medications, including pregabalin.
description: The response should recommend discussing medication side effects with their oncology team.
Question: My mother has pancreatic cancer and is considering participating in a clinical trial. What should we know before making this decision?

Grading rubric:
description: The response should state that they should be informed about the aim of the clinical trial.
description: The response should state that they should understand the potential benefits of the clinical trial.
description: The response should state that they should understand the potential risks of the clinical trial.
description: The response should state that they should be aware of the inclusion and exclusion criteria for the trial.
description: The response should state that they should be aware of the time commitments associated with participating in the trial.
description: The response should state that they should be aware of the costs associated with participating in the trial.
description: The response should recommend understanding the phase of the clinical trial.
description: The response should recommend understanding if there are crossover options.