Just diagnosed with Pancreatic Cancer — what should I do first

Your First Steps After a Pancreatic Cancer Diagnosis

I'm sorry you've received this diagnosis. Here's what you should prioritize right now:

1. Get Molecular and Genetic Testing Done

This is your most important first step. According to Dr. [removed] Strickler (Duke University Medical Oncology), every pancreatic cancer patient should ask their doctor: "Have you done molecular profiling on my cancer? Can I see the report?"

Here's why this matters:

• KRAS mutations are found in about 87% of pancreatic cancers and are now increasingly targetable with newer drugs
• Other mutations (BRCA, PALB2, mismatch repair genes, BRAF) may qualify you for specific targeted therapies
• Germline testing (checking if you inherited cancer-predisposition genes) is now recommended in national guidelines and can affect your treatment options

Action item: Ask your oncologist if they've ordered:

• Tumor molecular profiling (testing your cancer cells)
• Germline genetic testing (testing your blood for inherited mutations)
• Get printed copies of these reports and keep them with you—they often don't automatically transfer between doctors

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2. Understand Your Tumor's Location and Stage

Pancreatic cancer location matters significantly for surgery options. Ask your doctor:

• Where exactly is the tumor located? (head, body, tail, or across multiple areas)
• What stage is it? (localized, locally advanced, or metastatic)
• Am I a candidate for surgery?

Early detection makes a real difference—as Dr. [removed] notes, pancreatic cancer is "extraordinarily difficult to cure," but catching it earlier significantly improves outcomes.

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3. Build Your Care Team

• Oncologist (cancer specialist) - essential
• Surgeon - if surgery is an option
• Gastroenterologist - may help with diagnosis and monitoring
• Consider getting a second opinion at a major cancer center

Bring your molecular profiling report to any second opinion appointment—it's critical information that sometimes gets lost.

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4. Ask About Your Treatment Options

The treatment landscape for pancreatic cancer is evolving. Depending on your molecular profile, you may be eligible for:

• Targeted therapies (if you have specific mutations like KRAS, BRCA, or others)
• Chemotherapy (traditional approach, often combined with other treatments)
• Immunotherapy (emerging option for certain patients)
• Clinical trials (including cancer vaccine trials, which show early promise)
• Surgery (if your tumor is resectable/removable)

Questions to ask your oncologist:

1. What is my tumor's molecular profile, and what does it mean for treatment?
2. Am I eligible for any targeted therapies based on my mutations?
3. What clinical trials might be appropriate for me?
4. What is the recommended treatment plan, and why?
5. What are the potential side effects, and how will we manage them?

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5. Explore Emerging Treatment Approaches

According to recent advances discussed by Dr. [removed]:

• KRAS-targeted drugs are showing promise and represent a major shift in pancreatic cancer treatment
• Cancer vaccines are in early clinical trials and show hints of benefit, though they're still 1-2 years away from widespread availability
• Precision medicine approaches (tailoring treatment to your specific tumor) are finally becoming standard practice

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6. Consider Early Detection and Prevention Resources

If you have family members, they should know:

• Blood-based early detection tests are emerging as potential screening tools
• Genetic counseling is important if you carry inherited mutations (BRCA, PALB2, etc.)

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7. Get Your [ID removed] Organized

• Request copies of all pathology reports, imaging (CT, MRI, PET scans), and lab results
• Keep molecular profiling reports in a separate folder—they're critical and often don't transfer automatically
• Consider using a personal health record platform to organize everything

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Key Resources to Explore

• PanCAN's "Know Your Tumor" program - offers molecular profiling guidance
• Clinical trial databases - ask your doctor about trials you might qualify for
• Cancer Patient Lab webinars - Dr. [removed] Strickler's "Navigating Pancreatic Cancer" webinar covers precision medicine approaches in detail

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Important Reminders

• Timing matters: Pancreatic cancer progresses relatively quickly, so getting started on treatment soon is important
• Molecular profiling is standard of care: This isn't optional—it's now part of national guidelines
• You're not alone: Many patients are exploring new treatment approaches and clinical trials

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.

Your oncology team will help you navigate these decisions based on your specific situation, tumor characteristics, and overall health. Don't hesitate to ask questions—understanding your diagnosis and options is essential to being an active partner in your care.