What questions should I ask my oncologist about Pancreatic Cancer

Important Questions to Ask Your Pancreatic Cancer Oncologist

I'm glad you're preparing to have informed conversations with your care team. Asking the right questions is one of the most important things you can do. Here are the key questions organized by topic:

About Your Specific Diagnosis & Treatment Plan

1. What is the goal of my treatment? Is it to shrink the tumor so I can have surgery, to extend my survival, or something else? Understanding the objective helps you evaluate whether treatment is working as intended.

2. Why did you choose this particular treatment regimen for me? Different chemotherapy combinations (like FOLFIRINOX or gemcitabine with Abraxane) have different benefits and side effects. Understanding your doctor's reasoning helps you feel more confident in the plan.

3. Have you done molecular profiling (genetic testing) on my cancer? According to Dr. [removed] O'Reilly's guidance on novel pancreatic cancer therapies, you should get "point of care" genetic testing—both hereditary testing on your normal cells AND testing on your tumor cells—at your first meeting. This is now standard of care and can identify whether you're eligible for targeted therapies.

4. Can I see my molecular profiling report? Ask for a printed copy to bring to consultations, as this information often exists outside your regular medical chart.

About Genetic Testing & Family Risk

1. Should I see a genetic counselor? Current guidelines recommend genetic counseling for ALL pancreatic cancer patients. Between 5-12% of patients may have a genetic predisposition (mutations in BRCA1, BRCA2, PALB2, or other genes). This matters because certain mutations may make you eligible for specific treatments like PARP inhibitors or platinum-based chemotherapy.

2. Do I have any inherited mutations that affect my treatment options? If you have mutations like BRCA1/BRCA2 or PALB2, this opens up different therapeutic pathways.

About Clinical Trials

1. Am I eligible to participate in clinical trials? Clinical trials are particularly important for pancreatic cancer because most standard treatments aren't effective long-term. Trials may offer access to cutting-edge therapies not yet widely available. According to Let's Win Pancreatic Cancer resources, patients in trials often do better because they receive more intensive monitoring.

2. What clinical trials are most relevant for my specific cancer profile? Ask your doctor to help you search ClinicalTrials.gov, the Let's Win Trial Finder, or use free services like Cancer Commons, Massive Bio, or myTomorrows that review your [ID removed] and recommend suitable trials.

About Monitoring Treatment Response

1. How will we know if the chemotherapy is working? Your doctor should track:

   • CA 19-9 levels (a tumor marker in your blood—higher numbers indicate active disease, so you want to see this number decrease)
   • Imaging tests like CT scans (the best way to see if tumors are shrinking)
   • Physical symptoms (improvements in how you feel overall)

2. What are the key markers I should understand from my blood tests? Ask your oncologist to explain which specific values matter for YOUR case so you can track changes over time.

About Side Effects & Quality of Life

1. What side effects can I expect, and when might they appear? Some happen immediately after treatment; others may develop months or years later. Understanding this helps you prepare.

2. Should I meet with a registered dietitian? Up to 90% of pancreatic cancer patients lose weight after diagnosis. A dietitian can help you maintain nutrition and manage side effects like nausea and poor appetite.

3. Are pancreatic enzymes appropriate for me? If your pancreas isn't functioning normally, supplemental enzymes can help with digestion and prevent weight loss.

4. Should I start exercising? Research shows regular physical activity before, during, and after treatment can improve outcomes, help with fatigue, improve sleep, and reduce anxiety. Ask about a "prehabilitation program."

About Your Support System

1. What support services are available to me and my family? This includes palliative care (which focuses on quality of life during all stages of treatment), counseling, support groups, and other resources.

2. Who should I call with questions between appointments? Know who to contact and how quickly you can expect a response.

3. How will treatment affect my daily life? Understand what to expect regarding work, activities, and family responsibilities.

About Getting a Second Opinion

1. Would you recommend I get a second opinion from an academic medical center? According to Dr. [removed] Strickler's guidance, academic centers often have access to cutting-edge technology and oncologists who specialize deeply in pancreatic cancer. They can help you understand what's happening in the field and which trials might be most relevant.

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Why These Questions Matter

According to Let's Win Pancreatic Cancer and expert oncologists, pancreatic cancer is not "one-size-fits-all." The field is changing rapidly—what was standard six months ago may be outdated now. New tests and treatments are being approved constantly, and increasingly, treatment decisions are shifting toward personalized approaches based on your tumor's specific genetics.

Key principle: About 15-20% of pancreatic cancer patients have actionable mutations that can be targeted with specific drugs. The other 80-85% need different approaches. Your molecular profiling helps determine which category you're in and what options exist for you.

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How to Make the Most of These Conversations

• Bring a family member or loved one to take notes or record conversations (with permission) so you're clear about recommendations
• Bring your molecular profiling report to consultations
• Write down your questions ahead of time so you don't forget them
• Ask follow-up questions if you don't understand the answer
• Request written summaries of your treatment plan and goals

Remember: As Let's Win Pancreatic Cancer emphasizes, "The only stupid question is the one you don't ask." Your healthcare team wants you to be informed and engaged in your care.

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