Definition

What Is Pancreatic Cancer?

Pancreatic cancer is among the most aggressive malignancies, with a current overall 5-⁠year relative survival of 13.7%¹. The dominant form (~85 to 90%) is pancreatic ductal adenocarcinoma (PDAC), arising from cells lining pancreatic ducts¹. Less common types include neuroendocrine tumors (PNETs), which have a considerably better prognosis.

The pancreas sits deep in the abdomen, allowing tumors to grow undetected. By the time symptoms emerge (jaundice, weight loss, abdominal pain), most cancers have already spread locally or distantly. Only about 20% are resectable at diagnosis², and resection is the only path to potential cure.

Risk factors include smoking, obesity, diabetes (both cause and consequence), chronic pancreatitis, family history (BRCA1/2, PALB2, ATM, Lynch syndrome; up to 10% are linked to inherited syndromes³) and aging. New-onset diabetes after age 50 may be the earliest sign; pancreatic cancer can cause diabetes 1 to 3 years before diagnosis.

⚠️ Critical Warning Sign: New-onset diabetes after age 50 with unexplained weight loss should trigger pancreatic imaging. Sudden development of jaundice, "tea-colored urine" or steatorrhea (greasy stools) requires immediate evaluation. Earlier diagnosis gives the best chance that surgery is still possible.

The liver, the stomach, the bile duct, the small intestine and the pancreas, with a tumor in the head of the pancreas where the bile duct passes through

Stages by Resectability

Resectable (~15 to 20%)

Confined to pancreas without vascular involvement. Whipple procedure or distal pancreatectomy. In a trial of chemotherapy after surgery, 43% of people on a four-drug regimen and 31% on a single drug were alive at five years⁴. Adjuvant chemotherapy essential.

Borderline Resectable / Locally Advanced (~30%)

Major vessel involvement. Neoadjuvant chemo ± radiation, then attempt surgery. Aggressive multimodal approach. More patients are now converted to resectable disease.

Metastatic (~50%)

Spread to liver, lungs, peritoneum. Systemic chemo (FOLFIRINOX or gemcitabine + nab-paclitaxel). Median survival is improving but is typically under a year; it was 11.1 months with FOLFIRINOX in its pivotal trial⁵. Palliative care critical.

Treatment Comparison

Conventional and Holistic Treatment for Pancreatic Cancer

🌿 HOLISTIC

💊 CONVENTIONAL

🌿

Holistic / Functional Approach

Nutritional support alongside conventional treatment. Cachexia, the loss of weight and muscle, is common in pancreatic cancer and worsens outcomes.

Nutrition Priority

Aggressive nutritional support, because sarcopenia and cachexia are common and worsen outcomes

Pancreatic Enzymes

Pancreatic enzyme replacement therapy (PERT) essential, improves digestion, weight, treatment tolerance

Prevention

Smoking cessation, weight management, treat diabetes/chronic pancreatitis

Palliative Integration

Early palliative care improves quality of life and possibly survival¹⁰

Full Holistic Approach Includes

Pancreatic Enzyme Replacement Therapy (PERT): prescription enzyme capsules, taken with every meal and snack. Most pancreatic cancer patients are enzyme deficient, and PERT improves fat absorption, weight maintenance and treatment tolerance.
Aggressive nutritional support: about 0.5 to 0.7 g of protein per pound (1.2 to 1.5 g/kg); adequate calories, about 16 to 18 kcal per pound (35 to 40 kcal/kg); small frequent meals; a dietitian on the care team if weight falls, who may add a protein supplement
Address malabsorption: fat-soluble vitamin replacement (A, D, E, K), measure and replace
Diabetes management: most patients have or develop diabetes; coordinate with endocrinology
Smoking cessation: the best-established way to lower risk; improves treatment tolerance after diagnosis
Correcting low vitamin D: deficiency is common in pancreatic cancer and may affect prognosis
Omega-⁠3 supplementation: sometimes used for cachexia, though a Cochrane review found insufficient evidence that it beats placebo¹¹
Curcumin: anti-inflammatory; human evidence is one small uncontrolled trial and no randomized trial has shown benefit¹²; discuss with your oncologist before taking it
Vitamin K2: pancreatic cancer makes blood clots much more likely, and treatment to prevent them is often needed. Because of that, do not start or stop a K2 supplement without clearing it with the clinician managing your anticoagulation
Address depression aggressively: common; improves quality of life and treatment adherence
Address pain; a celiac plexus block can be life-changing for retroperitoneal pain
Early palliative care, integrated alongside oncology, improves quality of life and mood; not just end-of-life
Family genetic screening if hereditary mutation identified

✅ Pancreatic Enzymes Are Critical:¹³ The large majority of pancreatic cancer patients develop exocrine pancreatic insufficiency. PERT with every meal and snack improves digestion, weight maintenance and treatment tolerance. Most patients are underdosed. Work with your oncology team to optimize.

💊

Conventional / Oncologic Approach

Surgery + chemotherapy stratified by stage. PARP inhibitors for BRCA carriers. Neoadjuvant approach increasingly used.

Resectable

Whipple or distal pancreatectomy + adjuvant FOLFIRINOX (modified) or gemcitabine + capecitabine

Borderline / Locally Advanced

Neoadjuvant FOLFIRINOX or gem/nab-paclitaxel ± radiation, then attempt resection

Metastatic

FOLFIRINOX (good performance status) or gemcitabine + nab-paclitaxel; sequential lines

BRCA1/2+

Olaparib (PARP inhibitor) maintenance after platinum response¹⁴; longer progression-free survival, with no significant overall survival benefit¹⁵

Conventional Approach Includes

Whipple Procedure (Pancreaticoduodenectomy): for tumors in pancreatic head. Major surgery, best done at high-volume centers (significantly better outcomes).
Distal pancreatectomy: for body/tail tumors. Often combined with splenectomy.
Adjuvant FOLFIRINOX (modified): standard of care if performance status allows (PRODIGE-⁠24 trial). Significant improvement in disease-free survival.
Adjuvant gemcitabine + capecitabine: alternative if FOLFIRINOX not tolerated
Neoadjuvant chemotherapy: increasingly used; allows downstaging, identifies aggressive tumors before surgery, ensures all patients get systemic treatment
FOLFIRINOX (metastatic): 5-⁠FU + leucovorin + irinotecan + oxaliplatin. Most active regimen but toxic. Reserved for good performance status patients.
Gemcitabine + nab-paclitaxel: alternative first-line for metastatic; better tolerated
Olaparib maintenance: for BRCA-mutated patients responding to platinum (POLO trial)
Pembrolizumab: for microsatellite instability-high (MSI-H) cases, which are rare⁹
NALIRIFOX: new first-line option (NAPOLI 3 trial), liposomal irinotecan + 5-⁠FU + oxaliplatin
Biliary stenting: for obstructive jaundice, endoscopic or percutaneous
Celiac plexus block: for retroperitoneal pain, significantly improves quality of life
Clinical trial enrollment: strongly encouraged for all patients

⚠️ High-Volume Centers Matter: Pancreatic surgery outcomes vary substantially by surgeon and hospital volume. In the landmark national analysis, mortality after pancreatic resection was 3.8% at the highest-volume hospitals against 16.3% at the lowest¹⁶. Strongly consider referral to a specialized center.

Supplement Protocol

Evidence-Based Supplements for Pancreatic Cancer

Pancreatic enzymes come first, and they are a prescription medicine rather than a supplement. Coordinate with oncology, because many supplements interact with chemotherapy.

Supplement	What it is for	Typical range	Timing	Notes & cautions
Pancreatic Enzymes (PERT)	Essential for most patients, who are deficient. Improves digestion, absorption, weight, energy, treatment tolerance.	40,000 to 80,000 USP lipase units per meal; about half that with snacks (such as 25,000)	With every meal and snack	By prescription; products differ in lipase per capsule, so the dose is matched to the product. If you can't swallow a capsule, open it onto a little soft, acidic food such as applesauce and swallow at once without chewing¹⁷. Doses often underestimated.
Fat-Soluble Vitamins (A, D, E, K)	Deficiency is common in pancreatic exocrine insufficiency. Test and replace.	Multivitamin + vitamin D at a dose set with your clinician + K2 200 mcg	With fat meal + PERT	Test D level. Measure A and E levels if symptomatic. If you take warfarin, clear any vitamin K supplement with the clinician managing your anticoagulation before starting or stopping it: vitamin K antagonizes warfarin, and changing your intake destabilizes the INR. Consistency matters more than avoidance. This does not apply in the same way to direct oral anticoagulants such as apixaban or rivaroxaban, but tell your prescriber about any supplement you take.
Omega-⁠3 (EPA/DHA)	Sometimes used for cachexia, but a Cochrane review found insufficient evidence that it beats placebo¹¹.	Not recommended for cancer cachexia (a review of five trials found no clear benefit over placebo)	Not applicable	Discuss with oncologist; some interactions with chemo. If you take a blood thinner, tell the clinician managing it about any fish oil: at high doses fish oil can have antiplatelet effects and may change clotting test results, so they may be checked more often¹⁸. In heart trials, fish oil supplements raised the risk of atrial fibrillation, an irregular heartbeat, more so above 1 g a day¹⁹, so check this dose with your clinician first.
Curcumin	Anti-inflammatory. Human evidence in pancreatic cancer is very thin: in a phase II trial of 25 patients on 8 g/day, 2 showed biological activity and 1 had brief tumor regression. Poorly absorbed, and not shown to help pancreatic cancer: no randomized trial has shown benefit.¹²	500 to 1,500 mg/day	With fat meal	Discuss timing with oncologist. If you take a blood thinner, ask first, as turmeric may increase bleeding risk; bioavailable forms have been linked to liver damage, so stop and seek advice if you notice dark urine or yellowing skin or eyes²⁰.
Vitamin D3	Deficiency is common. Possibly affects prognosis.	Test 25-⁠OH-D first and set the dose with your clinician²¹	With fat meal + PERT	Higher doses often needed due to malabsorption. Retest at 3 months.
MCT Oil (Medium-Chain Triglycerides)	Absorbs without pancreatic lipase, calorie source that bypasses enzyme deficiency.	1 to 3 tablespoons/day	Throughout day	Start low to avoid GI upset. Add to smoothies, coffee.
Glutamine	May reduce chemo-induced mucositis and neuropathy; evidence is mixed.	10 to 30 g/day during chemo	Divided doses	Some controversy; discuss with oncologist.

References & Evidence Notes

Each numbered entry below is either a source you can follow or a note setting out what the evidence does and does not support. Both are numbered together so the markers in the text line up.

Last reviewed October 20, 2026. Supplement entries are cross-checked against the NIH National Center for Complementary and Integrative Health and the Linus Pauling Institute Micronutrient Information Center.²⁴ Nothing on this page treats pancreatic cancer. The nutrition here is supportive care, and on this page that is not a small thing: sarcopenia and cachexia are a leading cause of death in pancreatic cancer, so maintaining weight and muscle genuinely affects how well treatment is tolerated. The single most useful item here is pancreatic enzyme replacement therapy, which is a prescription and is routinely under-dosed. None of it substitutes for surgery, chemotherapy or radiation therapy, and no dietary change should delay treatment. Tell your oncology team about every supplement. Two further things worth knowing: this cancer should be managed at a high-volume center, and clinical trial enrollment is worth asking about at every stage. Several supplements interact with cancer treatment.

SEER (National Cancer Institute) pancreatic cancer statistics. seer.cancer.gov. Source for the estimate of 67,530 new US cases in 2026, the overall 5-⁠year relative survival of 13.7% for 2016 to 2022, the share that is pancreatic ductal adenocarcinoma, and the stage distribution at diagnosis. The pooled survival figure is dominated by late presentation and is not an individual prognosis. ↩
On resectability: the US National Cancer Institute's clinician summary states that approximately 20% of patients present with pancreatic cancer that can be removed surgically, NCI, pancreatic cancer treatment, health professional version. ↩
On risk factors: the US National Cancer Institute calls smoking a major risk factor, with smokers significantly more likely to develop pancreatic cancer, and lists obesity (a body mass index of 30 or higher), diabetes, chronic pancreatitis, heavy drinking, a first-degree relative with pancreatic cancer, inherited syndromes including those caused by BRCA1, BRCA2, PALB2, ATM, CDKN2A and the Lynch syndrome genes, and age, with nearly two-thirds of people diagnosed at 65 or older. Up to 10% of pancreatic cancers are linked to inherited syndromes, newly diagnosed diabetes can be a symptom, and screening may be available to people at high risk. Nothing reliably prevents it, but quitting smoking, limiting alcohol and keeping a healthy weight lower the risk, NCI, pancreatic cancer causes and risk factors. ↩
On chemotherapy after surgery: in a randomized trial of 493 people who had their pancreatic cancer removed, given 24 weeks of chemotherapy afterward, 43.2% of those on a four-drug regimen and 31.4% of those on a single drug were alive at five years. That is a comparison between two chemotherapy regimens, PubMed 36048453. ↩
On metastatic survival: in the trial that established FOLFIRINOX for metastatic pancreatic cancer in patients with good performance status, median overall survival was 11.1 months, against 6.8 months with gemcitabine, PubMed 21561347. ↩
On the 2030 projection: Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM. Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014;74(11):2913-⁠2921. PubMed 24840647. Projecting from changing demographics and recent trends in incidence and death rates, it found lung cancer would remain the top cancer killer and pancreatic cancer would pass breast, prostate and colorectal cancer to become the second leading cause of cancer death in the US by 2030. It is a projection, not a count. ↩
On symptoms, risk and treatment: NHS guidance lists yellowing of the skin or eyes, often with itchy skin, darker urine and paler stools, as a reason for an urgent same-day appointment. It advises losing weight if overweight, cutting down on alcohol and stopping smoking, and getting any symptoms checked whatever your level of risk. Treatment may include surgery to remove the cancer, procedures to unblock the bile duct, chemotherapy before or after surgery or with radiation therapy, and supportive care including enzyme replacement to help digest food. Where the cancer cannot be removed, treatment aims to limit it and its symptoms and help people live longer, with a palliative care team, NHS, pancreatic cancer treatment, NHS, pancreatic cancer symptoms. ↩
On CA 19-⁠9: reported sensitivity varies widely between studies and is lowest in early-stage disease, which is the reason it is not a screening test. Biliary obstruction and benign disease raise it, and a minority of people cannot express it at all because they lack the Lewis antigen. The figure of "around 80%" that circulates for this marker is unreliable: the studies that report it are often measuring specificity, or sensitivity in advanced disease, rather than the proportion of all pancreatic cancers that are marker-positive. It is used for monitoring response and recurrence. ↩
On molecular testing: KRAS mutations are present in over 90% of pancreatic ductal adenocarcinomas, PubMed 42635442, with TP53, CDKN2A and SMAD4 also common. Germline BRCA1/2 and PALB2 testing matters because it changes treatment, and microsatellite-instability-high tumors (roughly 1 to 2%) may respond to pembrolizumab. ↩
On early palliative care: integrating palliative care alongside oncology treatment improves quality of life and mood, and in some trials survival, without shortening it. It is not end-of-life care and asking for it early is not giving up. ↩
On omega-⁠3 for cancer cachexia: a Cochrane review of five trials with 587 patients found insufficient data to establish whether oral EPA was better than placebo, and no evidence that adding it to nutritional supplements improved cachexia symptoms, PubMed 17253515. ↩
On curcumin in pancreatic cancer: Dhillon N, et al. Phase II trial of curcumin in patients with advanced pancreatic cancer. Clin Cancer Res. 2008;14(14):4491-⁠4499. PubMed 18628464. Twenty-five patients on 8 g/day: two showed clinical biological activity and one had a brief but marked tumor regression. Oral bioavailability was very poor. This is a signal worth studying, not a treatment. No randomized trial has shown benefit in pancreatic cancer. ↩
On pancreatic enzyme replacement therapy: exocrine pancreatic insufficiency affects the large majority of patients with pancreatic cancer, and PERT improves fat absorption, weight maintenance and treatment tolerance. Typical dosing is 40,000 to 80,000 USP lipase units with meals and about half that with snacks, taken through the meal rather than before it. Under-dosing is the usual error. Several prescription enzyme products are available in the US; lipase content per capsule differs between them, and the dose has to be matched to the product. ↩
POLO trial: Golan T, et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer. N Engl J Med. 2019;381:317-⁠327. Basis for PARP inhibitor maintenance after platinum-based chemotherapy in germline BRCA-mutated disease. ↩
On olaparib overall survival: final POLO results in 154 patients with germline BRCA-mutated metastatic pancreatic cancer showed no statistically significant overall survival benefit, although olaparib delayed the need for further chemotherapy, PubMed 35834777. ↩
On resectability and surgical outcomes: roughly 15 to 20% of patients are reported to present with resectable disease, and 5-⁠year survival after resection with adjuvant chemotherapy is substantially better than for unresectable disease. Whipple mortality is consistently lower at high-volume centers, one of the better-replicated findings in surgical oncology; in the landmark national analysis, pancreatic resection showed the largest volume effect of any operation studied, 16.3% mortality at the lowest-volume hospitals against 3.8% at the highest, PubMed 11948273. This is a reason to ask where an operation will be done, not a reason to delay it. ↩
On taking enzyme capsules when you cannot swallow them: MedlinePlus advises that the delayed-release capsules can be opened and the contents mixed with a small amount of a soft, acidic food such as applesauce, and that the mixture be swallowed right after mixing without chewing or crushing the contents, followed by a full glass of water or juice, MedlinePlus, pancrelipase. ↩
On omega-⁠3 and blood thinners: NIH guidance notes that fish oil can have antiplatelet effects at high doses and might prolong clotting times with a vitamin K antagonist anticoagulant, although most research finds 3 to 6 g a day does not significantly change anticoagulant control and a review found no rise in clinically significant bleeding; people taking an anticoagulant should have their clotting tests monitored, NIH Office of Dietary Supplements, omega-⁠3 fatty acids. ↩
Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine omega-⁠3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144(25):1981-⁠1990. PubMed 34612056. Seven trials with 81,210 people followed for about 5 years: omega-⁠3 supplements were linked to a higher risk of atrial fibrillation (hazard ratio 1.25), more so in trials of more than 1 g a day (1.49), and the risk rose with each additional gram. ↩
On turmeric and curcumin safety: a cancer center's herb database lists an increased risk of bleeding with blood thinners, based on laboratory studies and a case report, Memorial Sloan Kettering, turmeric. NIH reviewers add that highly bioavailable curcumin formulations may harm the liver, and advise stopping and seeking advice at signs such as fatigue, nausea, poor appetite, dark urine or jaundice, NCCIH, turmeric. ↩
On vitamin D dosing: the adult tolerable upper intake level is 4,000 IU/day, so test 25-⁠OH-D first and set the dose with a clinician. Vitamin D deficiency is near-universal in pancreatic cancer and correcting it is reasonable; self-directed high-dose supplementation is not. ↩
On blood clots: NHS guidance advises an urgent same-day appointment for suspected deep vein thrombosis, with pain and swelling in the leg, and calling emergency services if those symptoms come with breathlessness or chest pain, because a clot can travel to the lungs, NHS, deep vein thrombosis. ↩
On fever and clots during chemotherapy: NHS guidance says to call your care team right away for a high temperature, feeling hot, cold, sweaty or shivery, or other signs of infection, and for throbbing or cramping pain, swelling and warmth in a leg or arm, or sudden breathlessness and sharp chest pain, which can be signs of a blood clot. The US National Cancer Institute lists a fever of 100.5°F (38°C) or higher as a sign of infection and says infections during cancer treatment can be life-threatening and need urgent medical attention, NHS, chemotherapy side effects, NCI, infection during cancer treatment. ↩
National Center for Complementary and Integrative Health (NIH), nccih.nih.gov, and the Linus Pauling Institute Micronutrient Information Center, lpi.oregonstate.edu/mic. ↩

Symptom	What happens
Key Warning Signs
Painless Jaundice	Yellow eyes/skin, dark urine, pale stools, itching. Tumor at pancreatic head obstructs common bile duct. Often the presenting feature in resectable disease. URGENT evaluation.
Unexplained Weight Loss	Significant unintentional weight loss of 10 lb (4.5 kg) or more. Often accompanied by reduced appetite, early satiety, taste changes.
New-Onset Diabetes (After 50)	Increasingly recognized: new diabetes after 50, especially with weight loss, may precede pancreatic cancer diagnosis by 1 to 3 years. A risk score (ENDPAC) can help a clinician decide who needs imaging.
Upper Abdominal / Back Pain	Persistent dull ache in epigastric area radiating to back. Worse lying flat, better leaning forward. Often progressive. Indicates tumor invading retroperitoneal nerves.
Additional Symptoms
Steatorrhea (Fatty Stools)	Pale, greasy, foul-smelling, floating stools. Indicates pancreatic enzyme insufficiency from tumor blocking duct. Often accompanies weight loss.
Nausea, Vomiting, Early Satiety	Especially with tumor in head/body. May cause gastric outlet obstruction. Feeling full after small meals. Persistent nausea unexplained.
Blood Clots (DVT, PE)	Pancreatic cancer makes blood clots much more likely (Trousseau's syndrome). Unexplained clots in a leg vein (deep vein thrombosis, DVT) or in the lung (pulmonary embolism, PE), especially "migrating" clots, may be the presenting feature.
Depression & Profound Fatigue	New-onset depression is sometimes a paraneoplastic phenomenon preceding pancreatic cancer diagnosis. Combined with weight loss, raises suspicion.

Cause	How It Contributes to Pancreatic Cancer	What Helps
Smoking	A major risk factor: smokers are significantly more likely to develop pancreatic cancer, as chemicals in tobacco smoke damage the DNA of pancreatic cells³	Stopping smoking, at any stage, as the diet section urges
Excess weight	Obesity, a body mass index of 30 or higher, is linked to a higher risk through changes in metabolism and insulin levels³	Before any diagnosis, losing weight if overweight lowers risk⁷, as the prevention list in the treatment section says. After a diagnosis of pancreatic cancer, do not try to lose weight: keeping weight and muscle is the goal.
Diabetes	Long-standing diabetes raises the risk, and newly diagnosed diabetes can itself be a sign of pancreatic cancer³	Diabetes care with your clinician; new diabetes after 50 with weight loss needs prompt checks, as the symptoms section explains
Chronic pancreatitis and heavy drinking	Long-term inflammation damages pancreatic tissue, and heavy drinking can lead to chronic pancreatitis³	Cutting down on alcohol⁷, and avoiding it during treatment, as the diet section advises
Family history and inherited syndromes	A parent or sibling with pancreatic cancer, or syndromes linked to genes such as BRCA1, BRCA2, PALB2 and ATM or to Lynch syndrome; up to 10% of cases are inherited³	Genetic counseling and testing, which the diagnosis section describes; screening may be available to people at high risk³
Age	Risk rises with age, and nearly two-thirds of people are diagnosed at 65 or older³	Age cannot be changed; get new symptoms checked promptly whatever your age⁷

Test	What it shows
Imaging & Biopsy
Pancreas-Protocol CT	Multiphasic CT with pancreatic protocol. Identifies tumor, assesses vascular involvement (defines resectability), detects metastases. First-line imaging.
MRI / MRCP	Better for cystic lesions, liver metastases. MRCP, a type of MRI scan, shows the pancreatic and bile ducts. Adjunct to CT.
EUS-Guided Biopsy	Endoscopic ultrasound (EUS), a scope with an ultrasound probe, used to take a fine-needle sample. Most accurate biopsy method. Tissue for diagnosis + molecular testing.
ERCP (When Jaundiced)	A scope passed through the mouth into the bile duct (ERCP), for biliary stent placement to relieve obstructive jaundice + brush cytology. Therapeutic + diagnostic.
Molecular & Lab Workup
CA 19-⁠9 (Tumor Marker)	Raised in many pancreatic cancers, but reported sensitivity varies widely and is lowest in early disease.⁸ Not a screening test (false positives common with biliary obstruction). Used for monitoring response and recurrence.
Germline Genetic Testing	NCCN recommends that all pancreatic cancer patients get germline testing. BRCA1/2, PALB2, ATM, Lynch syndrome, implications for treatment (PARP inhibitor drugs, PARPi) and family screening.
Somatic Testing	KRAS (95%), TP53, CDKN2A, SMAD4.⁹ Identifies actionable mutations: BRCA1/2 (PARPi), microsatellite instability (immunotherapy), KRAS G12C (sotorasib trials).
Staging Laparoscopy	For "resectable" disease, checks for peritoneal metastases not visible on imaging. Avoids futile laparotomy.

What to eat or do	Details
✅ Prioritize:
High Protein at Every Meal	Eggs, fatty fish, poultry, dairy, legumes. At least 0.5 to 0.7 g per pound (1.2 to 1.5 g/kg) a day. Take pancreatic enzymes with every protein-containing meal.
Easily Digestible Foods	Eggs, fatty fish, well-cooked vegetables, smoothies. Avoid very high-fiber foods if causing GI distress.
Healthy Fats (with PERT)	Olive oil, avocado, fatty fish. Need calorie-dense food + pancreatic enzymes to absorb. MCT oil bypasses pancreatic lipase needs.
Small Frequent Meals	5 to 6 small meals/day vs 3 large. Better tolerance, improved absorption with enzymes, prevents nausea.
Adequate Hydration	Diarrhea common (from disease and chemo). Track intake. Electrolyte solutions if losing significant volume.
❌ Avoid:
Smoking	A major risk factor for pancreatic cancer³. Continuing to smoke after diagnosis worsens treatment response. Quitting at any time helps.
Alcohol	Heavy use causes chronic pancreatitis → cancer risk. During treatment, abstain; alcohol affects the liver, drug metabolism and healing.
High-Fat Meals Without Enzymes	Cause diarrhea, steatorrhea, weight loss. Always take pancreatic enzymes (PERT) with fatty meals. MCT oil better tolerated.
Heavily Processed Foods	Low nutrient density. Spend caloric intake on nutrient-dense foods that support recovery. If you are losing weight, ask your care team for a nutrition plan.
Raw Foods (During Chemo)	During chemo-induced neutropenia: avoid raw sushi, raw eggs, unpasteurized dairy, raw sprouts. Infection risk.

Pancreatic Cancer

What Is Pancreatic Cancer?

Stages by Resectability

Resectable (~15 to 20%)

Borderline Resectable / Locally Advanced (~30%)

Metastatic (~50%)