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PANCREATIC CANCER

Metastatic Pancreatic Cancer Support

Information can lead to different roads.

Find information, practical resources, and personal support for metastatic, Stage IV, or advanced pancreatic cancer.

Palliative care, hospice care, advance care planning, end-of-life planning, or help starting a difficult conversation.
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When pancreatic cancer spreads

Pancreatic cancer is not one single disease. Pancreatic ductal adenocarcinoma (PDAC), pancreatic neuroendocrine tumors, acinar cancers and other rare subtypes can require very different Roads. For pancreatic adenocarcinoma, resectability, prior surgery, performance status, germline genetics, tumor sequencing, RAS biology, and exactly where the cancer has spread can all change what may be worth exploring next.

START WITH OPTIONS

What would help you today?

You do not have to know the right words or have everything figured out. Choose the thing that feels biggest right now. RoadMap will help with that first—and you can always explore another Road.

RoadMap is about OPTIONS. Medical. Emotional. Financial. Practical. Access. Support. Sometimes the next Road is another treatment. Sometimes it is another expert, an appeal, a resource—or another person who understands.
MY ROADS

You told us what you need. Let’s work through it together.

You do not have to solve everything at once. Start with whichever feels most important today. When you finish one Road, come back here and choose another.

Want to look at the whole picture?

The Complete RoadMap is still here when you want a broader medical review. It is optional—you do not have to complete it to get help with the Roads you selected.

START WITH WHAT YOU NEED

Let RoadMap help with what you chose.

You do not have to complete the medical questionnaire first. For this question, you can ask in your own words or show RoadMap a relevant report, scan result, lab, pathology result, or portal screenshot. If more detail would truly change the answer, RoadMap can tell you what it needs next.

A clear photo or screenshot is fine. RoadMap will first identify what kind of document it appears to be, then explain what matters for the question you chose.

YOUR CANCER

What kind of pancreatic cancer are you navigating?

Ronnie’s RoadMap starts with the diagnosis and anatomy because treatment is very different for pancreatic adenocarcinoma, pancreatic neuroendocrine tumors, and rarer pancreatic cancers.

GENETICS & TUMOR BIOLOGY

What testing has been completed?

Ronnie separated inherited testing from tumor testing for a reason. Pancreatic cancer can reveal inherited risk, and tumor sequencing can uncover uncommon but very important treatment Roads.

One lab number should never drive the whole Road. CA 19-9 can be useful for trends in some patients, but it can be affected by biliary obstruction and some people do not produce it reliably.
WHERE THINGS ARE NOW

Where has the cancer been found?

Ronnie’s navigation work deliberately maps each metastatic site. Limited disease in one organ may deserve a different multidisciplinary discussion than widespread progression.

Local treatment is not automatically appropriate in metastatic pancreatic cancer. But when disease is limited or behaving differently in one site, a multidisciplinary review can ask whether surgery, SBRT, ablation, or another procedure has a role alongside systemic therapy.
TREATMENT HISTORY

What treatment has already been tried?

The next Road depends heavily on what was used first, what worked, what stopped working, and what toxicity made difficult.

CURRENT OPTIONS

What treatment Roads deserve a fresh look?

UPDATED THROUGH SEPTEMBER 2026

This page preserves Ronnie’s guideline-based structure and adds major public FDA/NCI updates so a patient can ask about current possibilities without assuming one treatment fits everyone.

Major 2026 update: Daraxonrasib (Rasonque), an oral RAS inhibitor, was FDA-approved August 26, 2026 for adults with metastatic pancreatic adenocarcinoma who have received at least one prior systemic therapy or are not candidates for multiagent systemic therapy.
Other important current Roads: NALIRIFOX is an FDA-approved first-line regimen for metastatic pancreatic adenocarcinoma. Zenocutuzumab is FDA-approved for previously treated NRG1-fusion pancreatic adenocarcinoma. Tumor-agnostic options may apply to uncommon MSI-H/dMMR, NTRK, or HER2 IHC3+ disease when labeling criteria are met.
YOUR TEAM, SYMPTOMS & TRIAL DETAILS

Who is reviewing the full picture?

Optional details that can improve TrialMagic matching

BUILD MY TREATMENT TEAM

Who should be looking at your cancer?

You do not need every specialist. RoadMap can help identify who may belong in the conversation based on your cancer, where it is, and the decisions in front of you.

Your oncologist does not have to be your entire treatment team. RoadMap is not replacing your doctor. It helps you ask whether another specialist or multidisciplinary review could add an option, perspective, or expertise worth discussing.
GET A SECOND OPINION

What do you want another expert to help decide?

A useful second opinion is not just another doctor saying yes or no. RoadMap can help you match the question to the right expertise, prepare the records, and find a place to start.

You do not have to change doctors to get a second opinion. A second opinion can confirm the plan, suggest another approach, or identify a question that deserves another specialty review.
GENETIC & BIOMARKER TESTING

What would you like help understanding?

You do not need to know the difference before you start. RoadMap will keep inherited genetic (germline) testing separate from tumor biomarker/genomic testing, because they answer different questions and use different resources.

Two kinds of testing can both matter. Genetic (germline) testing looks for inherited changes that may matter to you and your family. Biomarker or tumor testing looks at characteristics of the cancer that may help guide treatment or clinical-trial discussions. You do not have to know which one you need before asking for help.
YOUR SUPPORT ROADMAP

What would make today a little easier?

You do not need to complete a medical questionnaire to ask for help.

FINANCIAL HELP

What is creating the most financial pressure?

Choose anything that is making cancer harder financially. We’ll use this to point you toward the right kind of help.

EMOTIONAL SUPPORT

What feels heaviest emotionally?

INSURANCE & ACCESS

What kind of access problem are you facing?

PATIENT-OWNED APPEAL ROADMAP

Show us exactly why they said no.

Start with the denial. RoadMap will help organize their words → their rules → the contradiction → your evidence → the right peer → precedent → urgency → your story. You stay at the center of the appeal; your medical team supplies the clinical evidence and peer-to-peer expertise.

Prototype: this keeps the document with your preparation workflow; the final RoadMap engine can extract the denial language and referenced policy.

What does your own plan say?

Who made this decision?

Does this need to move fast?

What evidence defeats this denial?

Build to the denial. The packet can be 20 pages or 200 pages. Include documentation because it proves a point in this case—not because every appeal needs the same attachments.

Show them who you are.

Optional. A reviewer needs the medical evidence, but in some settings it can matter that the person behind the case becomes visible.

Where should the appeal go?

PRACTICAL HELP

What is getting in the way of everyday life or treatment?

Choose the actual problem. RoadMap will give you a starting plan for that problem—not just another referral.

SYMPTOMS & SIDE EFFECTS

What is making daily life harder?

Choose what is happening. RoadMap will give you practical ideas you can use today, what to track, and when to call your medical team.

FAMILY & CAREGIVER

Who else needs support?

THE DIFFICULT CONVERSATIONS

What do you want clear information about?

These are different kinds of care and planning. Choose what you need. RoadMap will explain it and take you directly to help.

HELP US POINT YOU SOMEWHERE REAL

Where are you looking for help?

Optional—but a ZIP code or city/state helps RoadMap point you toward local programs instead of saying “look for local resources.”

MY ROADS

Let’s take these one at a time.

Start with the one that feels biggest today. Your other choices will still be here when you come back.

More than one problem is normal. You do not have to solve all of this today. Work one Road, come back, then choose the next.
YOUR NEXT ROAD

Here is what to do next.

Direct information first—then the next useful step.

YOUR PERSONAL ROADMAP

Here are OPTIONS worth exploring.

This is an organizing guide—not a treatment recommendation. Your care team knows the medical details RoadMap cannot see.

What You Told Us

    What Looks Important Right Now

      Information You May Still Need

        People Who May Belong in the Conversation

          Possibilities to Discuss

            Questions Worth Asking

              Where You Can Go Next

              These resources are matched to what you selected. Programs, funding and eligibility can change, so check current availability.

              Your YES Connections

              Important: RoadMap is educational and does not diagnose cancer, determine eligibility, or recommend a specific treatment. Options depend on pathology, scans, prior treatment, organ function, overall health, goals, and expert review. New or rapidly worsening symptoms may require urgent medical attention.

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