Of all the cancer cases in the U.S., about 3 in 100 will be pancreatic cancer. In 2026, an estimated 67,530 Americans will be diagnosed with this condition. Researchers are continuously on the lookout for better ways to diagnose and treat this type of cancer.
In a WebMD Reddit AMA about living with pancreatic cancer, doctor and researcher Andrew Hendifar, MD, discussed a variety of topics, from prevention and treatment expectations to tips for living better with this condition.
Hendifar, a professor who leads the Gastrointestinal Oncology Disease Research Group at Cedars-Sinai in Los Angeles, offers insight into some of the questions asked during the Reddit AMA.
The answers have been lightly edited for length and clarity.
For folks who may have a higher risk of developing pancreatic cancer, is there anything to help prevent it?
Hendifar: I would connect with any group that screens high-risk patients for pancreatic cancer. They can assess your risk and, if necessary, start a program of scans and scopes. High-risk screening is a concern, but how we define high-risk is not always clear. High-risk patients should be seen by a physician and a screening program initiated when appropriate.
What can be done to make sure that people are diagnosed with enough time to get the treatment?
Hendifar: Weight loss is a huge early sign. Increased blood sugar or worsening of diabetes is a red flag. Pain means you have to be scanned immediately. A big problem is that we're too tough and ignore things — especially weight loss — because we are always trying to lose weight.
How accurate is the CA 19-9 blood test for pancreatic cancer?
Hendifar: This is a tough one. If the marker is elevated and you're sure it's from the tumor and not a biliary obstruction, it's a rough estimate. Sometimes, it's less accurate than other times, depending on tumor biology changes with time. Generally, it's a good idea to check it and use it to help make decisions regarding your treatment. Some patients don't produce a CA 19-9 (up to 20%).
What's the chance of survival if pancreatic cancer is found in stage II?
Hendifar: It's good! That's an early stage. The problem with staging using a scan is that the scan isn't too accurate. If this is pathologic staging, that's more precise.
People diagnosed today have treatment options we only dreamed about a few years ago.
What's the outlook for stage III vs. stage IV pancreatic cancer?
Hendifar: Staging from scans is not super accurate. That's why it's hard to say. Nonetheless, if your scans don't show evidence of cancer and markers are normal or improving, that's good. The medicines and approaches for the stages aren't dramatically different.
What's your approach to treating people with stage IV pancreatic cancer after a good response to treatment?
Hendifar: Active surveillance after a good response to treatment or continuing with treatment are both perfectly acceptable, and I would follow your oncologist's lead. I wouldn't change treatments if the plan is to enroll in suitable trials. We usually shy away from surgery for oligometastatic disease unless you have a team of experts.
Have you treated ascites — the buildup of fluid in the abdomen — in any patients successfully?
Hendifar: This is tough. Ascites has been a research subject of mine. About 90% of the time, the fluid has a high SAAG (serum-ascites albumin gradient). This means the fluid is from a blocked pipe (portal vein or superior mesenteric vein) rather than direct spread of cancer cells into the abdominal lining. If the fluid looks almost like a beer and the SAAG is greater than 1.1, I'd recommend trying a diuretic or combination like Lasix and Aldactone. Please discuss with your oncologist, and they'll know what I mean.
Is it normal for people to have digestive problems and fatigue years after a Whipple procedure?
Hendifar: Yes. Whipple survivors are all warriors — It's a lifelong battle. Please make sure you're taking pancreatic enzyme supplementation. Check to make sure you're not vitamin-deficient and take a good multivitamin. Please seek the advice of a dietitian who knows how to care for pancreatic cancer patients who have had a surgery.
For people who want to concentrate on keeping comfortable for as long as possible instead of prioritizing living as long as possible, how would that change the recommended treatment?
Hendifar: This is a reasonable decision. Usually, my recommendation for this scenario is single-agent gemcitabine. You could try the new medication daraxonrasib (Rasonque), as it's very effective but it requires TLC to care for the rash. I would say that if pain is your biggest issue, daraxonrasib will shrink the tumor best and afford pain control.
What are your top tips for living well with pancreatic cancer?
Hendifar: I think living well means coming to terms with a difficult disease and living your best life. Maybe take time to be with family and friends. Take a trip you've been meaning to take.
Overall, I always recommend exercise as the best nonmedicinal way to combat cancer. Research shows that movement can help support the immune system, reduce inflammation, and build muscle. This leads to better response to treatments and helps you fight off the cancer.
Show Sources
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SOURCES:
Andrew Hendifar, MD, researcher, professor; medical director, Gastrointestinal Oncology Disease Research Group, Cedars-Sinai, Los Angeles.
Hirshberg Foundation for Pancreatic Cancer Research: "Pancreatic Cancer Facts."
American Cancer Society: "Key Statistics for Pancreatic Cancer," "What's New in Pancreatic Cancer Research?"
