Coming to Terms With Your Pancreatic Cancer Prognosis

Written by Abby McCoy, RN
Medically Reviewed by Laura J. Martin, MD on June 24, 2026

Pancreatic cancer survival rates have almost tripled in the past few decades, but getting a diagnosis can still feel overwhelming and scary. And the statistics you see online, especially for late-stage pancreatic cancer (stages III and IV), can make this disease look tough to beat.

Stage III pancreatic cancer prognosis is worse than earlier stages because cancer cells have spread to your lymph nodes (small filters that remove waste) or blood vessels. Stage IV means it has spread to other organs, like your liver.

A prognosis is an estimate that tells you how likely you are to recover based on how much time people usually live after their diagnosis. Higher cancer stages often mean a worse prognosis.

When your oncologist gives you a stage III or IV pancreatic cancer diagnosis, you might feel shocked, scared, helpless, or angry. In December 2023, Mark Ruegg was diagnosed with stage IV pancreatic cancer in Los Angeles, California. “At that initial meeting with that oncologist, I mean, I was in shock,” Ruegg says. 

He asked his oncologist what his diagnosis meant. “And he looks at me and he says, it means you have about four to six months to live. And it was probably the biggest gut punch that I have ever received in my life.”

Dana Stone, who lives in Wheeler, Oregon, got her stage IV diagnosis in November 2023, right after Thanksgiving. She describes feeling frozen with fear, her mind running wild. “I panicked,” Stone says.

Patricia Andrews says she didn’t cry at first when she got her stage IV pancreatic cancer diagnosis in January 2024 in Orange County, California. “I got quiet and started thinking about what needed to happen next.”

There is no right or wrong way to react to a pancreatic cancer diagnosis and prognosis. But once you accept what’s happening in your body, you can fight it better, and with less stress.

Getting a pancreatic cancer diagnosis, especially one with a serious prognosis, is one of the most difficult experiences anyone can face, says Kevin Liu, MD, a palliative medicine specialist with Cleveland Clinic in Ohio. 

“Your instinct can be flight, fight, or freeze, and it is normal and completely human to feel anger, sadness, or want to bargain or to believe we made a terrible, cruel mistake,” Liu says.

But what does it mean to accept your diagnosis?

“For me, acceptance doesn't mean giving up or assuming the worst outcome is inevitable,” Andrews says. “It means understanding the reality of the diagnosis while continuing to live your life. I understand the statistics, but I don't spend my days thinking about dying.”

After two years of treatment, on a roller coaster of good and bad news, cancer spread (metastasis), and many "scary scans," Stone reached a place of acceptance. “I plan for the worst and hope for the best.” 

To Stone, acceptance means that she accepts the inevitability of dying. “I am not special. Some people live five minutes. I've had 62 years.”

Andrews tries not to brood about her prognosis. “Instead, I focus on what's in front of me,” Andrews says. “Life is still going on. I spend time with family and friends, I make plans and I keep moving forward. I'm not ready to die yet.”

Acceptance doesn’t mean giving up and waiting for the inevitable, Ruegg says. “I tell everybody, you can accept your diagnosis, but don't accept the prognosis because nobody knows. Your doctor doesn't know, nobody knows when that ticket is up.”

Research suggests that accepting your cancer diagnosis can decrease physical symptoms and increase your quality of life. And talking through everything with your health care team can help you get to acceptance faster. Honest, open conversations about the prognosis of the disease are a cornerstone in good cancer care, Liu says. 

“Rather than stripping away hope, our goal is to redirect hope toward achievable goals and focusing on a life lived by a patient’s terms built on comfort, dignity, and making sure every day counts in a way that reflects the values, wishes, and relationships that are important to our patients,” Liu says.

If you don’t accept your diagnosis, you can’t move forward, says Stone. “Cancer calls for radical acceptance of the self, with all its shadows, grief, shame, doubt, fear,” Stone says.

You can follow many paths to accepting your pancreatic cancer diagnosis and prognosis. Some people lean on friends and family, some rely on their health care team, and some join support groups and learn how others have accepted their diagnosis. 

Empower yourself with information

To start on the path to acceptance, it helps to understand your diagnosis better. You may not want to scour the internet for information on pancreatic cancer, which can look like a parade of gloom and doom. But it can be hard to know who to ask about it.

Fatima Zelada‑Arenas, the senior director of patient services at Pancreatic Cancer Action Network in Manhattan Beach, California, has talked to many people who have gotten a late-stage pancreatic cancer diagnosis. “One of the things that stands out to me about a lot of our interactions is that people are – a lot of times – still in shock,” Zelada‑Arenas says. “So when they contact us, they don't even really know what to ask or where to start.”

Even as a nurse who spent years helping other people navigate serious illnesses, Andrews craved more information about her diagnosis. “I found myself taking what felt like a crash course in oncology nursing against my will,” Andrews says. “I wanted information, I wanted a treatment plan, and I wanted to get started, preferably close to home.”

Ruegg’s cancer had spread to his liver and lymph nodes, but he had no idea what lymph was. “I always heard about it. But I had no idea until I started to understand it. Lymph is our body's detox system.” 

Once Ruegg understood what was happening in his body, he could not only accept it, but use that information to take self-care steps like eating a healthier diet and exercising more.

Find the right care team

Your cancer care team can include doctors, nurses, case managers, dietitians, chaplains, and many more. The right team will make space for easy communication, which can help you learn more about your illness and have a clear picture of the plan — two important aspects of acceptance. “One thing that helped me was trusting the people taking care of me,” Andrews says. 

“These are incredibly smart people who have devoted their careers to treating cancer,” Andrews says. “They have a tremendous amount of knowledge and experience, and they're working on your behalf because they want you to succeed.”

Once Andrews started treatment with her team, she felt more focused. “Instead of worrying about every possible outcome, I concentrated on the next step.”

Ruegg encourages people to change providers if they need to — that accepting your diagnosis doesn’t mean accepting the prognosis your first provider might give you. “There's an amazing medical team out there waiting to heal and help you,” Ruegg says.

The right care team will help you make treatment decisions that match your values and goals. “Choosing to receive treatment or forgo it is a highly personal choice, and there is no right or wrong,” Stone says. 

“Don't let anyone push you into doing something you are opposed to,” Stone says. “This is your body. Your choice. And the more in tune you become with it, you'll know which road to take.”

Accept emotional and practical support

You don’t have to reach acceptance alone — you can lean on loved ones and people who have lived through the same thing.

When Stone got her diagnosis, she called two friends and asked them to come over right away to help her process it. That night, she stayed on a video call with her sister all night long, so if she woke up, she knew she wasn’t alone.

Right after Ruegg left his appointment, he called each of his nine brothers and sisters. “And I remember I'm on that ride home, I was calling everybody,” Ruegg says. “Find me the best of the best. Do your research. I'll go anywhere. I'll do anything.”

Less than 24 hours later, Ruegg got a call from Roger Magowitz at the Seena Magowitz Foundation. “And I remember he's like, Mark, I talked to your sister-in-law last night. And she told me what that doctor said,” Ruegg says. 

Magowitz offered to put him in touch with 15-, 20-, and 30-year pancreatic cancer survivors. “Roger changed my life by giving me a little bit of hope,” Ruegg says.

Andrews recommends surrounding yourself with positive, supportive people who can help you come to terms with your diagnosis and keep living your life. You don't have to hover or talk about medications and treatments, Andrews says to loved ones. “What's helped me most is having people in my life who continue to treat me like myself.” 

“One of my closest friends will say, ‘Look at you. You're doing great. Let's go for a walk.’ She sees my limitations without focusing on them,” Andrews says.

Even if you don’t have a huge network of friends and family to lean on, you can find help reaching acceptance in other places. “Several organizations offer free, professional support services including helplines, online support groups, counseling referrals, and educational materials,” Liu says.

Here are a few:

“One resource that we think is really important is connecting with other survivors, other people that have had this experience that can really talk through what they went through and how they managed it,” Zelada‑Arenas says. Many organizations offer support groups or one-on-one calls with someone who has gone through a similar cancer journey.

Control what you can, release the rest

When you get a cancer diagnosis, it can feel like you lose control over a lot of things, Zelada‑Arenas says. Sometimes people feel like they have to go with what they’re being told, Zelada‑Arenas says. “And that's not always the case.” Part of acceptance is taking back control where you can, Zelada‑Arenas says.

“I've learned that there are some things I can control and some things I can't,” says Andrews. “I can show up for treatment, ask questions, stay informed, and work with my medical team. I can't control every outcome.”

Andrews also encourages people to advocate for themselves. “Ask questions. Learn about your options. If possible, seek care from specialists who treat your type of cancer every day and ask whether there are clinical trials that may be appropriate,” Andrews says.

Asking these questions and learning about your cancer type can help you reclaim control and make informed decisions, Zelada‑Arenas says. 

Guard your mindset

Acceptance of cancer doesn’t mean accepting defeat, and your mindset (how you think about your illness) can make a big difference in how you live with pancreatic cancer.

“Through this journey, I have learned to stay present in the moment,” Stone says. Obsessing over possible futures causes anxiety and fear, and she says, “I have no time for that anymore.” 

Stone began a meditation practice this year that has helped her tremendously. “Just sitting quietly with thoughts of healing and light and grace and belief that no matter what happens, I will be supported, loved, and safe,” Stone says.

Ruegg does a body scan the moment he wakes up every morning. He says to himself, “Okay, I'm alive, things are OK. I don't think I'm dying today, so let's make it the best 24 hours of my life that I possibly can.”

“I'm still doing that because life is so precious, and we drown ourselves in this fear,” Ruegg says, even though you might be around for many more years. “Why are you gonna waste all of that time wondering when your ticket is gonna be called, when that number is up? Start living it for today,” Ruegg says. 

It’s easy to get caught in a down moment and focus on the what-ifs and maybes, Ruegg says. “Those moments, if we sit there, they start to multiply. And it's so important for us to catch it.” 

“I don't want anyone to deny their own feelings,” Ruegg says. “Feel it, but then we gotta flip it.” 

When Ruegg caught himself in a low point, he used a mantra: I am strong, I am powerful, I am healthy, I am healed. “And the more that I said it, the more that I thought it, the more I started to believe it,” Ruegg says.

“There have been several times during the course of treatment when I felt defeated and wanted to quit,” Stone says. “But then, something beautiful catches my eye and I keep moving forward. I have found that staying centered and focusing on gratitude for the life I've lived helps to keep me grounded.”

Andrews has always gone into treatment expecting it to help. “That doesn't mean I think everything will be perfect, but I do think it's important to believe things can work,” Andrews says. “For me, it's about staying hopeful without feeling like I have to predict the future.”

Get help from a mental health professional

Psychologists and professional counselors can help you learn strategies to accept your pancreatic cancer diagnosis. Your mental health provider may offer therapies like:

“ACT is particularly well suited to serious illness because it doesn’t try to talk people out of difficult thoughts,” Liu says. “If you’re thinking, ‘I’m going to die,’ ACT doesn’t challenge it because it’s realistic.” Instead, ACT focuses on developing psychological flexibility: the ability to fully experience the present moment while acting in line with your personal values, Liu says.

CBT can help you identify unhelpful thought patterns and behaviors and gently shift them toward more constructive ones, Liu says. IMCP centers on the idea of finding and creating meaning, even in the face of a life-limiting illness, through the love given, the experiences received, and the choices we make on how to face what comes next, Liu says. 

Once you accept your diagnosis, you can focus on living every day to the fullest, says Ruegg. After he was diagnosed, Ruegg and his wife decided to enter what they called a healing bubble. 

They turned off the news and only spent time with people who brought them love, joy, and positivity. “We started traveling more,” Ruegg says. “We started spending more time with family and friends.”

“When I started, a lot of patients were just told to get their affairs in order,” Zelada‑Arenas says. But earlier diagnosis and new treatments are changing what it means to have pancreatic cancer.

“Statistics are important, but they're based on large groups of people. They don't tell you exactly what is going to happen to you,” Andrews says.

“Treatments are improving all the time, and there may be options available today that weren't available even a few years ago,” says Andrews, who took part in a clinical trial for daraxonrasib, an experimental cancer medication that worked well for her.

Don't stop living while you're receiving treatment, Andrews says. “I still spend time with friends and family. I recently bought a convertible Mini Cooper because it looked fun to drive.”

Stone writes poetry and encourages anyone with a pancreatic cancer diagnosis to find a creative outlet. “I think that's really important for anyone going through this,” Stone says.

“If we can just live and be alive today, let tomorrow take care of tomorrow,” Ruegg says. “And the fact that I can now live pretty much in 24-hour increments, that has probably been the greatest gift I think cancer has actually given me.”

Stone says it sometimes feels like she’s been dealt the losing hand. “But, I'll tell you, my life has become so much richer since my diagnosis,” Stone says. “I've released shame and guilt and fear, and instead choose to believe I am protected, supported, and guided. One day at a time.”

Stone wrote this poem to paint a picture of her acceptance of pancreatic cancer:

Lifeboat

To navigate illness,

its tempestuous seas,

we captain our ship.

We bend at the knees.

Grateful for moments 

of grace with each wave. 

Loving each other,

our own lives we save.

Add WebMD as a Preferred Source to see more of our trusted content across Google Search, AI Overviews, and AI Mode