• Pancreatic intraepithelial neoplasia (PanIN), the microscopic precursor of pancreatic cancer: PanIN is the name for abnormal cells lining the small pancreatic ducts that can, over years, turn into pancreatic cancer.
• R0 and R1 margins in pancreatic cancer: the 1 mm rule and standardised specimen reporting: After a pancreatic cancer is removed, the pathologist checks whether cancer reaches the cut edges of the specimen.
• High-risk stigmata and worrisome features of pancreatic cysts (IPMN and MCN surgical criteria): Most pancreatic cysts never become cancer, so doctors watch them and operate only when warning signs appear.
• Resection margins (R0 / R1 / R2): Whether the edge of the removed tissue is free of cancer.
• Distal pancreatectomy (removal of the body and tail of the pancreas, usually with the spleen): Distal pancreatectomy removes the body and tail of the pancreas, the part to the left of the main vessels, usually with the spleen when the cause is cancer.
• Whipple procedure (pancreaticoduodenectomy): The big operation for cancers of the head of the pancreas: the surgeon removes the pancreatic head, the duodenum, the gallbladder and part of the bile duct, then reconnects everything.
• Grade: How abnormal the cancer cells look under the microscope, from grade 1 (close to normal, slow) to grade 3 or 4 (wildly abnormal, fast).
• Neoadjuvant / adjuvant / perioperative: Neoadjuvant therapy is treatment given before surgery, adjuvant therapy is treatment given after it, and perioperative therapy is both.

Biomarker results to ask for: Histological type of the invasive component (tubular, colloid, oncocytic) and of the precursor epithelium (gastric, intestinal, pancreatobiliary, oncocytic), Distance between the IPMN and the invasive carcinoma (associated versus concomitant, Baltimore 2015), GNAS mutation (IPMN lineage) alongside KRAS; TP53 and SMAD4 changes with progression, CA 19-9 and cyst-fluid CEA before surgery.

Scans and tests linked to this cancer: Endoscopic ultrasound and EBUS systems, Histopathology & immunohistochemistry, MRI, High-risk pancreatic surveillance (CAPS / PRECEDE).

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Resectable: Pancreatoduodenectomy, distal pancreatectomy or total pancreatectomy according to the extent of duct involvement, with regional lymphadenectomy and adjuvant chemotherapy as for ductal adenocarcinoma; surveillance of the remnant gland. (Whipple procedure (pancreaticoduodenectomy), Distal pancreatectomy (removal of the body and tail of the pancreas, usually with the spleen), FOLFIRINOX / mFOLFIRINOX, Neoadjuvant / adjuvant / perioperative, High-risk pancreatic surveillance (CAPS / PRECEDE), MRI)
• Advanced: Treated as pancreatic ductal adenocarcinoma: resection with adjuvant chemotherapy when removable, the chemotherapy rows of the parent page when not; the parent record carries the trials. (FOLFIRINOX / mFOLFIRINOX, Gemcitabine + nab-paclitaxel, NALIRIFOX (liposomal irinotecan + oxaliplatin + 5-FU/LV))

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.