At the Table: Looking Forward 10 Years

2026 has started off with a bang for pancreatic cancer patients.

This year there is already one treatment approved for locally advanced cancer, and of course the results from the daraxonrasib trial have every metastatic patient looking to get the treatment on expanded access, as it moves through the FDA approval process. Researchers know that once one drug has kicked open the door for formerly “undruggable” KRAS, more will follow. The treatment landscape is clearly changing.

We asked our Patient Advisory Board members to look into the future and tell us what they think will come about and what they wish will happen. Their responses covered a wide spectrum, from cures and better use of AI to early detection blood tests.

The Ideal Goal: Survival

Dr. Ira Sharp: In the next 10 years, I would like to see pancreatic cancer survival rates rise significantly. I would like to see many more long-term (greater than five-year) survivors.

Martin Hynes: In the next decade, I’d like to see survival rates increase to those of other solid tumors such as prostate cancer and breast cancer. Our goal should be to turn pancreatic cancer into a chronic disease or find the cure.

Pancreatic cancer incidence has been on the rise over the last 10 years. If no cure is in sight, it would be wonderful to see that trend reversed, and to have the incidence of pancreatic cancer decline exponentially.

John Sanders: Of course, in 10 yearsI would like to see “A Cure for Pancreatic Cancer.” But if we don’t have a cure by then, there should be a test that is able to detect pancreatic cancer.

The Realistic Goal: Earlier Detection

Earlier detection is one goal everyone agrees on, whether it is through biomarkers, better scans, or better reading of scans.

Kim Vernick: I think early detection is a must and I know there are lots of promising tests in the works. In the next 10 years I am hoping that a blood test or a test like a colonoscopy (or endoscopy) will be used for routine testing.  

William Ramshaw: I remain hopeful that we will figure out a way to detect pancreatic cancer early while it is still treatable using minimally invasive methods. In my perfect world, having a Whipple Procedure would be a rarity rather than the frontline treatment it is today.

Andy Lyons: I’m an eternal optimist. More progress will certainly be made in early detection techniques, better and easier treatment, and more comprehensive genetic testing. Because of my family’s history I was scanned and tested for many years before my diagnosis. My first test, about 25 years ago, looked at a just a handful of genes. Last year, it was like 75 different genes. That’s promising and exciting. More data means more knowledge; more knowledge is power.

Martin Hynes: In the next decade, with the advent of new biomarkers we should be able to detect the development of pancreatic cancer at much earlier stages of the disease. Additionally, it would be a significant achievement if we were able to fully deploy artificial intelligence to read CT and MRI scans to detect pancreatic cancer at much earlier stages of the disease, thus increasing the number of people who can be cured.

Marisa Harris: In 10 years there should be better imaging, more reliable biomarkers, and liquid biopsies.  This alone could significantly improve survival.  If caught early, the five-year survival could go up to 75 to 80 percent, making this disease almost curable. Ten years from now there could be approved multi-cancer tests that catch pancreatic cancer at stage I or II.

I also hope to see an improvement in investigation by non-cancer doctors, especially family practice doctors. These physicians can routinely screen patients at annual visits for new-onset diabetes, BRCA/PALB/ATM carriers, family history, or chronic pancreatitis.

But some have a more down-to-earth view of the future of early detection.

Brooke Dwars: I would love to be more optimistic. But, while I admire the push for early detection, I’ve spoken with several providers in the field and no one can give a specific point for where the cut-off is for early detection in pancreatic cancer. Even those people who are diagnosed at stage I can have recurrence, so while even having something that can help with early detection would be a positive, I don’t think it’s going to initially be the slam dunk a lot of the general public hopes it will be.

The Role of AI

There are already developments regarding AI and early detection.

Steven Merlin: Mayo Clinic researchers have developed a method of using AI to analyze scans of the pancreas. This technique can identify pancreatic cancer three years before it develops.

Burt Rosen (pancreatic neuroendocrine tumor patient): I see the advent of AI as a technology that can help us break through with a lot of cancers. With the ability to aggregate data from multiple sources, synthesize the data, and draw insights and recommendations, I think we are in for a period of progress across all cancers unlike anything that we have seen. I actually see AI helping us cure cancer (or make a real difference) in the next 10 years as we get more and more data.

Most importantly (and this ties in to my second focus) I think AI is going to help us evolve from treating populations to treating individuals. With AI, an entity that will know as much about me as I want it to, I see my treatments evolving from “70% saw a PFS of XXX” to “based on everything I know about you, diet, environment, mindset, treatments, etc., here is what is recommended.” That shift from treating the population to treating the individual could be huge. The integration of integrative oncology into Western oncology helps us get there too.

Rob Weker: The upcoming decade will be driven by AI! AI will be an enabler for so many on so many fronts.  It will help researchers make strides in leaps rather than small steps by targeting new treatment paradigms based on scientific data. It will level the playing field by helping patients who do not have easy access to leading-edge NCCN doctors and institutions to directly benefit from the latest research and insight. It will enable early detection of pancreatic cancer by reading scans and give patients and their doctors a fighting chance to get to surgery.  Fundamentally, AI will allow patients to finally make truly informed decisions for them and their families by considering all options and creating tailored treatment plans for individual patients that address the patient’s unique considerations, both medical and nonmedical.  And finally, our healthcare system will enable affordable, accessible pancreatic treatment for all.  While it’s never a great time to get pancreatic cancer, there is no better time than now.

Changing Treatment Protocols

Rob Weker: I believe we are on the cusp of making tremendous strides in dealing with pancreatic cancer.  New therapies that were unimaginable only a few years ago are soon to be broadly available.

Marty Hynes: In the next decade, increasing the percentage of patients treated at high- volume surgical centers would be a highly desirable outcome

Dr. Ira Sharp: I would like to see better management of chemotherapy and its side effects, better immunotherapy, and more targeted therapies. Realistically, I don’t know how much we will actually see, given the limited funding for research and development of some of these therapies.

Steven Merlin: I want to see the employment of atomic force microscopy, which measures stiffness and softness of tumors. The reason for this is that rigid tumors are less likely to metastasize but are more resilient to chemotherapy whereas soft tumors are more likely to become metastatic. This information helps both patient and clinician in making treatment decisions, based on better information about the tumor structure and microenvironment.

Martin Hynes: In the next decade I hope to see some changes in chemotherapy, for example more patients treated with targeted therapy, such as KRAS inhibitors, as well as the development of other novel therapies that address the majority of mutations found in pancreatic cancer tumors. In the last decade, immunotherapy—such as checkpoint inhibitors—has played a very limited role in the treatment of pancreatic cancer. With the advent of additional checkpoint inhibitors, it is hoped that some of these immune therapies will be useful in treatment.

Finally, it would be great to see widespread use of individual vaccines as a part of the standard treatment regimen for pancreatic cancer. Ideally there would be the development of vaccines to prevent pancreatic cancer in high-risk patients.

Brooke Dwars: I would like to see continued and additional focus on multimodal cancer treatment using next-generation sequencing to really target each patient’s cancer individually. I think this is where we can truly make a difference by focusing on multiple tumor-treating pathways along with targeting specific mutations in the tumor. 

I would like to see next-generation sequencing and genetic testing become standard of care for any patient who is diagnosed with pancreatic cancer regardless of their family history. I think this is truly the way forward for treatment and finding better ways to turn this into a treatable disease instead of the death sentence it used to be.

Nonmedical Aspects of Treatment Have a Role

Marisa Harris: I would like to see better communicationbetween patients and doctors. Patients from differing backgrounds almost uniformly express a desire for their oncology team to realize that they are whole human beings and not just an organ with a disease.

The key question to ask is “What Matters Most?” That means inquiring about their values, spiritual/religious beliefs/practices, preferences, goals, circumstances, and concerns. This information would be collected in advance and the oncologist and team would have read this beforehand. I would like to see this asked at the first session and not when options have disappeared. 

Overall communication skills need to be better. Patients should no longer hear on the first visit that they are stage IV and will die in a matter of months or even a couple of years. Medical professionals would be required to take communication skills training on a recurring basis. Research has shown that with regular training physicians feel more confident in being able to be more empathic and more able to have those difficult conversations with warmth. It is also valuable not only when the outlook is grim but also at the beginning when a patient is first diagnosed and is stage III or IV, to present with the language of hope based on the progress that has been made with targeted drugs.

Angella Dixon-Watson: I would like to see a betterpartnership between the holistic advocates/medical professionals and traditional oncologists. This would help encourage patients to incorporate the eight laws of health—nutrition, exercise, hydration, sunlight, moderation in all things, fresh air and deep breathing, rest, and faith—into their daily lives.  

Marisa Harris concurs with Angella regarding the importance of exercise, nutrition, stress reduction through mind/body practices.

Marisa Harris: I would like to see newly-diagnosed patients introduced to an integrated support team that includes nurse practitioner, receptionist, palliative care specialist, psychologist/social worker, financial advisor, and other optional professionals, for example an acupuncturist, although with information on nutrition, exercise, stress management,.  Ideally there would be a patient/caregiver care manager who coordinates this.

I want to emphasize the importance of palliative care. Since painful and debilitating symptoms are common even before diagnosis and extend into the treatment, palliative care should start at the first visit or very soon after. Research shows that palliative care improves quality of life and some studies have shown it impacts survival.

Support For Patients and Families

John Sanders: In the next decade there will be a post-pancreatic cancer treatment plan to restore, rejuvenate, and revitalize your mind and body after months and years of chemotherapy and radiation treatments.

Marisa Harris: Strong social support networks increase resilience, the ability to deal with the challenges and disruptions of treatment. I cannot overemphasize the need for more support, from start to finish, whether facing survivorship, end of life, or for caregivers, bereavement.

This extends to caregivers as well. Caregivers need to be recognized for their importance—they have essential responsibilities. But they also face tremendous stress, from a lack of sleep and appetite, exhaustion, and anxiety. Clinicians should learn to ask the caregiver questions: Are you sleeping, eating? Do you have help?  What do you need that you are not getting now? What has helped you that you could share with others?

The Role of Hope

Dave Price (caregiver): My hope for the next 10 years is this: At some point a decade on, a 54-year-old man, named Steve—just like my brother—will be diagnosed with pancreatic cancer, but his outcome will be completely different. Because of all the trials, the research, the patient education and resources, he will cured. He will experience old age, live a healthy and happy life, and be around when his own wish of eradicating this disease completely is achieved sometime during his lifetime. I don’t just dream that, I can see that future. It is closer than ever.

Andy Lyons: I’d love to think they’ll find the way to stop pancreatic cancer in the coming decade. But if not then, then the following decade. For sure!