Inclusion Criteria:

• Age ≥ 18 years
• Histologically or cytologically confirmed diagnosis of pancreatic exocrine malignancy (e.g.pancreatic ductal adenocarcinoma, acinar cell carcinoma, pancreatic adenosquamous carcinoma, etc.) or clinical features highly suggestive of such malignancy with diagnostic confirmation anticipated during the screening or early study period.
• Presentation consistent with resectable, borderline resectable, local, or locally advanced, or metastatic disease
• May or may not have had surgery
• Treatment plan likely includes systemic therapy for pancreatic cancer
• ECOG performance status 0-2
• Able to tolerate oral intake and not currently receiving enteral or parenteral nutrition
• Able to read and speak English
• Able to provide written informed consent

Exclusion Criteria:

• Pregnant or breastfeeding at the time of enrollment
• Current use of tube feeding (enteral) or total parenteral nutrition
• Presence of ascites or other findings suggestive of decompensated disease
• Evidence or history of bowel obstruction or any gastrointestinal condition that may limit food intake
• Severe or uncontrolled psychiatric illness (e.g., psychosis, dementia) that would interfere with participation
• Presence of other uncontrolled intercurrent illnesses (e.g., infection, heart failure, liver failure) that may interfere with protocol adherence