Share Your Story

We invite you to share your inspirational story about how pancreatic cancer has touched you. We are also very interested to hear from survivors who have participated in a clinical trial.

*indicates a required field

First Name*

Last Name*

Address*

City*

State*

Zip*

Country

Primary Phone*

Secondary Phone

Email*

I am a* (Please select all that apply.)
 Survivor/Patient
 Caregiver
 Volunteer
 Researcher
 Health Professional
 Family Member/Friend of a Patient

Submitting a photo is a requirement when you submit your story in order for the Pancreatic Cancer Action Network to consider it for placement on our website and/or in other communication or promotional materials.

How pancreatic cancer has touched me (please limit to 650 words):*

If this story is about diagnosis and treatment, please provide as much of the following information as possible:

Age of Patient at Diagnosis:
Date of Diagnosis:

Diagnosis

Type the characters you see in the picture:

captcha

By submitting this I agree that the Pancreatic Cancer Action Network may post my story and photo on the Pancreatic Cancer Action Network website, newsletter and/or other promotional materials.
All stories are subject to review and editing by the Pancreatic Cancer Action Network . Only select stories will appear on the Pancreatic Cancer Action Network website.

*The Pancreatic Cancer Action Network will not sell, trade, or rent your personally identifiable information to third parties. Our full privacy policy can be found at www.pancan.org/section-privacy-legal/privacy-policy/