Stage 3 Pancreatic Cancer Questionnaire | Pancreatic Cancer- Protact | Pancreatic Cancer Treatment Clinical Trial

Initials (two-letter initials only; e.g. if your name is John Smith type: JS )*

Email*

Phone*

Are you older than 18 years? *

Yes

Unfortunately, it seems you're not eligible to participate in this clinical trial.

Were you diagnosed with Pancreatic cancer stage 3?*

Yes

I don’t know

Unfortunately, it seems you're not eligible to participate in this clinical trial.
Only patients who are diagnosed with stage 3 pancreatic cancer can participate in the study

Were you diagnosed as “Resectable” ?*

Yes

I don’t know

Unfortunately, it seems you're not eligible to participate in this clinical trial. Only patients who have been diagnosed with unresectable (Unable to be removed surgically) pancreatic cancer are eligible to participate in the study

Have you been diagnosed with Metastatic disease?*

Yes

I don’t know

Unfortunately, it seems you're not eligible to participate in this clinical trial.
Only patients who have been diagnosed with LAPC (locally advanced pancreatic cancer) and do not have Metastatic disease are eligible to participate in the study

Are you currently treated with chemotherapy?*

Yes

I don’t know

Unfortunately, it seems you're not eligible to participate in this clinical trial.
Only patients who have not received any chemotherapy for their current diagnosis are eligible to participate in the study.

Are you pregnant?*

Yes

irrelevant question (for men only)

Unfortunately, pregnant women are not eligible to participate in this clinical trial

Have you undergone major surgery in the last 4 weeks without complete recovery?*

Yes

I don't know

Unfortunately, it seems you're not eligible to participate in this clinical trial. Patients who have undergone major surgery in the last 4 weeks without complete recovery cannot participate in the study

Have you been diagnosed with HIV, hepatitis B virus, or hepatitis C virus?*

Yes

I don't know

Unfortunately, it seems you're not eligible to participate in this clinical trial.
Patients who have been diagnosed with HIV, hepatitis B, or hepatitis C, cannot participate in the study

Good news, according to this preliminary questionnaire
you are eligible to join our new clinical trial.

Please select a medical site where you would
like to schedule an appointment.

please note!
After submitting this form you will be forwarded to a page
which contains contact information for the medical sites.
We advise you to contact the medical site personally
for prompt answers or urgent matters

participation in the clinical trial requires the approval of our research physician
and can only be obtained after your onsite appointment.

Please select a medical site for your appointment

By submitting this form your personal information will be sent online to the medical site of your choice.

i agree

Find out if Your Eligible to Participate