Pilot Study of a Multimodal Prehabilitation Pancreatic Cancer Program

Inclusion Criteria * Adults age 18 years or older. * Diagnosed within 8 weeks with upfront resectable, borderline resectable, or locally advanced unresectable PDAC as defined by the National Comprehensive Cancer Network (NCCN). * Planning to undergo TNT at MGH. * Planning to receive modified FOLFIRINOX for neoadjuvant chemotherapy. * Planning to undergo surgical resection of PDAC at MGH. * Verbal fluency in English. Exclusion Criteria * Metastatic disease. * Previous treatment for pancreas adenocarcinoma and no prior therapy for any cancer within 5 years. * Known history of cognitive or psychologic impairment. * Known history of physical impairment such as immobility, use of walking aids, or required wheelchair use. * Known history of the following orthopedic comorbidities: advanced osteoarthritis or rheumatoid arthritis, mobility-limiting amputations, orthopedic injuries, or widespread chronic pain (e.g. fibromyalgia). * Known history of the following pulmonary comorbidities: severe chronic obstructive pulmonary disease (COPD) defined as FEV1 ≤ 50%, emphysema, interstitial lung disease, and/or use of supplemental oxygen. * Known history of the following cardiovascular comorbidities: uncontrolled hypertension, severe congestive heart failure (NYHA Class IV), and/or myocardial infarction within the last 6 months. * Inability to tolerate diet through routine oral routes and/or patients with strict nutritional restrictions, allergies, and/or dietary preferences.