Resistance Training Intervention to Improve Physical Function in Patients With Pancreatic Cancer Receiving Combination Chemotherapy or Have Undergone Surgery, PancStrength Study

Inclusion Criteria:

• Biopsy-proven pancreatic adenocarcinoma, advanced stage (III-IV) (study 1) ORbiopsy-proven pancreatic adenocarcinoma, at least 10 weeks post-surgical tumorresection and currently with no radiographic evidence of disease on recentcomputerized tomography (CT) scan (study 2)

• Eastern Cooperative Oncology Group (ECOG) performance status 0-1

• Treatment plan of first-line FOLFIRINOX chemotherapy with planned return visit to MDAnderson Main Campus for restaging (study 1) OR plans to return to MDACC forrestaging appointments in 3-4 months, including follow up CT scan (study 2)

• Able to schedule baseline (T0) appointment for fitness testing and program teachingat the Behavioral Research and Treatment Center (BRTC) or able to schedule remotefitness testing and program teaching

• Able to understand the description of the study, exercise program, and willing toparticipate

• Home access to wireless internet (Wi-Fi) and agreement to engage with studypersonnel for real-time tele-RT sessions

• Age >= 18

• Meet all screening requirements

• PROVIDERS (FOR ACCEPTABILITY INTERVENTION): All GI medical oncologists, GI surgeons,advanced practice providers, and clinical dietitians who are involved inparticipants' care and have some interaction with intervention personnel duringrecruitment, referral, scheduling, or follow up will be asked to completequestionnaires assessing intervention acceptability. The exact number of providerswho will be asked to complete questionnaires will depend on whether patients enrollfrom the different GI Medical Oncology and GI Surgery clinics, but we expect 10-20providers to be eligible

Exclusion Criteria:

• Non-English speaking

• Has participated in regular RT (RT for all major muscle groups at least twice perweek) throughout the month prior to recruitment

• Unable to complete the baseline assessment questionnaires or functional assessments

• Screen failure for exercise safety based on Physical Activity ReadinessQuestionnaire (PAR-Q) and/or Patient Reported Outcomes Measurement InformationSystem (PROMIS) questions

• Underlying unstable cardiac or pulmonary disease or symptomatic cardiac disease (NewYork Heart Association functional class III or IV)

• Recent fracture or acute musculoskeletal injury that precludes the ability to weightbear fully on all 4 limbs in order to participate in an exercise intervention

• Numeric pain rating scale of >= 7 out of 10

• Myopathic or rheumatologic disease that impacts physical function

• FEMALES ONLY: Known pregnancy, as communicated to study personnel by clinicians ingastrointestinal (GI) Medical Oncology; females of childbearing potential receiveadvice to use methods of contraception per usual care