Background <p>Pancreatic cancer patients demonstrate elevated vulnerability to depression and anxiety relative to other gastrointestinal malignancies, attributable to the disease’s dismal prognosis and substantial symptom burden. However, symptom-level relationships among anxiety, depression, and resilience in pancreatic cancer remain insufficiently understood. Therefore, this study employed network analysis to investigate the interrelationships among anxiety, depression, and psychological resilience in the population. Additionally, a comparative analysis of the network structure was conducted to explore gender differences. Ultimately, this study aims to provide theory-driven intervention strategies and practical guidelines for supporting the mental health of patients diagnosed with pancreatic cancer.</p> Method <p>This cross-sectional study enrolled 759 patients with pancreatic cancer from Guangzhou, China, between June 2024 and July 2025. Anxiety, depression, and resilience were assessed using the Hospital Anxiety and Depression Scale (HADS) and Brief Resilience Scale (BRS). A regularized partial correlation network was constructed based on the survey data, and the bridge expected influence index was applied to quantify the bridge components. We also compared the network structures of male and female samples to explore sex differences.</p> Results <p>The prevalence rates of anxiety and depression were 24.2% and 30.3%, respectively. A7 “Panic” (0.903) was the core symptom in the anxiety, depression, and resilience symptom networks. R1 “Bounce back quickly” (-3.342) was the core bridge symptom connecting the three network clusters. A comparison of male and female networks indicated that the overall network structure exhibited no significant sex differences; however, the global strength of the female network was significantly higher. The strongest positive associations remained consistent across the male and female networks (R1 “Bounce back quickly” and R3 “Recover from stress quickly”). A7 “Panic” emerged as a shared core symptom in both male and female networks.</p> Conclusion <p>“Panic” was identified as the central symptom in the anxiety–depression–resilience symptom networks, while “Bounce back quickly” served as the key bridge node connecting these three symptom clusters. These findings provide potential symptom-level targets for future psychological assessments and intervention research. Additionally, there were significant differences in global strength between male and female networks, with gender-specific strategies recommended for each.</p>