Treatment overview for pancreatic cancer

Macmillan Cancer Support Medical Reference

The type of treatment you are offered depends on the stage of your cancer, its size, and your general health.

Surgery to remove all or part of the pancreas is the most effective treatment for early-stage pancreatic cancer. This is only suitable if the cancer is small and hasn’t spread.

However, many pancreatic cancers are not diagnosed until the cancer is quite advanced. If the cancer is too large, or has already spread beyond the pancreas when it’s diagnosed, surgery to remove the pancreas is not possible. Learning that your cancer has spread, and therefore that certain treatments are not suitable for you, is distressing news to cope with. Your doctor will advise you about the treatments that are most likely to help in your situation.

Chemotherapy (anti-cancer drugs) and radiotherapy (high-energy x-rays) may be used for cancers that have not spread but where an operation isn’t possible. They may be given separately or together. Chemotherapy can also be used if the cancer has spread to other parts of the body such as the liver.

Treatment for pancreatic cancer also includes treatments to control symptoms and make you feel more comfortable, known as supportive care.

Research is going on to find more effective treatments for pancreatic cancer and you may be invited to take part in a clinical trial of a new drug or treatment.

Multidisciplinary team

Your treatment will be planned by a team of specialist doctors and other healthcare professionals. This is known as a multidisciplinary team (MDT) and may include a:

• surgeon who specialises in treating pancreatic cancer
• clinical oncologist – a doctor who treats cancer with radiotherapy and chemotherapy
• medical oncologist – a doctor who treats cancer with chemotherapy
• pathologist – a doctor who specialises in how disease affects the body
• radiologist – a doctor who analyses x-rays and scans
• specialist nurse who gives information and support to people with pancreatic cancer.

The MDT may also include other healthcare professionals, such as:

• a dietitian
• a physiotherapist
• an occupational therapist
• a psychologist or counsellor.

Treatment by stage of cancer

Early-stage (resectable)

The most effective treatment for early-stage pancreatic cancer is surgery to remove part, or all, of the pancreas. This may cure the cancer for some people but it is a major operation. It is only suitable for people who are fit enough to have the surgery and who have cancers that are small and haven’t spread. Chemotherapy may be used after the operation to try to reduce the chances of the cancer coming back.

Locally-advanced (unresectable)

Chemotherapy may be used to control the cancer and relieve symptoms. Sometimes chemotherapy and radiotherapy are given together. This is called chemoradiation. If the cancer is blocking the bile duct or the bowel, surgery or stents may be used to relieve symptoms.

Metastatic or advanced cancer

The main aim of treatment is to reduce symptoms and make you feel more comfortable. This is called supportive care. Stents may be used to relieve jaundice or other symptoms caused by a blocked bile duct or bowel. Chemotherapy may be offered to help to reduce symptoms. Radiotherapy, painkillers and nerve blocks may be used on their own or in combination to control any pain.