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Chemotherapy may be given after surgery| to try to reduce the chance of the cancer coming back. This is known as adjuvant chemotherapy.
If the cancer can’t be removed by surgery, chemotherapy may help to shrink and control it for a time. Chemotherapy may also be used to relieve symptoms caused by the cancer.
Chemotherapy may be given together with radiotherapy|. This is known as chemoradiation.
Some chemotherapy drugs are given as tablets, but most are given by injection into a vein (intravenously). Intravenous chemotherapy can be given into a vein in your arm or hand, or through a flexible plastic tube (a central line) that sits in a vein just under your collarbone at the top of your chest.
Whether chemotherapy is given as tablets or into a vein, the drugs are absorbed into the blood and carried all round the body. The chemotherapy then destroys cancer cells wherever they are in the body.
Chemotherapy is usually given as several sessions of treatment. Each treatment is followed by a rest period of a few weeks to allow your body to recover from any side effects. The treatment and the rest period together make up what’s called a cycle of treatment. The number of cycles you have will depend on the drugs that are used, and how well the treatment is working. This is checked by your doctor at regular appointments.
Most people can have their chemotherapy as an outpatient.
A number of research trials| are being carried out to try to improve the results of treatment for pancreatic cancer. You may be invited to take part in a trial.
The chemotherapy drugs used to treat pancreatic cancer include:
It’s unusual for more than one chemotherapy drug to be given at a time to treat pancreatic cancer. But sometimes gemcitabine is given in combination with capecitabine tablets. Other combinations of drugs may be given in research trials|. Clinical trials are also looking at treatments called biological therapies. These treatments interfere with the way that cancer cells grow.
Chemotherapy can sometimes cause side effects, but it can also make you feel better by relieving the symptoms of the cancer. Most people have some side effects, but these can often be well controlled with medicines. Some of the possible side effects are described here, along with some of the ways in which they can be reduced.
Chemotherapy can temporarily reduce the number of white cells in your blood. When these cells are reduced you are more likely to get an infection|, so it’s important to avoid crowded places and anyone with an infection, such as a cold or flu.
Contact your doctor straight away if you have any signs of infection, such as a high temperature (above 100.4˚F/38˚C), or if you suddenly feel unwell, even with a normal temperature. During chemotherapy, the level of white cells in your blood will be checked regularly and, if necessary, you will be given antibiotics to treat any infection.
Some chemotherapy drugs can make your mouth sore| and cause mouth ulcers. Regular mouthwashes are important and your nurses will show you how to use these properly. A toothbrush with soft bristles is gentler for a sore mouth.
Eating foods that are soft and moist and avoiding foods that are dry, salty or highly spiced may also help. If you don’t feel like eating you could try replacing some meals with nutritious drinks. Our section on eating well| has some useful tips on coping with eating problems.
Some chemotherapy drugs irritate the lining of the bowel and may cause diarrhoea| for a few days. Your doctor can give you medicine to slow down your bowel and reduce the diarrhoea. You may also be able to help to control it by eating a low-fibre diet. This means avoiding wholemeal bread and pasta, raw fruit, cereals and vegetables for a few days after each treatment. There are more tips in our section on eating well.
There are very effective anti-sickness drugs (anti-emetics) to prevent or reduce nausea and vomiting|. Your doctor can prescribe these for you. Let your doctor or nurse know if your anti-sickness drugs are not helping you, as different types can be used.
Some anti-emetics can cause constipation|. Let your doctor or nurse know if this is a problem.
Most chemotherapy drugs used to treat pancreatic cancer don’t cause hair loss. Your doctor can tell you whether the drugs you are taking are likely to make your hair thin or fall out. If you do have hair loss, it is temporary and your hair will start to grow back once treatment is over. Our section on coping with hair loss| has some useful tips.
Chemotherapy can affect the skin and nails, causing dryness and flaking. Some drugs make your skin more sensitive to the sun, so it's important to cover up and use a high-factor sun cream (SPF 15 or greater).
Although these side effects may be hard to bear at the time, they will gradually disappear over a few weeks once your treatment has finished.
Our chemotherapy| section discusses the treatment and its side effects in more detail.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
Drugs that may be used to treat pancreatic cancer:
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.