Multidisciplinary team (MDT) for pancreatic cancer

A team of specialists meet to talk about the best treatment for you. They are called a multidisciplinary team (MDT).

The MDT look at national treatment guidelines or the latest evidence for the type of cancer you have. If you have any treatment preferences, your doctor will tell them about this.

The MDT will usually include the following professionals:

  • Surgeon – a doctor who does operations (surgery).
  • Clinical oncologist – a doctor who uses radiotherapy, chemotherapy and other anti-cancer drugs to treat people with cancer.
  • Medical oncologist – a doctor who uses chemotherapy and other anti-cancer drugs to treat people with cancer.
  • Pathologist – a doctor who looks at cells or body tissue under a microscope to diagnose cancer.
  • Radiologist – a doctor who looks at scans and x-rays to diagnose problems.
  • Interventional radiologist – a doctor who uses scans and x-rays to give treatments such as ablation or embolisation.
  • Endoscopist – a doctor who specialises in doing an endoscopy, EUS or ERCP.
  • Clinical nurse specialist (CNS) – a nurse who gives information about cancer, and support during treatment.

Depending on the type of cancer you have, the MDT may also include:

  • a dietitian – someone who gives information and advice about food and food supplements
  • a physiotherapist – someone who gives advice about exercise and mobility
  • an occupational therapist (OT) – someone who gives information, support and aids to help people with tasks such as washing and dressing
  • a palliative care doctor or nurse – someone who specialises in symptom control and supportive care.
  • a psychologist or counsellor – someone who gives advice about managing feelings and behaviours.

Types of treatment for pancreatic cancer

Treatment for pancreatic cancer depends on:

For many people their main treatment is chemotherapy to control the cancer and to relieve symptoms. There are also other treatments and things that can be done to control symptoms and help you to feel better.

Your doctor may explain your treatment based on whether surgery:

  • can remove the cancer (resectable)
  • cannot remove the cancer (unresectable).

This will depend on the stage of the cancer and also on your general health.

Treating resectable cancer

Surgery is the most effective treatment for early-stage pancreatic cancer. It involves removing part of the pancreas or the whole pancreas. For some people, this may cure the cancer. But it is a major operation. It is only suitable for people who are fit enough. You can only have surgery if the cancer is small, does not affect any large blood vessels, and has not already spread.

You might also have chemotherapy or radiotherapy after surgery, to lower the chances of the cancer coming back. This is called adjuvant treatment.

Treating borderline resectable cancer

Sometimes, the cancer has started to affect nearby blood vessels. This can make it more difficult for the surgeon to remove the whole cancer. It is important to remove the whole cancer and an area of healthy tissue around it. This is called a clear margin. If this is not possible, there is a high risk of the cancer coming back.

You may have chemotherapy before surgery. This is sometimes followed by a combination of chemotherapy and radiotherapy (chemoradiation) to shrink the tumour. The surgeon then decides if they can remove the cancer, along with a clear margin of healthy tissue. This can also reduce the risk of the cancer cells spreading. This is called neo-adjuvant treatment. You may have the treatment as part of a cancer research trial.

Treating locally advanced (unresectable) cancer

Unresectable cancer is when the tumour has spread into the blood vessels around the pancreas. This usually means surgery is not an option.

Chemotherapy is the main treatment if the cancer has started to spread. You may have it to control the cancer for some time and to relieve symptoms.

Sometimes, you may have chemotherapy and radiotherapy together. This is called chemoradiation. Or, you may be offered radiotherapy on its own. Your doctor can discuss this with you.

Sometimes, chemotherapy or chemoradiation shrinks the tumour more than expected. This is not common, but may mean that it is possible to remove the tumour with surgery.

An operation is unlikely to be helpful if it is not possible to completely remove the cancer. You may have surgery to relieve symptoms. For example, you may have surgery if the cancer is blocking the bile duct or the bowel.

You may need other treatments to help with symptoms. If your pancreas is not working properly, you may need treatment called enzyme replacement therapy to help your body digest fats and proteins.

Irreversible electroporation (IRE)

Sometimes the cancer cannot be removed by surgery following neo-adjuvant treatment because the nearby blood vessels are still affected. Irreversible electroporation (IRE) is a new treatment that

might be used in this situation. A needle is inserted into the pancreas and an electric current is given through it to destroy the tumour. IRE is only available in a few hospitals in the UK. Your doctor or specialist nurse can give you more information.

Treating metastatic or advanced cancer

If the cancer is advanced and has spread to the liver or lungs, or to other organs, you may have the option of treatment to control it. The main aim of this treatment is to reduce symptoms so that you feel as well as possible. This is called supportive care.

You may have chemotherapy to shrink the cancer and relieve symptoms. Chemotherapy may also help some people live for longer.

Depending on your symptoms, you may need to have a stent put in. This relieves jaundice or other symptoms caused by a blocked bile duct or bowel. To control any pain, you may have radiotherapy, painkillers, and nerve blocks (on their own or combined). You may need treatments to help with eating and digestion.

If your pancreas is not working properly, you may need treatment called enzyme replacement therapy to help your body digest fats and proteins.

About our information

  • References

    Below is a sample of the sources used in our pancreatic cancer information. If you would like more information about the sources we use, please contact us at

    European Society for Medical Oncology, Cancer of the pancreas: ESMO clinical Practice Guidelines. Volume 26, Supplement 5, V56-V68, 1 September 2015. Available from: (accessed May 2021).

    National Institute for Health and Care Excellence. Pancreatic cancer in adults: diagnosis and management. NICE guideline (NG85). Published 7 February 2018. Available at: (accessed May 2021).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 05 January 2022
Next review: 05 January 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

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