Treatment for pancreatic cancer

Treatment for pancreatic cancer depends on the position and stage of the cancer, and whether surgery can remove the cancer.

Treating pancreatic cancer

Treatment for pancreatic cancer depends on:

the stage and grade of the cancer
the position of the cancer in the pancreas
your general health and preferences

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.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

Call the Macmillan Support Line on 0808 808 00 00.
Chat to our specialists online.
Visit our pancreatic cancer forum to talk with people who have been affected by pancreatic cancer, share your experience, and ask an expert your questions.

Treating resectable early stage cancer

If the cancer is small and has not spread (early stage) surgery is the most effective treatment. They remove part or all of the pancreas. This is called resectable cancer.

For some people it may cure the cancer. But it is a major operation. It is only suitable for a small number of people who are fit enough. You may have chemotherapy after surgery or sometimes before surgery to shrink the tumour. It may be given as part of a cancer research trial.

Treating borderline resectable, locally advanced cancer

Borderline resectable is when it may be possible to remove a cancer that has spread to nearby blood vessels (locally advanced). Because it’s in blood vessels it makes it difficult for the surgeon to remove the whole cancer and an area of healthy tissue around it (a clear margin). If it is not possible to get a clear margin, the risk of the cancer coming back is high. Only a small number of people can have surgery in this situation.

You may have chemotherapy first to shrink the tumour. The surgeon then decides if an operation is possible. If it is not, you will continue to have treatment with chemotherapy.

Treating unresectable, locally advanced cancer

This is when surgery to remove a locally advanced cancer is not possible because of how much the cancer has spread nearby. Chemotherapy is usually the main treatment. But some people may have chemotherapy and radiotherapy together. This is called chemoradiation.

If the cancer is causing a blockage in the bile duct or the bowel, surgery is sometimes used to relieve symptoms.

Treating advanced (metastatic) cancer

Surgery is not possible when the cancer has spread to other parts of the body such as the liver or lungs (metastatic). You may have chemotherapy to shrink the cancer and relieve symptoms. Chemotherapy may help some people live for longer.

You may need treatments to relieve jaundice or other symptoms caused by a blocked bile duct or bowel. There are different drugs and treatments that can be used to control any pain or other symptoms. This is called supportive care.

You can read more about this in our information about controlling the symptoms of pancreatic cancer.

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 cancerinformationteam@macmillan.org.uk

British Society of Gastroenterology. Guidelines for the management of patients with pancreatic cancer peri-ampullary and ampullary carcinomas. 2005.

European Society for Medial Oncology. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2015. 26 (Supplement 5): v56 to v68.

Fernandez-del Castillo. Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer. UpToDate online. Jan 2018.

Fernandez-del Castillo C, et al. Supportive care of the patient with locally advanced or metastatic exocrine pancreatic cancer. UpToDate online. Feb 2017.

Winter JM, et al. Cancer of the pancreas, DeVita Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology (10th edition). Lippincott Williams and Wilkins. 2016.

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.