Chemotherapy for pancreatic cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the most commonly used treatments for pancreatic cancer.

Chemotherapy may be given:

  • after surgery to reduce the chance of the cancer coming back (adjuvant chemotherapy)
  • if surgery is not possible to shrink the cancer, to relieve symptoms and improve survival (palliative chemotherapy)
  • to shrink a cancer before surgery (neoadjuvant chemotherapy)
  • with radiotherapy (chemoradiation).

The most commonly used chemotherapy drugs are gemcitabine and capecitabine. Chemotherapy is usually given as several sessions of treatment. Most people can have their chemotherapy as an outpatient. Your doctor or nurse will explain which chemotherapy is best for you. They will also explain the possible side effects of the drugs.

Sometimes, you may have treatment as part of a cancer research trial.

Chemotherapy

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the most commonly used treatments for pancreatic cancer.

You may have chemotherapy:

  • after surgery, to reduce the chance of the cancer coming back (called adjuvant chemotherapy)
  • if surgery is not possible, to shrink the cancer, relieve symptoms and prolong life (called palliative chemotherapy)
  • to shrink a cancer before surgery (called neoadjuvant chemotherapy) – you may have this as part of a cancer research trial.

Sometimes, you may have chemotherapy with radiotherapy. This is called chemoradiation. If you have chemotherapy with radiotherapy before surgery, it is called neoadjuvant chemoradiation. This would usually be part of a cancer research trial. Your doctor or specialist nurse can give you more information about chemoradiation.

Three months after surgery I started chemotherapy. I did not feel ready or strong enough and on the first day of treatment I felt really nervous and anxious but it passed quickly enough and it wasn’t as bad as my imagination had led me to believe.

Carol


Chemotherapy after surgery

You may have chemotherapy after an operation to remove the cancer. The chemotherapy will usually start within 3 months of the operation and will last about 6 months.

The most commonly used chemotherapy drugs are:

You may have these together (called GemCap) or separately.

Another drug you may have is fluorouracil (5FU). You will have this as a drip (infusion) into a vein.

Gemcitabine

You have gemcitabine as a drip into a vein over 30 minutes. You will usually have this once a week for 3 weeks. You will then have a week of rest. These 4 weeks make up a cycle of treatment.

Capecitabine

You have capecitabine as tablets, twice a day. You should swallow them whole with a glass of water. You need to take them within half an hour after eating a meal.

You usually take the tablets every day for 2 weeks. This is then followed by a week of no tablets. These 3 weeks make up a cycle of treatment.

GemCap

If you are having gemcitabine and capecitabine together (GemCap), each cycle usually takes 4 weeks. You have a drip of gemcitabine once a week for 3 weeks and also take the tablets for 3 weeks. Then you will have no treatment in week 4.

To many people the word "chemo" is almost as scary as cancer, but it is just medicine.

Mark


Chemotherapy for advanced pancreatic cancer

People with advanced pancreatic cancer may have treatment with a single chemotherapy drug. Or they may have two or three combined. Common treatments are:

Your doctor will talk to you about what drugs are available and suitable for you.

Gemcitabine and nab-paclitaxel (Abraxane®)

You will have both gemcitabine and nab-paclitaxel as drips into a vein. The treatment usually takes half an hour. You will have it once a week for 3 weeks. This will be followed by a rest week. These 4 weeks make up a cycle of treatment. Your doctor or nurse will tell you more about this and how many cycles you will likely have.

FOLFIRINOX

Sometimes, you may have a combination of drugs called FOLFIRINOX. It combines:

Folinic acid is not a chemotherapy drug. But you may have it with 5FU, as it has been shown to make 5FU work better.

FOLFIRINOX can cause more side effects because it contains three chemotherapy drugs. So it is only suitable for people who are well enough to cope with these side effects.

Each cycle of treatment lasts 2 weeks. Your doctor or nurse will tell you more about this and how many cycles you will likely have.

Other drugs

Other drug combinations or new drugs may be used to treat pancreatic cancer. Sometimes, this will be as part of cancer research trials.

Cancer research trials are also looking at treatments called targeted therapies and immunotherapy. Targeted therapy drugs interfere with the way cancer cells grow. Immunotherapy tries to trigger the body’s immune system to attack cancer cells. The body’s immune system fights infection and disease.

Cancer research trials aim to improve the results of treatment for pancreatic cancer.

Chemotherapy

This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.

About our cancer information videos

Chemotherapy

This video provides a brief overview of chemotherapy treatment, how it can be given, how it works and possible side effects.

About our cancer information videos


How chemotherapy is given

You usually have chemotherapy as an outpatient. Most drugs are given into a vein (intravenously). You take some drugs (such as capecitabine) as tablets.

You may have drugs through:

PICC lines and central lines playlist

Watch our short animated videos about having PICC lines and central lines put in.

PICC lines and central lines playlist

Watch our short animated videos about having PICC lines and central lines put in.


Side effects of chemotherapy

Chemotherapy drugs may cause some unpleasant side effects, but they can also make you feel better. This is because they relieve the symptoms caused by the cancer. Most people have some side effects, but they can usually control these with medicines. The side effects usually go away once treatment has finished. Treatment with a combination of chemotherapy drugs tends to cause more severe side effects than single chemotherapy drugs. You can talk to your doctor or nurse about what to expect from your treatment.

Back to Chemotherapy explained

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.