Treatment overview

Surgery, chemotherapy and radiotherapy may all be used to treat pancreatic cancer. Treatments are also used to control symptoms and make you feel more comfortable. This is known as supportive care.

The most effective treatment for early-stage (resectable) pancreatic cancer is surgery to remove part, or all, of the pancreas. Chemotherapy may be given before surgery to shrink the tumour or to reduce the risk of the cancer cells spreading. Radiotherapy may be used after surgery to reduce the chances of the cancer coming back.

If the cancer has spread to nearby blood vessels it can be more difficult to remove (borderline resectable). Sometimes chemotherapy can shrink the tumour so that it can be removed. Otherwise, you will continue to have chemotherapy.

For locally advanced (unresectable) pancreatic cancer, chemotherapy may be used to control the cancer for some time and to relieve symptoms. Sometimes, chemotherapy and radiotherapy are given together (chemoradiation).

If the cancer is advanced (metastatic), you may be offered treatments to control symptoms.

Types of treatment

Surgery, chemotherapy and radiotherapy are all possible treatments for pancreatic cancer.

People with pancreatic cancer often have treatments to control symptoms and make them feel more comfortable. This is known as supportive care.

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

The treatment you have depends on the stage, grade and position of the cancer. It also depends on your general health and preferences.

It is important that you have the chance to discuss treatment with your doctors. They can help you understand why they have suggested a particular plan of treatment. They can also explain how the treatment may affect you.

Your treatment will depend on whether surgery can remove (resect) the cancer.

  • If the cancer is resectable, it means your doctors can remove the cancer with surgery.
  • If it is borderline resectable, an operation may be possible.
  • If the cancer is unresectable, it means it has spread into nearby blood vessels (locally advanced) or to other parts of the body (metastatic).

General information

Venus on treatment

'During my treatment I would ring up and talk to Macmillan nurses - that was really, really good for me.'


Treatment by stage of cancer

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 a small number of people who are fit enough. You can only have surgery if the cancer is small and has not already spread.

You may have chemotherapy before surgery to shrink the tumour. This can also reduce the risk of the cancer cells spreading. This is called neoadjuvant treatment. You may have the treatment as part of a cancer research trial.

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

Borderline resectable cancer

Sometimes, the cancer spreads to 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 (a clear margin). If this is not possible, the risk of the cancer coming back is high.

You may have chemotherapy first to shrink the tumour. The surgeon then decides if they can remove the cancer along with a clear margin. Only a small number of people can have surgery in this situation. Otherwise, you will continue to have chemotherapy.

Locally advanced (unresectable) cancer

Chemotherapy is the main treatment if the cancer has begun 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.

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

Metastatic or advanced cancer

If the cancer is advanced, 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.

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

You may need to have a stents. This will relieve 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). This is called supportive care.

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