Treatment for pancreatic cancer

Main treatments for pancreatic cancer

Pancreatic cancer can be difficult to treat.

The treatment you have will depend on:

• the size and type of pancreatic cancer you have
• where it is
• if it has spread
• your general health

It may include surgery, chemotherapy, radiotherapy and supportive care.

The specialist care team looking after you will:

• explain the treatments, benefits and side effects
• work with you to create a treatment plan that is best for you
• help you manage any side effects, including changes to your diet to help you digest your food

You'll have regular check-ups during and after any treatments. You may also have tests and scans.

If you have any symptoms or side effects that you are worried about, talk to your specialists. You do not need to wait for your next check-up.

Surgery

Your treatment will depend if the cancer can be removed or not.

• if pancreatic cancer is found early and it has not spread, you may be able to have surgery to remove it
• if the cancer cannot be removed, you may have surgery to help control some of your symptoms

Surgery to remove pancreatic cancer

There are several surgeries used to treat pancreatic cancer.

Surgery will remove part or, in a small number of cases, all the pancreas. All or parts of other organs around the pancreas may also need to be removed.

Recovery from surgery to treat pancreatic cancer can take a long time. The specialist team looking after you will discuss all the benefits and side effects.

Surgery to help control symptoms of pancreatic cancer

This can include surgery to:

• unblock the bile duct or stop it getting blocked, which helps with jaundice
• unblock the first part of the small intestine (duodenum) or to stop it getting blocked, which helps with feeling or being sick
• bypass a blockage in the bile duct or small intestine (duodenum), which helps with jaundice and feeling or being sick

Many of these procedures are done using endoscopy, where the surgeon uses a long, thin, flexible tube to reach the blockage or organ.

The aim of these operations is to help improve your symptoms, not to cure the cancer.

Chemotherapy

Chemotherapy uses medicines to kill cancer cells.

You may have chemotherapy for pancreatic cancer:

• to control symptoms if you're not able to have surgery because you are very unwell, or the cancer cannot be removed by surgery – it may be combined with radiotherapy (chemoradiotherapy)
• after surgery to help stop the cancer coming back
• before surgery to help make the cancer smaller
• to treat early cancer

Radiotherapy

Radiotherapy uses high-energy rays of radiation to kill cancer cells.

Radiotherapy is not often used to treat pancreatic cancer. But you may have radiotherapy:

• to treat early cancer if you are not able to have surgery because you are very unwell or the cancer cannot be removed by surgery – it's usually combined with chemotherapy (chemoradiotherapy)
• with chemotherapy before surgery to help make the cancer smaller
• to help control and improve the symptoms of advanced cancer

Supportive care

There are several other treatments that can help you feel better and improve the symptoms of pancreatic cancer. This is called supportive care.

Treatments can help with many symptoms of pancreatic cancer, including:

• problems eating and weight loss, including prescribing enzyme replacement tablets to help you digest your food better
• relieving any pain
• tiredness
• feeling or being sick, including prescribing anti-sickness tablets

The specialists will talk to you about what supportive care you might need.

What happens if you've been told your cancer cannot be cured

If you have advanced pancreatic cancer, it might be very hard to treat. It may not be possible to cure the cancer.

If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

You will be referred to a special team of doctors and nurses called the palliative care team or symptom control team.

They will work with you to help manage your symptoms and make you feel more comfortable. The clinical nurse specialist or palliative care team can also help you and your loved ones get any support you need.