The mainstay of treatment for pancreatic cancer is surgery. Unfortunately, it is rarely possible to completely remove the tumour - it has usually spread outside the pancreas or it is too large by the time patients experience any symptoms and present to the doctor. Often a surgeon will perform a bypass procedure called a Whipple's operation. This allows the food to pass from the stomach to the small bowel and the bile to pass from the liver to the gut freely. Alternatively, a stent is inserted into the bile duct during a procedure called ERCP. This involves a flexible tube which passes from through the mouth into the part of the gut next to the bile duct,  the physician can look down the tube and then insert a small plastic tube up the duct.

Chemotherapy - The choice of  chemotherapy drugs depend on the characteristics of the individual patient, the personal experience of your doctor, current scientific evidence and logistics of the oncology clinic.  Patients who are fit may benefit from a trial of chemotherapy. The side effects of the two most commonly used regimens in the UK are described by clicking on the headings below following headings:

Chemotherapy options after incomplete removal are then palliative. The aim of palliative treatment is not to cure, but to control or shrink the tumour especially if it is causing a specific symptoms. This treatment should improve the quality of life; therefore the side effects from the chemotherapy should not outweigh the benefits of shrinking the tumour. The overall chance of a sustained response to chemotherapy is less than 40% and unfortunately treatment remains at best palliative.

Your oncologist would require a full re-assessment of your disease after two or three cycles, to check whether treatment  is working effectively. This may involve repeat scans, clinical examination or a formal assessment of quality of life. If not effective, the treatment regime could be stopped or changed.

Hormone therapy - There are ongoing trials to establish which treatment is best for which patients but one interesting development is the use of hormones to treat cancer of the pancreas. In the same way as breast cancer are stimulated by the bodies own female hormone (Oestrogen) there is evidence that pancreas may be stimulated by the bodies male hormone . Stopping the hormones reaching the tumour can cause the cancer cells to stop growing and in some of the cells shrivel up and die completely (self destruct - apoptosis). Ongoing trials are investigating the use of hormone blockers Flutamide or casodex for pancreatic cancer. 

Radiotherapy - Occasionally, especially if you have pain a short course of radiotherapy may be recommended which is sometimes successful in relieving the pain (For side effects see radiotherapy to the abdomen). Alternately a pain specialist could consider a nerve block (coeliac plexus block).

Other information:

Links to national cancer institute site (USA)

Links to pancreas information site (UK)

Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.