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The American Cancer Society estimates that about 60,430 people will be diagnosed with pancreatic cancer in 2021. The majority of these people will undergo chemotherapy at some point in their treatment.

Chemotherapy is a treatment that involves taking drugs with chemicals that help kill cancer cells, but it also happens to kill healthy cells that divide quickly.

People with pancreatic cancer often receive chemotherapy before or after surgery, and sometimes together with radiation therapy or other treatments.

In this article, we look at when chemotherapy is used to treat pancreatic cancer, what you can expect during treatment, and what other treatments may be used.

Most people who receive treatment for pancreatic cancer receive chemotherapy. Chemotherapy may be given before or after surgery for people with early-stage cancer. It may also be used to treat cancer that has spread to multiple organs or can’t be completely removed with surgery.

Chemotherapy for early-stage pancreatic cancer

The primary treatment for early-stage pancreatic is surgery. Chemotherapy is often used before or after surgery to increase the chance of completely removing the cancer cells. If chemotherapy is combined with radiation therapy, it’s called chemoradiation therapy.

Chemotherapy performed before surgery is called neoadjuvant therapy. It’s sometimes used to shrink a tumor before it’s removed.

Chemotherapy administered after surgery is called adjuvant therapy. Adjuvant therapy is used to destroy any cancer cells that may not have been removed during surgery, even if they’re not detectable.

Studies have found that people who receive the chemotherapy drugs gemcitabine (Gemzar) or 5-fluorouracil (Tolak, Fluoroplex, Efudex) after surgery have an improved overall survival rate of 6 months, compared with people who only have surgery. Newer studies are examining the potential benefits of using a combination of chemotherapy drugs.

Chemotherapy for late-stage pancreatic cancer

Cancer that has spread to multiple organs is known as stage 4 cancer. Typically, stage 4 pancreatic cancer is not considered curable.

Treatment for stage 4 pancreatic cancer is palliative, meaning it aims to improve your quality of life by managing the side effects and symptoms of the disease.

Surgery isn’t an option for cancer that has spread to multiple organs. Chemotherapy may be used by itself or with targeted therapy. Targeted therapy is a drug therapy that destroys cancer cells while mostly leaving healthy cells unaffected.

Chemotherapy may also be administered with other treatments in clinical trials.

A variety of different types of chemotherapy drugs may be used, but gemcitabine (Gemzar) is the most common.

Chemotherapy drugs are often administered intravenously (IV), meaning directly into a vein. The procedure may be done at your doctor’s office, hospital, or a chemotherapy clinic.

The drugs may be administered through your arm or a larger type of IV called a central venous catheter (commonly called a “port”). A tube connected to your central venous catheter is inserted through your chest into a large vein near your heart.

Some types of chemotherapy drugs can also be taken through oral pills.

Adjuvant and neoadjuvant chemotherapy usually last 3 to 6 months. The length of chemotherapy treatment for late-stage pancreatic cancer depends on the treatment’s effectiveness and side effects.

Pancreatic cancer has a better outlook when it’s caught early. The National Cancer Institute reports the following survival rates:

StageCancer extent5-year relative survival rate
LocalizedIsolated to pancreas41.6%
RegionalSpread to surrounding lymph nodes or tissues14.4%
DistantSpread to distant tissues and organs3.0%

NOTE: The data shown in this table is from 2011 to 2017.

A 2019 study found that the mean overall survival was 31 months for 115 people with borderline resectable pancreatic cancer who received chemotherapy and surgery. Borderline resectable cancer means it isn’t clear if the tumor can be completely removed with surgery.

Surgery followed by adjuvant chemotherapy is the preferred treatment for cancers considered resectable. A recent clinical trial found that people treated with a type of multidrug chemotherapy (a modified regimen that included FOLFIRINOX) had a median survival time of 54.4 months.

Chemotherapy drugs target cells that divide rapidly. Along with cancer cells, healthy cells in your body such as cells in your digestive system, skin, and hair follicles can be damaged. Damage to healthy cells can cause side effects such as:

It’s a good idea to let your treatment team know about any side effects you experience. Your team can work with you to address any side effects you’re having and to make sure your treatment plan balances your quality of life with the need to get rid of the cancer.

Some drugs may come with other risks. For example, cisplatin (Platinol), oxaliplatin (Eloxatin), and paclitaxel (Abraxane) can cause nerve damage.

The chemotherapy drug gemcitabine (Gemzar) has been frequently given after surgery since the 1990s to treat local pancreatic cancer. In recent years, it’s often combined with capecitabine (Xeloda).

According to the American Cancer Society, the following drugs are also commonly used before or after surgery:

  • albumin-bound paclitaxel (Abraxane)
  • cisplatin (Platinol)
  • gemcitabine (Gemzar)
  • irinotecan (Camptosar, Onivyde)
  • oxaliplatin (Eloxatin)

For treating more advanced pancreatic cancer, the American Cancer Society lists the following drugs as the most common:

  • 5-fluorouracil (Tolak, Fluoroplex, Efudex) or capecitabine (Xeloda)
  • gemcitabine (Gemzar)
  • irinotecan (Camptosar, Onivyde) or liposomal irinotecan (nal-IRI, Onivyde)
  • cisplatin (Platinol) and oxaliplatin (Eloxatin)
  • paclitaxel (Abraxane), docetaxel (Docefrez, Taxotere), and albumin-bound paclitaxel (Abraxane)

A multidrug chemotherapy regimen called FOLFIRNOX is sometimes used to treat pancreatic cancer. It consists of the drugs:

  • leucovorin calcium (Wellcovorin)
  • fluorouracil (Tolak, Fluoroplex, Efudex)
  • irinotecan hydrochloride (Camptosar, Campto, Onivyde)
  • oxaliplatin (Eloxatin)

Along with chemotherapy, other treatments for pancreatic cancer include:

Chemotherapy is a part of most pancreatic cancer treatments. It’s commonly administered before or after surgery in people with early-stage pancreatic cancer. People with late-stage pancreatic cancer may receive chemotherapy if their cancer isn’t surgically removable.

Researchers are continuing to improve their understanding of the best way to treat pancreatic cancer. You can ask your doctor about clinical trials in your area that may offer state-of-the-art treatment techniques, or you can search the National Library of Medicine’s database.