While surgery for pancreatic cancer can potentially remove the cancer from the body, many people with pancreatic cancer aren’t eligible for surgery. Other treatments for this type of cancer include chemotherapy, radiation, targeted therapy, and immunotherapy.

Pancreatic cancer starts in the pancreas, which makes enzymes important for digestion as well as hormones that regulate blood sugar levels. About 64,050 people in the United States will receive a diagnosis of pancreatic cancer in 2023.

There are a variety of treatments that may be used for pancreatic cancer. The type of treatment that’s recommended will depend on many factors, such as the stage of the cancer, your age, and your overall health.

In this article, we take a look at the primary types of treatment used for pancreatic cancer.

Questions for your doctor about pancreatic cancer treatment

Receiving a diagnosis of pancreatic cancer can be overwhelming. Many different questions may come to mind. Below are some examples of questions to ask your doctor about your pancreatic cancer treatment:

  • Is my cancer resectable? If not, why?
  • What are the treatment choices that are available to me?
  • What treatment are you recommending and why?
  • What are the benefits and risks of this type of treatment?
  • How will this treatment affect my outlook?
  • When will I need to start my treatment?
  • Where will I get my treatment?
  • How often will I receive treatment and how long will each session take?
  • What are the potential side effects of this treatment? What can I do to help prevent or manage them?
  • In what ways may this treatment impact my daily activities? Will I be able to work while receiving treatment?
  • Will my health insurance cover my treatment? If not, what can I do?
  • What are the next steps if the recommended treatment isn’t effective?

It may be helpful to bring a list of questions with you when you meet with your healthcare team. Be sure to take notes during your appointment so that you can refer to them later.

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Surgery is one of the main types of treatment for pancreatic cancer. It’s also the only potentially curative treatment, meaning that it has the potential to completely remove the cancer from your body.

Your doctor will use the results of imaging and other tests to determine if your cancer is resectable. That means that it can safely be removed using surgery. The procedures that may be used include:

  • pancreaticoduodenectomy, which is also called the Whipple procedure and involves the removal and reconstruction of parts of the pancreas and digestive tract
  • distal pancreatectomy, which removes the tail of the pancreas, part of the body of the pancreas, and the spleen
  • total pancreatectomy, which is used less often and removes the entire pancreas as well as parts of surrounding organs and tissues

Most pancreatic cancers are in a more advanced stage at diagnosis. As such, only about 15% to 20% of pancreatic cancers are resectable.

However, surgery can still be used to treat complications of pancreatic cancer, such as a blocked bile duct. This is called palliative surgery and can include stent placement or bypass surgery to relieve a bile duct blockage.

The potential side effects of surgery for pancreatic cancer can include:

Chemotherapy (chemo) uses drugs that affect the growth and division of cancer cells. There are a few situations when chemo is used for pancreatic cancer:

Some examples of chemo regimens that may be used for pancreatic cancer are:

Because chemo targets cell growth and division, it can also affect healthy cells that grow at a faster rate. This can lead to side effects like:

Radiation therapy uses high energy radiation to kill cancer cells. It may be used in the following ways for pancreatic cancer:

  • as a neoadjuvant therapy before surgery
  • as an adjuvant therapy after surgery
  • as one of the main treatments for pancreatic cancer that’s not resectable
  • to ease pain in people with advanced pancreatic cancers

Radiation therapy is often given along with chemo because sometimes chemo drugs can help the radiation therapy to work better. This type of treatment is called chemoradiation.

Some of the side effects of radiation therapy include:

Targeted therapy uses drugs that target certain markers in or on cancer cells. It may be used when pancreatic cancer is more advanced. A few examples of targeted therapy drugs that are used for pancreatic cancer include:

Sometimes, you may receive a targeted therapy drug along with a chemo drug. An example of this is gemcitabine (Gemzar) with erlotinib (Tarceva).

The specific side effects of targeted therapy can vary based on the drug that’s used. Some of the common side effects may include:

Immunotherapy is a type of cancer treatment that helps your immune system to respond to the cancer. Like targeted therapy, it’s used for more advanced pancreatic cancers.

An immunotherapy drug that’s used for pancreatic cancer is pembrolizumab (Keytruda). This is a type of drug called an immune checkpoint inhibitor. It helps certain immune cells to better recognize cancer cells in your body.

The common side effects of pembrolizumab (Keytruda) can include:

Researchers continue to work on developing more effective treatments for pancreatic cancer. This includes evaluating new combinations of existing cancer treatments or testing new treatments.

Gene therapy and improving chemoradiation are two examples of recent research into pancreatic cancer treatment.

Gene therapy

A 2022 study reported on a gene therapy where immune cells called T cells are collected from a person’s blood and are modified to target pancreatic cancer cells with a specific mutation. These cells are then infused back into the person.

Researchers reported significant tumor regression in an individual with metastatic pancreatic cancer who received this experimental therapy.

Improving chemoradiation

Another 2022 study looked at a new approach to chemoradiation in mice. In this experimental treatment, mice were injected with a gel containing radioactive particles.

When used in combination with the chemo drug paclitaxel (Taxol), there was a 100% response rate.

Clinical trials for pancreatic cancer treatment

New treatments for pancreatic cancer need to be tested in clinical trials before being made widely available. These trials look at both how safe and how effective a new treatment is.

If you’ve received a diagnosis of pancreatic cancer and are interested in joining a clinical trial, talk with your healthcare team to see if there are trials for which you’d be eligible. A list of available trials for pancreatic cancer can also be found here.

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Some of the factors that can affect the outlook for pancreatic cancer include:

  • the stage of your cancer
  • the type of treatment that’s recommended
  • how your cancer responds to treatment
  • whether the cancer has come back (recurred) or spread (metastasized) after treatment
  • your age and overall health

Most pancreatic cancers are diagnosed at advanced stages, with more than half (52%) being diagnosed when the cancer has already metastasized. Because of this, the outlook for pancreatic cancer is quite poor.

The table below shows the 5-year relative survival rates of pancreatic cancer from 2012 to 2018 in the United States. These survival rates are based on the extent of cancer at diagnosis.

Localized to pancreas43.9%
Regional spread to nearby tissues14.7%
Spread to distant tissues (metastasis)3.1%

The statistics above don’t reflect individual factors or recent advances in treatment. To get a better idea of your specific outlook, have an open discussion with your healthcare team.

What is a relative survival rate?

A relative survival rate gives you an idea of how long someone with a specific condition may live after their diagnosis compared with someone without the condition.

For example, a 5-year relative survival rate of 11.5% means that someone with that condition is 11.5% as likely to live for 5 years as someone without the condition.

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There are several treatments for pancreatic cancer. While surgery can potentially remove the cancer completely, most people with pancreatic cancer aren’t eligible for surgery based on the extent and location of their cancer.

Other treatments for pancreatic cancer include chemo, radiation, and targeted therapy. If you’ve received a diagnosis of pancreatic cancer, talk with your care team about what type of treatment is recommended, why, and how it may affect your outlook.