Pancreatic Cancer Treatment by Stage

You are your own best advocate. The Pancreatic Cancer Action Network strongly recommends that you discuss your treatment goals with your healthcare team and know all of your options at every stage of your disease.

Pancreatic cancer treatment depends on the patient’s general health and the disease stage. Staging is the process doctors use to describe the cancer’s size and location.

Please note: This information applies specifically to adenocarcinoma, the most common form of pancreatic cancer. Pancreatic neuroendocrine tumors (PNETs) and other rare pancreatic cancer types have different treatments.

All Stages

For all stages, the Pancreatic Cancer Action Network strongly recommends:

• Clinical trials at diagnosis and during every treatment decision
• Molecular profiling of your tumor to help determine the best treatment options
• Symptom management and supportive (palliative) care, provided early in your diagnosis as well as during and after treatment

PanCAN Patient Services can help you understand these options.

Treatment by Stage

• Stage I Treatment
• Stage II (Locally Advanced) Treatment
• Stage III (Locally Advanced) Treatment
• Stage IV (Metastatic) Treatment
• Treating Recurrent Pancreatic Cancer

Stage I Treatment

At this stage, many tumors are resectable, or able to be removed through surgery.

Although 20 percent of pancreatic cancer patients may be eligible for surgery, data shows that up to half of those patients are told they are ineligible. The Pancreatic Cancer Action Network strongly recommends you see a surgeon who performs a high volume of pancreatic surgeries (more than 15 per year) to determine eligibility.

For eligible patients, surgery is the best option for long-term survival of pancreatic cancer. Data show high volume surgeons at high volume hospitals have higher success rates and fewer complications. The Pancreatic Cancer Action Network strongly recommends you have a high volume pancreatic surgeon (more than 15 surgeries per year) perform the surgery.

Your tumor’s location determines the type of surgery you have. The most common pancreatic surgery is the Whipple procedure. This is used for cancer in the head of the pancreas.

After surgery, very small cancer cells could remain in the body. These cancer cells can spread and form new cancerous tumors. So, many doctors recommend patients get treatment after surgery to potentially prevent the cancer from returning. Treatment after surgery is called adjuvant treatment.

If surgery is not possible, other standard treatment choices include chemotherapy, radiation or both. More choices may also be available through clinical trials.

Stage II (Locally Advanced) Treatment

At this stage, your tumor may be resectable (able to be removed by surgery) or borderline resectable (possibly able to be removed by surgery). The treatment can be very different from person to person, depending on the cancer’s exact location and whether it can be removed by surgery.

About 30 to 50 percent of patients who are eligible for surgery are told they are ineligible. The Pancreatic Cancer Action Network strongly recommends you see a surgeon who performs a high volume of pancreatic surgeries (more than 15 per year) to determine eligibility. PanCAN Patient Services can give you a list of high volume pancreatic surgeons in your area.

Patients with borderline resectable pancreatic cancer may get treatment before surgery. This may be chemotherapy, targeted therapy, radiation therapy or a mix of these. The goal of this treatment is to shrink the cancer or move it away from blood vessels so that it can be removed more easily through surgery. Treatment before surgery is called neoadjuvant therapy.

If surgery is not possible, other standard treatment choices include chemotherapy, radiation or both. More choices may also be available through clinical trials.

Stage III (Locally Advanced) Treatment

At this stage, most tumors are unresectable (unable to be removed by surgery) and are treated with therapies that travel through the bloodstream to reach cancer cells throughout the body.

Common stage III treatment choices are chemotherapy, radiation or both. More choices may also be available through clinical trials.

Stage IV (Metastatic) Treatment

Stage IV patients usually get a treatment that travels through the bloodstream to reach cancer cells that are in many places throughout the body. Stage IV treatment is typically chemotherapy. More choices may also be available through clinical trials.

Seeing pancreatic cancer specialists, physicians who diagnose and treat a high volume of pancreatic cancer patients, improves outcomes. The Pancreatic Cancer Action Network strongly recommends you consult with pancreatic cancer specialists who have experience diagnosing and treating the disease. PanCAN Patient Services can give you a list of pancreatic cancer specialists in your area.

Treating Recurrent Pancreatic Cancer

When the disease returns after treatment, it is called a recurrence. The cancer may come back to the pancreas or to another place or organ in the body, such as the liver.

There is not one standard treatment for pancreatic cancer that has recurred, but it is often treated like metastatic pancreatic cancer (spread outside the pancreas). This treatment is usually chemotherapy. More choices may also be available through clinical trials.

Get More Information About Pancreatic Cancer Treatment

Contact PanCAN Patient Services for free, in-depth disease information, including treatment information, a personalized clinical trials search and a list of pancreatic cancer specialists near you.

Information reviewed by PanCAN’s Scientific and Medical Advisory Board, who are experts in the field from such institutions as University of Pennsylvania, Memorial Sloan-Kettering Cancer Center, Virginia Mason Medical Center and more.

Information provided by the Pancreatic Cancer Action Network, Inc. (“PanCAN”) is not a substitute for medical advice, diagnosis, treatment or other health care services. PanCAN may provide information to you about physicians, products, services, clinical trials or treatments related to pancreatic cancer, but PanCAN does not recommend nor endorse any particular health care resource. In addition, please note any personal information you provide to PanCAN’s staff during telephone and/or email communications may be stored and used to help PanCAN achieve its mission of assisting patients with, and finding cures and treatments for, pancreatic cancer. Stored constituent information may be used to inform PanCAN programs and activities. Information also may be provided in aggregate or limited formats to third parties to guide future pancreatic cancer research and education efforts. PanCAN will not provide personal directly identifying information (such as your name or contact information) to such third parties without your prior written consent unless required or permitted by law to do so. For more information on how we may use your information, you can find our privacy policy on our website at https://www.pancan.org/privacy/.