Treatments for metastatic pancreatic cancer

The following are treatment options for metastatic pancreatic cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Chemotherapy

Chemotherapy is usually offered for metastatic pancreatic cancer.

Chemotherapy drugs and drug combinations used to treat metastatic cancer include:

  • gemcitabine (Gemzar)
  • FOLFIRINOX – folinic acid (leucovorin), 5-fluorouracil (Adrucil, 5-FU), irinotecan (Camptosar) and oxaliplatin (Eloxatin)
  • gemcitabine and nab-paclitaxel (Abraxane)

Surgery

You may be offered surgery to relieve symptoms of metastatic pancreatic cancer (called palliative surgery).

Stent placement is one of the most common ways to relieve a blockage caused by a pancreatic tumour. A stent is a thin, hollow tube that is placed into the duct to keep it open.

Surgical bypass may be used in some cases. There are different types of surgical bypass used depending on the location of the blockage.

Radiation therapy

You may be offered radiation therapy to control pain from metastatic pancreatic cancer (called palliative therapy).

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Some clinical trials in Canada are open to people with pancreatic cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Alberta Health Services. Adenocarcinoma of the Pancreas Clinical Practice Guideline [GI-006]. Alberta Health Services; 2015.
  • American Cancer Society. Pancreatic Cancer. 2016.
  • American Society of Clinical Oncology. Pancreatic Cancer. 2015.
  • BCCA protocol summary for palliative combination chemotherapy for advanced pancreatic adenocarcinoma using irinotecan, oxaliplatin, fluorouracil and folinic acid. BC Cancer Agency. Chemotherapy Protocols. Vancouver, BC: BC Cancer Agency; 2013.
  • BCCA protocol summare for first-line palliative chemotherapy for advanced gallbladder cancer and cholangiocarcinoma usign gemcitabine and cisplatin. BC Cancer Agency. Chemotherapy Protocols. Vancouver, BC: BC Cancer Agency; 2012.
  • BCCA protocol summary for palliative chemotherapy for upper gastrointestinal tract cancer (gastric, esophageal, gall bladder, pancreas carcinoma and cholangiocarcinoma) and metastatic anal using infusional fluorouracil and cisplatin. BC Cancer Agency. Chemotherapy Protocols. Vancouver, BC: BC Cancer Agency; 2013.
  • BCCA protocol summary for palliative chemotherapy for pancreatic adenocarcinoma, gallbladder cancer and cholangiocarcinoma using gemcitabine. BC Cancer Agency. Chemotherapy Protocols. Vancouver, BC: BC Cancer Agency; 2012.
  • The use of Folfirinox as first-line treatment for metastatic pancreatic adenocarcinoma. Cancer Care Ontario. Evidence-Based Series (EBS) and Practice Guidelines (PG). Toronto, ON: Cancer Care Ontario; 2011.
  • Dragovich, T. Pancreatic Cancer Treatment and Management. 2016: http://emedicine.medscape.com/article/280605-treatment#showall.
  • Dragovich, T. Pancreatic Cancer Guidelines. 2016: http://emedicine.medscape.com/article/280605-treatment#showall.
  • National Cancer Institute. Pancreatic Cancer Treatment (PDQ®) Health Professional Version. 2016.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Pancreatic Adenocarcinoma (Version 2.2016).
  • Winter JM, Brody JR, Abrams RA, Lewis NL, Yeo CJ . Cancer of the pancreas. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 49: 657-684.