Treatment to manage pancreatic cancer and symptoms

Managing pancreatic cancer

Pancreatic cancer usually has no symptoms in its early stages, so many people are diagnosed when the cancer is advanced. If the cancer involves nearby organs or blood vessels (locally advanced – some stage 3 cancers) or has spread to other parts of the body (metastasised – all stage 4 cancers), surgery to remove the cancer may not be possible. Instead, treatments will focus on shrinking or slowing the growth of the cancer and relieving symptoms without trying to cure the disease. This is called palliative treatment.

Some people think that palliative treatment is only offered at the end of life. However, it can help at any stage of pancreatic cancer. It does not mean giving up hope – rather, it is about managing symptoms and living as fully and comfortably as possible. Palliative treatment is one aspect of palliative care. Many studies have shown that when palliative care is delivered early it can improve people’s quality of life.

Palliative treatments may include surgery, chemotherapy and radiation therapy, either on their own or in combination. These treatments may be used to help manage the cancer and relieve some common symptoms of advanced pancreatic cancer, such as:

• jaundice caused by narrowing of the common bile duct
• ongoing vomiting and weight loss caused by a blockage in the stomach or small bowel
• pain in the abdomen (belly) and middle back.

Many people with advanced pancreatic cancer have digestive problems. For example, a blockage in the pancreatic duct can stop the flow of the digestive enzymes required to break down food. This can be treated with pancreatic enzyme supplements. Learn ways to change your diet to help manage some common problems.

Treatment options to manage cancer and symptoms

Managing pain in pancreatic cancer

If pain becomes an issue, you may need a combination of treatments to achieve good pain control.

Options for relieving pain may include:

• strong pain medicines such as opioids
• nerve blocks – when anaesthetic or alcohol is injected into nerves
• anticonvulsant medicines to help control nerve pain
• chemotherapy and/or radiation therapy to shrink cancer pressing on nerves
• complementary therapies such as acupuncture, massage and relaxation techniques.

Tell your treatment team if you have any pain, as it is easier to control when treated early. Don’t wait until the pain is severe. Your team can also refer you to a pain specialist or palliative care specialist if needed.

How palliative care can help

The treatment options described in this section are generally part of palliative treatment. Palliative treatment is one aspect of palliative care, in which a team of health professionals work together to meet your physical, emotional, cultural, spiritual and social needs. Specialist palliative care services see people with more complex needs and can also advise other health professionals. See below for more information about palliative care.

Contacting a specialist palliative care service soon after diagnosis gives them the opportunity to get to know you, your family and your circumstances. You can ask your treating doctor for a referral.

See Palliative care and Living with advanced cancer and listen to Cancer Council's podcast series The Thing About Advanced Cancer.

How palliative care works

Palliative care is an important part of care for many people with pancreatic cancer. Palliative care may be helpful at any time after diagnosis and is often delivered alongside active cancer treatment to help maintain your quality of life.

When to start

Palliative care is useful at all stages of advanced cancer. Contacting a palliative care team after a diagnosis of advanced pancreatic cancer can help you work out when is best to start palliative treatment.

Symptom relief

Palliative treatment can help you manage symptoms related to the cancer or its treatment, such as fatigue, pain or nausea.

Who provides care

The palliative care team is made up of people with different skills to help you with a range of issues. Care may be led by a GP, nurse practitioner or community nurse, or a specialist palliative care team.

Support services

The palliative care team will help you work out how to live in the most fulfilling way you can. They can refer you to organisations and services that can assist with practical, financial and emotional needs.

Family and carers

If you agree, the palliative care team will involve your family and carers in decisions about your care. They can also provide them with practical and emotional support.