• Making treatment decisions

    Make sure you discuss all the options available with your medical team. This allows you to make an informed decision about your treatment pathway. Questions to ask your doctor should include:

    • What is the stage and grade of my cancer?
    • How fast is the cancer growing?
    • How quickly can treatment start?
    • Is surgery an option to remove the cancer?
    • What is the aim of the treatment?
    • Will treatment cure or control my cancer?
    • Am I healthy enough to undergo the treatment?
    • What are the potential side effects of the recommended treatment?
    • Will the treatment improve my quality of life?
  • Treatment team

    Your treatment team may involve a diverse group of health professionals, each specialising in different aspects of care to offer comprehensive treatment and support. This team may include:

    • GP (General Practitioner): Oversees your overall health and coordinates treatment with specialists. 
    • Gastroenterologist: Specialises in diagnosing and treating diseases of the digestive system.
    • Endocrinologist: Specialises in diagnosing and treating hormonal disorders.
    • Surgeon (hepatopancreatobiliary): Expert in surgical procedures involving the pancreas and liver.
    • Radiation oncologist: Prescribes and coordinates your radiation therapy.
    • Medical oncologist: Prescribes and manages your chemotherapy treatment.
    • Cancer nurse: Provides care and support throughout your treatment, including information and assistance to help manage side effects and navigate the healthcare system.
    • Other allied health professionals: Includes social workers, pharmacists, and counsellors to support your emotional, social, and holistic needs during treatment.
     

Surgery for early pancreatic cancer

Getting a diagnosis in the early stages of pancreatic cancer, before the disease spreads to other parts of your body means surgery to remove the cancer may be possible.

Your doctor may recommend one of the procedures listed below:

  • Whipple procedure

    A Whipple procedure (or pancreaticoduodenal resection) is the most common surgery to remove tumours in the head of the pancreas. The procedure involves removing: 

    • the head of the pancreas 
    • the first part of the small intestine (duodenum) 
    • the gall bladder
    • part of the bile duct 
    • lymph nodes near the pancreas
    • part of the stomach, if required 
    • the second part of the small intestine (jejunum).

    After the procedure, your surgeon will reconnect the pancreas, bile duct and stomach to the small intestine. This allows digestion to function again after surgery. 

     
  • Distal pancreatectomy

    A distal pancreatectomy is a procedure to remove tumours in the tail and body of the pancreas. The procedure involves removing the tail, or the tail and part of the body of the pancreas. Your surgeon will generally remove your spleen as well.

  • Total pancreatectomy

    If the tumour is large or multiple tumours exist within your pancreas, your surgeon may recommend a total pancreatectomy. This procedure involves removing your entire pancreas. Your surgeon will also remove your spleen, gallbladder, part of the stomach, small intestine, bile duct and the lymph nodes close to the pancreas. 

    Living without a pancreas means that your body can no longer produce insulin. Without insulin, your body can’t regulate your blood sugar levels. This means you will develop type 1 diabetes. Type 1 diabetes is a condition that will need to be managed for the rest of your life.

Watch: Surgery for pancreatic cancer | Patient education video


Surgery for advanced pancreatic cancer


If the cancer has spread (metastasised), the removal of the tumour may not be possible. In this case, your specialist may suggest surgery to relieve symptoms related to blockages caused by the tumour. This will help to improve your quality of life. 

Surgical options for advanced pancreatic cancer include:

  • Stenting

    Cancer in the head of the pancreas may result in a blockage of the bile duct or small intestine. A surgeon can insert a stent (a small metal or plastic tube) to open up the bile duct or bowel to allow food to pass through. This will also relieve pressure caused by a tumour.

    A stent is usually put in during an ERCP (endoscopic retrograde cholangiopancreatography) procedure. 

  • Bypass surgery

    Another method for relieving a blocked bile duct is bypass surgery. This procedure involves re-directing the flow of bile from the common bile duct directly to the small intestine, bypassing the pancreas. Bypassing the blockage will allow your stomach to empty and stop a future blockage to the first part of the small intestine (duodenum). 

  • Gastroenterostomy

    This procedure involves surgically connecting your stomach to the second part of your small intestine (jejunum). This allows food to pass straight from the stomach to the middle section of your small intestine. This procedure bypasses the first section of the small intestine (duodenum) if damage exists.

  • Venting gastrostomy

    This procedure involves connecting the stomach to an artificial opening on the abdomen to insert a thin tube. This tube allows fluids to drain out of your stomach, vent air and give medicines if needed. The procedure also helps relieve nausea and vomiting, which improves quality of life.

Before any surgery, your care team at Epworth will provide you with detailed information about the procedure. This will include information on:

  • preparing for the procedure
  • what the procedure involves
  • what to expect after the operation
  • discharge from hospital and recovery
  • the possible side effects resulting from the operation.

Chemotherapy

Chemotherapy is one of the main treatments used to treat pancreatic cancer. It involves using drugs to kill cancer cells in your body. Chemotherapy can also damage healthy cells which often causes the side effects of chemotherapy.

Depending on your treatment plan, you may receive chemotherapy on its own, or in conjunction with radiotherapy and/or surgery. Your treatment plan will depend on the stage of your cancer.  

Watch: Chemotherapy and radiation therapy for pancreatic cancer | Patient education video

Chemotherapy can be prescribed with different treatment goals. Your doctor may recommend chemotherapy to: 

  • shrink your tumour before surgery for a better chance of removal (called neo-adjuvant chemotherapy) 
  • destroy any remaining cancer cells after surgery to help prevent the cancer from returning (called adjuvant chemotherapy)
  • when surgery is not an option, it can slow down the cancer growth. 

Chemotherapy is generally administered through a drip (intravenously) into the veins. Some chemotherapy medicines also come in tablet form.

Before chemotherapy, your medical oncology team will provide you with detailed information on your chemotherapy drugs and common side effects based on your individual treatment plan. This will include information on preparing for chemotherapy, what to expect after and how to best manage side effects.

  • Side effects of chemotherapy

    Most chemotherapy drugs work to kill fast-growing cells (e.g. cancer cells). However, they may also affect other types of fast-growing cells such as cells in the bone marrow, gastrointestinal tract, skin, hair and nails. This leads to common side effects of chemotherapy, including:

    • nausea and vomiting
    • hair loss
    • skin and nail changes
    • mouth sores
    • changes in appetite, taste, and smell
    • increased risk of infections (due to reduced white blood cell counts) 
    • bruising or bleeding more easily (from low platelet counts)
    • anaemia (low red blood cell counts) leading to tiredness and shortness of breath. 

    Additionally, certain chemotherapy drugs can cause specific long-term effects on the heart, kidneys, and other organs, as well as fertility issues. The intensity and type of side effects vary widely among individuals and depend on the specific drugs used, the dosage, and the duration of treatment.

    Treatments for pancreatic cancer may also cause changes in how your pancreas works. As a result of these changes, you may experience the following symptoms: 

    • nausea and vomiting
    • diarrhoea 
    • no appetite 
    • changes in bowel habits 
    • heartburn or indigestion
    • feeling full quickly after eating (early satiety).   

    Before you start chemotherapy, your doctor will discuss your treatment options with you and the potential side effects of your specific treatment. If you start to experience any side effects, notify your healthcare team immediately so that they can be managed effectively and as soon as possible. 

     
  • Timing of chemotherapy

    Chemotherapy may be used at different times in the treatment process and with different goals.

    • Neoadjuvant chemotherapy is given before the main treatment, which is usually surgery. The goal is to shrink the tumour to make surgery easier and more effective. By reducing the size of the tumour, it might be possible to go from needing a more extensive surgical procedure to a less invasive one. For some cancers, neoadjuvant chemotherapy can even make an inoperable tumour operable.
    • Adjuvant chemotherapy is given after the primary treatment, which is often surgery. The goal is to kill any cancer cells that might still be in the body, even if they can't be seen. These lingering cells can cause the cancer to come back later, so adjuvant chemotherapy is used to reduce the risk of cancer recurrence.
    • Palliative chemotherapy is not intended to cure cancer but to alleviate symptoms and improve the quality of life. It is used for advanced cancers to help shrink tumours that are causing pain or pressure. Even though the cancer might not be curable, reducing the tumour size can help relieve symptoms and potentially extend life.
     

Radiation therapy

Radiation therapy (or radiotherapy) uses radiation to safely treat and manage cancer. Radiation therapy treats cancer by damaging cancer cells while limiting the impact to healthy cells. 

Some damage may still occur to normal cells immediately around the treatment area. As with chemotherapy, damage to normal cells may cause side effects. These can include skin reactions and tiredness. 
  
Radiation therapy won’t cure the cancer. For this reason, it’s not as common in the treatment of pancreatic cancer as chemotherapy. However, it can help to control the cancer and slow down its growth.

There are various ways to use radiation therapy in your treatment. Your specialist may recommend radiation therapy to: 

  • shrink the tumour before surgery to make it easier to remove. 
  • destroy the remaining cancer cells after surgery to help prevent the cancer from returning. 
  • help relieve tumour-related symptoms. 

Types of radiation therapy

There are two different types of radiation therapy (for both procedures you will be awake): 

  • External radiation therapy – this is the most common procedure. It involves an external beam targeting your pancreas from outside your body. You are not radioactive after this procedure. 
  • Internal radiation therapy – you will receive an injection of radioactive material near the cancer. You may release small amounts of radiation for a few days after the procedure. Your doctor will tell you what you need to do if this is the case.

If radiation therapy is part of your treatment, your medical oncology team will provide you with detailed information, including potential side effects based on your individual treatment plan. This will include information on preparing for radiation therapy, what to expect after radiation therapy and how best to manage side effects.

GP referral

Get referred

Once referred to the Jreissati Pancreatic Centre at Epworth, you will have an appointment to see one of our experienced specialists within 72 hours.
Contact

Talk to our pancreatic nurse coordinator

You don’t have to navigate pancreatic cancer on your own. Please get in touch if you have a question about the Jreissati Pancreatic Centre at Epworth.
Need help?

Talk to our pancreatic nurse coordinator 

Your pancreatic nurse coordinator will be your first point of contact during your treatment journey at Epworth. They will be able to provide answers to any questions that your or your family may have.
Get in touch

Navigation