Medical advice

What happens when pancreatic cancer has been diagnosed?

If you have undergone tests that show you may have pancreatic cancer, you will be referred to a pancreatic surgeon in a specialist centre which deals with a high number of these cancers.Your case will be reviewed by an expert (multi-disciplinary) team (surgeons, gastroenterologists, cancer specialists, radiologists, pathologists) to decide on your treatment. Sometimes a further assessment called a laparoscopy is needed as well.This is carried out under general anaesthetic and a small telescope is passed into the abdomen through the belly button to get a close look inside.

Can I have surgery to remove the cancer?

This depends on how far the cancer has grown and if you are well enough to have surgery. If it is at an early stage it may be possible to remove the cancer using surgery. This is a major operation and should only be done in a specialist pancreatic centre.You will be able to ask your surgeon about the risks of surgery and make sure you are fit for major surgery. If the cancer is in the tail of the pancreas, then the left side of the pancreas will be removed. If the cancer is in the head, then the head of pancreas, duodenum and bile duct and gallbladder will be removed.The remaining areas are then re-joined to the intestines. Occasionally the whole of the pancreas may need to be removed (total pancreatectomy), and sometimes part of the stomach as well

What happens after I have surgery?

You will stay in hospital for 2-3 weeks and take 3 or more months to recover.You should be able to eat normally when you have left hospital.You may need to take capsules containing enzymes to help you digest your food at mealtimes. If you have had a total pancreatectomy you will become diabetic after surgery and need medication (insulin) for this.You will usually be considered for a course of chemotherapy once you are over the surgery.You will be followed up in the outpatient clinic with regular. Sometimes further scans are needed to see if the cancer has come back. If this is the case then further chemotherapy or other treatment may be necessary.

What happens if I cannot have surgery to remove my cancer?

If your cancer has spread outside the pancreas (advanced cancer) and is not able to be removed by surgery (or you are not well enough to have an operation) then other treatments can be considered. If you are jaundiced you will need to be treated using ERCP or PTC to place a stent in the bile duct. Painkillers will be needed for pain relief and capsules are needed to help your digestion at mealtimes. Chemotherapy is the usual treatment for advanced pancreatic cancer and newer treatments may be available as part of a clinical trial.These therapies aim to control the cancer.You will be followed up regularly in the clinic. You will normally have a specialist nurse throughout your care who you can contact for any help or problems.

If I have had pancreatic cancer, what can I do to stop it coming back?

A healthy lifestyle and positive mental attitude can help. Regular medical follow-up is very important.

Are there any implications for my family?

Advice to family members about not smoking is useful. Unless you are part of a family with a specifi c inherited disorder associated with pancreatic cancer, your family will not need to be screened.