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Chemotherapy before and after surgery

Chemotherapy may be suitable for some people with borderline resectable (operable) pancreatic cancer. It is also used after surgery to reduce the chances of the cancer coming back.

Chemotherapy for borderline operable pancreatic cancer

Borderline resectable cancer is cancer that has grown very close to the major blood vessels near the pancreas. It may be possible to remove the cancer, but it depends which blood vessels are affected and how far the cancer has grown. Chemotherapy aims to shrink the cancer to improve the chances of successfully removing it with surgery. This may be followed by radiotherapy.

Chemotherapy with radiotherapy (chemoradiotherapy)

Chemotherapy can also be used in combination with radiotherapy, which used high energy x-rays (radiation) to destroy cancer cells. This is known as chemoradiotherapy. The chemotherapy drug is given in the normal way but at a lower dose, together with a daily treatment of radiotherapy. The aim is for the chemotherapy drugs (and sometimes other drugs) to make the cancer cells more sensitive to the radiotherapy so that it works better.

Chemoradiotherapy may be suitable for people with borderline resectable (operable) cancer, where surgery may be an option or for people with locally advanced pancreatic cancer. It is still unclear how well chemoradiotherapy works for borderline resectable or locally advanced pancreatic cancer, and clinical trials are looking at this.

Chemotherapy after surgery to remove cancer

If you have had surgery to completely remove pancreatic cancer, your oncologist (cancer specialist) will discuss with you whether having chemotherapy afterwards would be helpful. The aim is to try to reduce the chances of the cancer coming back.

The drugs most often used after surgery are gemcitabine and capecitabine. Recent research suggests that using gemcitabine together with capecitabine (GemCap) can reduce the chances of the cancer returning, but they can also be given separately.

Chemotherapy will usually start within 12 weeks of surgery, and is normally given for up to six months.

More chemotherapy information

Published May 2017

Review date May 2019

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