If you have been diagnosed with locally advanced (stage 3) or advanced (stage 4 or metastatic) pancreatic cancer, you may have been told that surgery to remove your cancer isn’t possible. Your doctor may call your cancer inoperable or unresectable.
Locally advanced cancer is cancer that has spread outside the pancreas. It may have spread to the large blood vessels near the pancreas, or to a number of lymph nodes. This is stage 3 cancer.
Read more about stage 3 pancreatic cancer.
Occasionally, stage 3 cancer is borderline resectable cancer. This means that the cancer has grown very close to the major blood vessels near the pancreas. You may be able to have surgery to remove the cancer, but it depends which blood vessels are affected. Some surgeons class this as stage 2 cancer.
Read more about borderline resectable cancer
Advanced cancer is cancer that has spread to other parts of the body. It may have spread to your lungs, liver or the lining of your tummy (peritoneum). It is stage 4 cancer. Your doctor may call it metastatic cancer.
Read more about stage 4 pancreatic cancer.
Sometimes it is not possible to have surgery to remove pancreatic cancer. It may not be possible to remove the cancer if it has grown around a major artery or veins near the pancreas. It won’t be possible to remove it if it has spread to other parts of the body.
Being told you have inoperable pancreatic cancer can feel devastating. You may have questions or worries about your diagnosis. Talk to your doctor or nurse about your questions and how you are feeling. It might also help to talk things through with our specialist nurses on our free Support Line.
If you can’t have surgery, you may be able to have treatments to try to control the cancer and help you live longer, such as chemotherapy or radiotherapy. This will depend on the stage of your cancer and how well you are. If you have symptoms, there are also treatments to help manage these.
Your medical team will talk to you about your treatment options. It’s a good idea to have someone with you at this appointment, to support you and help you remember what’s said.
Whatever your options, having treatment is your decision, and you don’t have to decide anything straight away. Ask questions about your treatment options and possible side effects. You can also discuss treatments with our specialist nurses on our free Support Line.
If you have locally advanced pancreatic cancer, it’s not usually possible to remove the cancer with surgery. You may be offered chemotherapy on its own first, and then sometimes with radiotherapy (chemoradiotherapy) afterwards. This aims to shrink the cancer and slow down its growth. Stereotactic ablative body radiotherapy (SABR) may also be an option if you have locally advanced cancer. For a small number of people, these treatments may make surgery to remove the cancer possible.
If you have advanced cancer and are well enough, you may be offered chemotherapy. It won’t cure the cancer, but it may control the growth of the cancer and help you live longer. You may be offered treatment as part of a clinical trial.
If you have symptoms from the cancer there are also treatments for these. A specialist palliative care team or supportive care team can help manage symptoms. They can help you live as long and as comfortably as possible, and access more treatments. They also provide emotional and practical support and can support you with making decisions about your future care. They can also support your family.
Some people find the thought of palliative care upsetting. But these services aren’t just for people at the end of their life. They are available at any point during treatment or care for people with cancer that can’t be cured.
Some people with advanced pancreatic cancer may not be able to have treatment to control their cancer. This will depend on your situation. For example, you might not be physically well enough for treatments like chemotherapy. Some people may decide not to have treatment for the cancer. This can be for lots of different reasons, and will be a very personal decision to you. You can still have treatments to help with any symptoms.
Clinical trials are carefully controlled medical research studies that involve people. Most trials in pancreatic cancer aim to find better and new treatments. Ask your doctor or nurse whether there are any suitable clinical trials that you could take part in. Taking part in a clinical trial may give you the chance to try a new treatment. But there’s no guarantee that it will be any better than current treatments.
Search for current pancreatic cancer trials.
You can ask for a second opinion about your treatment options from a different medical team, if you want one. Most doctors will help you do this, if you ask them. But don’t delay your treatment while you get a second opinion, as it can take several weeks.
Some people want to know how long they may have left to live or whether their cancer can be cured. This is called your prognosis, outlook or life expectancy.
This will be different for each person, and depends on several things. You can read more about prognosis. It’s important to talk to your doctor about your own situation, if you want to know more.
Pancreatic cancer can cause symptoms, and the treatments can cause side effects. Tell your medical team about any symptoms as they can help manage them. Managing symptoms can improve how you feel, both physically and emotionally.
Not everyone will have the same symptoms or side effects. Common symptoms include:
Pancreatic cancer can cause problems with digestion. Taking capsules containing pancreatic enzymes when you eat can help problems with digestion. This is called pancreatic enzyme replacement therapy (PERT). It can make a big difference to how you feel.
Different people will want support and information in different ways. Whatever you need, we can help.
If you have just been diagnosed with locally advanced or advanced cancer, download our booklet: Pancreatic cancer if you can’t have surgery (inoperable cancer). A guide if you have just been diagnosed.
You can also order a printed copy.
Mum was anxious about changing symptoms. Some months there was no pain, but she vomited, other times there was bad indigestion, sometimes there was pain in her abdomen. I urged her to keep track and make sure she told the doctors or nurse. The nurse was amazing and really worked with her to get her symptoms sorted.
We would like to thank the following people who reviewed this information.
Published March 2026
To be reviewed March 2029
