If you can’t have surgery (inoperable cancer)

This information is for people who have been diagnosed with locally advanced pancreatic cancer (stage 3) or advanced pancreatic cancer (stage 4).

If you have been diagnosed with locally advanced or advanced (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 – which means it can’t be removed with surgery.

What is locally advanced pancreatic cancer?

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. It is stage 3 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.

What is advanced pancreatic cancer?

Advanced cancer is cancer that has spread to other parts of your body. It is stage 4 cancer. Your doctor may call it metastatic cancer.

What are my treatment options?

You may be able to have treatments to try to control the cancer, such as chemotherapy. There are also treatments for any symptoms. The aim of treatment will be to control the growth of your cancer, manage any symptoms and generally improve how you feel.

Whatever your options, having treatment is your decision, and you don’t have to decide anything straight away. You may be offered another appointment if you need it to discuss any questions you have.

Treatments for locally advanced cancer

If you have locally advanced pancreatic cancer, you may be offered chemotherapy on its own or together with radiotherapy (chemoradiotherapy). This is to try to shrink the cancer, slow down its growth, and control your symptoms. For a small number of people, this treatment may shrink the cancer enough to make surgery to remove the cancer possible.

Treatments for advanced cancer

If you have advanced cancer and are well enough, you may be able to have chemotherapy. Chemotherapy won’t cure the cancer, but it may help you to live longer and relieve your symptoms.

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 also provide emotional and practical support. They can help you live as long and as comfortably as possible, and plan for the future. 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.

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 different reasons. Whatever your situation there is medical, emotional and practical support available, and you should be able to have treatment for any symptoms you have. Read more about the care you will have if you can’t have treatment to control the cancer.

Clinical trials

Clinical trials are carefully controlled medical research studies that involve patients. Most trials in pancreatic cancer aim to find better treatments. Ask your medical team whether there are any clinical trials that you could take part in. A clinical trial may give you the chance to try a new treatment – although there’s no guarantee that it will be any better than current treatments.

Getting a second opinion

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.

Order our booklet for people just diagnosed

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.

Order the booklet

Questions about your diagnosis?

You will probably have lots of questions about your diagnosis or treatment options. Ask your doctor or nurse any questions you have – they are there to support you.

You can also speak to our specialist nurses on our free Support Line with any questions about your diagnosis and treatment options.

Specialist nurse Support Line
Pancreatic Cancer Nurse Jeni Jones

Questions to ask your doctor or nurse

  • Will chemotherapy help control my cancer?
  • Are radiotherapy or chemoradiotherapy suitable for me?
  • What side effects do these treatments have?
  • Are there any clinical trials that I could take part in?
  • What treatments can I have for my symptoms?

Dealing with symptoms and side effects

Pancreatic cancer can cause symptoms, and the treatments can cause side effects. Not everyone will have the same symptoms or side effects.

It’s important to talk to your medical team about any symptoms as they can help you with managing them. Getting treatment for symptoms can improve how you feel, both physically and emotionally.

What symptoms might I get?

We have more information about all these symptoms. Remember that not everyone will get all these symptoms.

What can I do about symptoms?

  • Tell your doctor or nurse about any symptoms you have as soon as you can.
  • Find out more about how symptoms are managed . This includes things you can do yourself.
  • If you have any symptoms of digestion problems, ask about pancreatic enzymes – these can help manage digestion problems and make a big difference to how you feel. Ask to be referred to a dietitian if you haven’t seen one.
  • Be aware of the symptoms of a blood clot . Contact your doctor or nurse as soon as possible if you get any of these symptoms.

Questions to ask your doctor or nurse

  • How can my symptoms be treated?
  • Are there things I can do myself?
  • Will taking pancreatic enzymes help my problems with digestion?
  • Can you give me advice about how to put on weight?
  • Are there other specialists who can help manage my symptoms? For example, a dietitian or palliative care specialist.

Mum was anxious about changing symptoms. 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.

Read other people's stories

Read about other people’s experiences of being diagnosed with inoperable pancreatic cancer.

Stories about inoperable cancer

Order our newly diagnosed pack

Order our newly diagnosed pack, to help you understand your diagnosis and treatment options

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Published September 2020

To be reviewed September 2022