Check-ups after surgery

You will continue to have check-ups with your medical team after your operation to remove pancreatic cancer. This is called follow-up. This page explains these.

Check-up after your operation

A doctor called a pathologist will look at the tissue that was removed during your surgery. You will have an appointment with your surgeon a few weeks after going home, to get the results of these tests. You can also talk about any side effects or other problems you are having.

What do my test results mean?

As well as removing the cancer, the surgeon removes some of the tissue around it. This is called a surgical margin. The pathologist checks for any signs of cancer near the edges of this tissue and in the lymph nodes that were removed. The aim is to make sure all the cancer has been removed.

They will describe your surgical margins as either:

clear (negative or R0): there are no cancer cells near the outer edges of this tissue.
not clear (positive, involved or R1): there are cancer cells near the outer edges of this tissue.

They will also say if cancer was found in any of the lymph nodes that were removed.

Your doctor will explain what your results mean for you. Even if there was no cancer in your surgical margins or lymph nodes, your doctor may talk to you about having chemotherapy.

You may get a letter after your surgery, with more information about your results. This may use another way to describe the cancer, called TNM (Tumour Nodes Metastases) staging.

What is the TNM staging?

Your TNM stage gives more detail about the size and location of the cancer, and about any lymph nodes that had cancer.
You may have been told your TNM stage when you were first diagnosed, based on the tests you had.

You may also be told the TNM stage after surgery. This is based on tests done on the tissue removed during your operation.

T is the size of the tumour.
T1: the cancer is contained in the pancreas and is smaller than 2cm.
T2: the cancer is contained in the pancreas. It is larger than 2cm but no larger than 4cm.
T3: the cancer is larger than 4cm.
T4: the cancer has grown into nearby large blood vessels.

N shows whether the cancer has spread to the nearby lymph nodes.
N0: the cancer has not spread to nearby lymph nodes.
N1: the cancer has spread to 1-3 nearby lymph nodes.
N2: the cancer has spread to 4 or more lymph nodes.

M shows whether the cancer has spread to another part of the body (metastatic cancer).
M0: the cancer has not spread to other parts of the body.
M1: the cancer has spread to other parts of the body, such as the liver or lungs.

Doctors combine the T, N and M results to give the stage of the cancer.

If you have any questions about your results or need help to understand them, speak to your medical team. Our specialist nurses on our free Support Line can also talk you through your results and what they might mean for you.

Longer term checks-ups (follow-up)

You will continue to have check-ups (known as follow-up) after your operation. You may have blood tests and a scan for these.

The appointments may be with your surgical team, or with an oncologist if you have chemotherapy. After the first few appointments, your follow-up may be at your local hospital, rather than the specialist centre.

Each hospital will do things slightly differently. Ask your medical team if you haven’t been told what to expect.

  • For the first two years, you may have a check-up every six months.
  • After two years, you may have a check-up every 12 months. These may be phone calls, rather than in person. This varies between hospitals.
  • After five years, you probably won’t have routine check-ups. You can speak to your GP if you feel unwell or have any concerns.

You may also have appointments for support with your digestion or with taking pancreatic enzyme capsules or other medicines. These appointments may be with other health professionals, such as a dietitian.

Check-ups are a chance for you to ask questions. If you have any problems between check-ups, ask your nurse for advice or an extra appointment. If you get any new symptoms, contact your medical team so they can find out what is causing them.

If your check-ups find any signs that the cancer has come back, you may be offered more treatment with chemotherapy.

Watch our video on check-ups after surgery

Specialist nurse, Lisa, explains check-ups after surgery for pancreatic cancer, and what happens at these appointments.

Questions to ask your doctor or nurse

  • How often will I have check-ups after my surgery?
  • Do I need to book these, or will the hospital or GP contact me?
  • What tests will I have to check the cancer hasn’t come back?
  • Who should I call if I have any problems?
  • Who can I contact for emotional support?

Chemotherapy after surgery

You may have chemotherapy after you have recovered from your surgery. This may help to reduce the chances of the cancer coming back. Ask your doctor about chemotherapy if they don’t mention it – there may be a good reason why you have not been offered chemotherapy.

Read more about chemotherapy after surgery for pancreatic cancer.

Questions after surgery?

If you have any questions or concerns, or need emotional support, speak to our specialist nurses on our free Support Line.

Speak to our nurses
A specialist nurse taking a phone call.

Updated January 2024

Review date January 2026