Pancreatic Cancer Treatment

Different types of treatment are available for pancreatic cancer. You and your cancer care team will work together to decide your treatment plan, which commonly includes more than one type of treatment. Many factors will be considered, such as the stage of the cancer, your overall health, and your preferences. Your plan will include information about the cancer, the goals of treatment, your treatment options and possible side effects, and the expected length of treatment.

Learn more about Pancreatic Cancer Treatment by Extent of Disease.

Talking with your cancer care team before treatment begins about what to expect will be helpful. You’ll want to learn what you need to do before treatment begins and how you’ll feel while going through it. You’ll also want to discuss how different treatments are expected to affect the cancer and outcome, how to manage side effects, and what kind of help you will need.

As you go through treatment, you may decide to continue, change, or stop treatment based on the severity of treatment side effects, results of tests checking organ functions, or whether treatments are expected to help against your cancer.

To learn more, visit Questions to Ask Your Doctor About Treatment.

Chemotherapy

Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells. Chemo either kills the cells or stops them from dividing. It may be combined with other treatments, such as radiation therapy or targeted therapy. If chemo and radiation are given at the same time, it’s called chemoradiation.

Chemotherapy for pancreatic cancer is usually systemic, meaning it is injected into a vein or given by mouth. When given this way, the drugs enter the bloodstream to reach cancer cells throughout the body.

Chemotherapy for pancreatic cancer is often given as a combination of different drugs. The two most common combinations are:

leucovorin, 5-fluorouracil, irinotecan, and oxaliplatin (FOLFIRINOX)
gemcitabine and nab-paclitaxel

Other chemotherapy to treat pancreatic cancer may include:

capecitabine
cisplatin
irinotecan sucrosofate (also called nanoliposomal irinotecan)

Chemotherapy not listed here may also be used.

Chemotherapy to treat pancreatic cancer can have serious side effects, and your doctor will help you choose a regimen that best fits your individual circumstances.

Learn more about how chemotherapy works, how it is given, common side effects, and more at Chemotherapy to Treat Cancer and Chemotherapy and You: Support for People With Cancer.

Surgery

When surgery can completely remove the tumor, you have the best chance of long-term survival. But pancreatic cancer is often diagnosed at an advanced stage when complete removal is not possible and surgery is not an option. Sometimes, imaging shows the tumor can be removed, but once the operation begins, the surgeon sees that removal is not possible and stops the procedure. Even if the tumor is completely removed, there is a high risk of the cancer coming back. When pancreatic cancer comes back after surgery, it often returns in other parts of the body and is considered metastatic cancer.

Surgery for pancreatic cancer is complex and carries risks. Your doctor will speak with you about the risks and benefits of surgery and help you decide if surgery is right for you.

Learn more about Surgery to Treat Cancer.

The type of surgery you undergo depends on the location and size of the tumor. Surgeries used to treat pancreatic cancer include:

Whipple procedure (pancreaticoduodenectomy)

A Whipple procedure, also called pancreaticoduodenectomy, is surgery to remove tumors in the head of the pancreas. It involves removing the head of the pancreas, the gallbladder, part of the small intestine, part of the bile duct, and part of the stomach. Enough of the pancreas is left to produce digestive juices and insulin, but you may need to take digestive enzymes when you eat to help your nutrition.

Distal pancreatectomy

Distal pancreatectomy is a surgery used for tumors in the body and tail of the pancreas. It involves removing the body and tail of the pancreas and sometimes the spleen.

Endoscopic treatments and palliative surgery

Endoscopic treatments or palliative surgery are done to relieve symptoms of pancreatic cancer but are not meant to cure the cancer or remove the tumor. Types of endoscopic treatments and palliative surgery used to relieve symptoms of pancreatic cancer include:

Endoscopic stent placement is done when cancer is blocking the flow of bile in the bile duct or food passage from the stomach into the duodenum—the first part of the small intestine. A gastroenterologist uses a flexible tube with a camera, called an endoscope, to place a stent in the bile duct or the duodenum to keep it open. Bile may have to drain to the outside of the body into a small bag to make it easier for the gastroenterologist to place the stent in the bile duct.
Gastric bypass may be done when cancer is blocking the flow of food from the stomach into the duodenum and stent placement is not possible. During gastric bypass, the surgeon connects the stomach directly to the small intestine after the duodenum. This bypasses the blockage and helps relieve symptoms such as nausea and vomiting by allowing food to leave the stomach.

Radiation therapy

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. This type of radiation therapy is called external radiation therapy and uses a machine outside the body to send radiation toward the area of the body with cancer. To minimize damage to the surrounding tissues, radiation therapy can be given in higher doses over fewer sessions. This is called stereotactic radiation therapy (SBRT) or gamma knife. SBRT not only reduces the number of therapy sessions needed but also may decrease radiation therapy side effects.

Learn more about External Beam Radiation Therapy for Cancer and Radiation Therapy Side Effects.

Targeted therapy

Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. A small number of pancreatic cancers may respond to targeted therapy. Molecular testing of the tumor is important and can help your doctor decide whether you are a candidate for targeted therapy.

Targeted therapies used to treat pancreatic cancer include:

Daraxonrasib was approved by the U.S. Food and Drug Administration on August 26, 2026 because it has been shown to extend survival and improve quality of life for people with advanced, previously treated pancreatic cancer. Daraxonrasib is a targeted therapy taken by mouth that targets mutations in the KRAS gene. Nine out of ten pancreatic cancers have this mutation, and it is one of the earliest gene changes found as the disease progresses. Daraxonrasib can have difficult side effects, such as rash and mouth sores.

Learn more about Targeted Therapy to Treat Cancer.

Immunotherapy

Immunotherapy helps a person’s immune system fight cancer. A small number of pancreatic cancers may respond to immunotherapy. Molecular testing of the tumor during diagnosis is important and can help your doctor understand whether you are a candidate for immunotherapy. Pembrolizumab and dostarlimab are immunotherapies used to treat pancreatic cancers that have certain changes in their DNA, such as high microsatellite instability (MSI-H), deficient DNA mismatch repair (dMMR), or high tumor mutational burden (TMB-H).

Your doctor will suggest biomarker tests to help predict your response to immunotherapy. Learn more about Biomarker Testing for Cancer.

Immunotherapy is also considered personalized therapy because it not only activates your immune system to destroy cancer cells but also targets specific substances or DNA changes in cancer cells.

Learn more about Immunotherapy to Treat Cancer and Immunotherapy Side Effects.

Pancreatic cancer clinical trials

Many new treatments for pancreatic cancer are being studied in clinical trials. A treatment clinical trial is a research study meant to obtain information on new treatments for people with cancer, including whether the new treatment works better against cancer than current treatments. Because pancreatic cancer is a complex disease and currently has limited treatment options, many experts believe it’s important for all people with pancreatic cancer to join a clinical trial, even if they have early-stage cancer.

You can find clinical trials for people with pancreatic cancer at Treatment Clinical Trials for Pancreatic Cancer or use the clinical trial search to find NCI-supported clinical trials that are accepting participants. The search allows you to filter trials based on the type of cancer, your age, and where the trials are being done. Clinical trials supported by other organizations can be found at ClinicalTrials.gov.

Two doctors speak with an elderly woman. The doctors are on either side of the elderly woman, who has short white hair, thick glasses, a pearl necklace, and a beige vest over a tan sweater. The doctors are wearing white coats and have stethoscopes around their necks. The doctors wear neutral-happy expressions; the elderly woman looks somewhat surprised. Large windows with multiple panels are in the background.

Palliative Care in Cancer

A fact sheet about palliative care, which is care meant to improve the quality of life of those with a serious or life-threatening disease.

Learn more about clinical trials, including how to find and join one, at Cancer Clinical Trial Information for Patients and Caregivers.

Palliative care for pancreatic cancer

Palliative care is an important part of pancreatic cancer treatment. Pancreatic cancer, especially in its later stages, often leads to symptoms like weight loss, weakness, pain, nausea, vomiting, or the inability to eat, which can be made worse by side effects of chemotherapy. Palliative care aims to improve quality of life and comfort by treating cancer-related symptoms, pain, and anxiety. Your care team will include palliative care specialists who focus on managing this aspect of your treatment.