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Chemotherapy treatment

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

When you have chemotherapy

You might have chemotherapy after surgery for pancreatic cancer. You have chemotherapy to help lower the risk of the cancer coming back if your surgeon completely removed your cancer. This is known as adjuvant chemotherapy. 

Chemotherapy may help to shrink what was left behind if it wasn't possible to remove all the cancer.

You usually have chemotherapy for about 6 months. You generally start treatment about 1 or 2 months after surgery.

For people who are fit you are most likely to have a drug combination called FOLFIRINOX or gemcitabine with either capecitabine or another drug. You might have gemcitabine on its own if you have any problems after surgery or are not so fit. 

How you have it

You have FOLFIRINOX, gemcitabine and nab-paclitaxel as liquids into your bloodstream. Capecitabine is a tablet that you swallow.

You usually have the treatment in cycles. You have treatment for a few days or weeks and then a time with no treatment to allow your body to recover.

Into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

Taking your tablets or capsules

You must take tablets and capsules according to the instructions your doctor or pharmacist gives you.

Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.

You should take the right dose, not more or less.

Talk to your specialist or advice line before you stop taking a cancer drug.

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take newspapers, books or electronic devices to help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
  • diarrhoea or constipation
  • hair loss
Contact your doctor or nurse immediately if you have any signs of infection such as a temperature higher than 37.5C or generally feeling unwell. Infections can make you very unwell very quickly.

Side effects depend on:

  • which drugs you have
  • how much of each drug you have
  • how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you take any supplements or if you have been prescribed anything by alternative or complementary therapy practitioners.

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. They could be harmful.

When you go home

Chemotherapy for pancreatic cancer can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. Your nurse will give you telephone numbers to call if you have any problems at home.

Research into chemotherapy for pancreatic cancer

Researchers are looking at ways to improve treatment for pancreatic cancer. So your doctor might ask you to take part in a clinical trial. 

Information and help