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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK65959_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK65959_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK65959_"><span class="title" itemprop="name">Pancreatic Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: March 5, 2024.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062957__274">This PDQ cancer information summary has current information about the treatment of adult pancreatic cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062957__275">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062957__110"><h2 id="_CDR0000062957__110_">General Information About Pancreatic Cancer</h2><div id="CDR0000062957__110.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062957__111">Pancreatic cancer is a type of cancer that forms in the tissues of the pancreas.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__118">Smoking and health history can affect the risk of pancreatic cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__122">Signs and symptoms of pancreatic cancer include jaundice, pain, and
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weight loss.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__126">Pancreatic cancer is difficult to diagnose
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early.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__130">Tests that examine the pancreas are used to diagnose and stage pancreatic cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__642">Some people decide to get a second opinion.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__134">Certain factors affect prognosis (chance
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of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062957__111"><h3>Pancreatic cancer is a type of cancer that forms in the tissues of the pancreas.</h3><p id="CDR0000062957__113">The pancreas is a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">gland</a> about 6 inches long that is
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shaped like a thin pear lying on its side. The wider end of the pancreas is
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called the head, the middle section is called the body, and the narrow end is
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called the tail. The pancreas lies between the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000415914/" class="def">spine</a>.<div id="CDR0000062957__250" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20pancreas&p=BOOKS&id=602734_CDR0000636528.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000636528.jpg" alt="Anatomy of the pancreas; drawing shows the pancreas, stomach, spleen, liver, bile ducts, gallbladder, small intestine, and colon. An inset shows the head, body, and tail of the pancreas. The bile duct and pancreatic duct are also shown." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the pancreas. The pancreas has three areas: the head, body, and tail. It is found in the abdomen near the stomach, intestines, and other organs. </p></div></div></p><p id="CDR0000062957__114">The pancreas has two main jobs in the body:</p><ul id="CDR0000062957__115"><li class="half_rhythm"><div>to make juices
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that help break down food into substances the body can use</div></li><li class="half_rhythm"><div>to make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045713/" class="def">hormones</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046187/" class="def">insulin</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270860/" class="def">glucagon</a>, that help control <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000658770/" class="def">blood sugar</a>
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levels and help the body use and store the energy it gets
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from food</div></li></ul><p id="CDR0000062957__331">Pancreatic cancer can occur in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270856/" class="def">exocrine pancreas cells</a>, which produce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046446/" class="def">digestive</a> juices, or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270854/" class="def">endocrine pancreas cells</a>, which produce hormones. About 95% of pancreatic
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cancers begin in exocrine
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cells.</p><p id="CDR0000062957__117">This summary is about exocrine pancreatic cancer.
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For information about endocrine pancreatic cancer, see <a href="/books/n/pdqcis/CDR0000062678/">Pancreatic Neuroendocrine Tumors (Islet Cell Tumors) Treatment</a>.</p></div><div id="CDR0000062957__118"><h3>Smoking and health history can affect the risk of pancreatic cancer.</h3><p id="CDR0000062957__332">Pancreatic cancer is caused by certain changes to the way pancreatic cells function, especially how they grow and divide into new cells. A risk factor is anything that increases the chance of getting a disease. Some risk factors for pancreatic cancer, like smoking, can be changed. However, risk factors also include things people cannot change, like their genetics and their family history. Learning about risk factors for pancreatic cancer can help you make changes that might lower your risk of getting it. </p><p id="CDR0000062957__333">There are many risk factors for pancreatic cancer, but many do not directly cause cancer. Instead, they increase the chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045671/" class="def">DNA</a> damage in cells that may lead to pancreatic cancer. To learn more about how cancer develops, see <a href="https://www.cancer.gov/about-cancer/understanding/what-is-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">What Is Cancer?</a></p><p id="CDR0000062957__334">Having one or more of these risk factors does not mean that you will get pancreatic cancer. Many people with risk factors never develop pancreatic cancer, while others with no known risk factors do.</p><p id="CDR0000062957__268"> Risk
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factors for pancreatic cancer include:</p><ul id="CDR0000062957__121"><li class="half_rhythm"><div>smoking</div></li><li class="half_rhythm"><div>carrying excess body weight</div></li><li class="half_rhythm"><div>having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642019/" class="def">personal history</a> of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044911/" class="def">diabetes</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045641/" class="def">chronic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045106/" class="def">pancreatitis</a></div></li><li class="half_rhythm"><div>having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of pancreatic cancer or pancreatitis</div></li><li class="half_rhythm"><div>having certain <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045983/" class="def">hereditary</a>
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conditions, such as:<ul id="CDR0000062957__264"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270861/" class="def">multiple endocrine neoplasia type 1 (MEN1)
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syndrome</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044884/" class="def">hereditary nonpolyposis colon
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cancer</a> (HNPCC; Lynch syndrome)</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045563/" class="def">von
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Hippel-Lindau syndrome</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000377716/" class="def">Peutz-Jeghers syndrome</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000751862/" class="def">hereditary breast and ovarian cancer syndrome</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270857/" class="def">familial
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atypical multiple mole melanoma (FAMMM) syndrome</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270853/" class="def">ataxia-telangiectasia</a></div></li></ul>
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</div></li></ul><p id="CDR0000062957__645">Talk with your doctor if you think you might be at risk.</p></div><div id="CDR0000062957__122"><h3>Signs and symptoms of pancreatic cancer include jaundice, pain, and
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weight loss.</h3><p id="CDR0000062957__272">Early on, pancreatic cancer may not cause any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a>, making it hard to detect. As the cancer grows, symptoms may include:</p><ul id="CDR0000062957__125"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046328/" class="def">jaundice</a>
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(yellowing of the skin and whites of the eyes)</div></li><li class="half_rhythm"><div>light-colored <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046605/" class="def">stools</a></div></li><li class="half_rhythm"><div>dark urine</div></li><li class="half_rhythm"><div>pain in the upper or middle <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> and back </div></li><li class="half_rhythm"><div>weight loss for no known reason </div></li><li class="half_rhythm"><div>loss of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454699/" class="def">appetite</a></div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000321374/" class="def">fatigue</a>
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</div></li></ul><p id="CDR0000062957__646">These symptoms may be caused by many conditions other than pancreatic cancer. It’s important to check with your doctor if you have any of these symptoms to find out the cause and begin treatment, if needed. </p></div><div id="CDR0000062957__126"><h3>Pancreatic cancer is difficult to diagnose
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early.</h3><p id="CDR0000062957__128">Pancreatic cancer is difficult to detect and diagnose for the
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following reasons:</p><ul id="CDR0000062957__129"><li class="half_rhythm"><div>There aren’t any noticeable signs or symptoms in the early
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stages</a> of pancreatic
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cancer.</div></li><li class="half_rhythm"><div>The signs and symptoms of pancreatic cancer, when present, are like the
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signs and symptoms of many other illnesses.</div></li><li class="half_rhythm"><div>The pancreas is hidden behind other organs such as the
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stomach, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046395/" class="def">gallbladder</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046738/" class="def">bile
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ducts</a>.</div></li></ul></div><div id="CDR0000062957__130"><h3>Tests that examine the pancreas are used to diagnose and stage pancreatic cancer.</h3><p id="CDR0000062957__132">Pancreatic cancer is usually diagnosed with tests and procedures
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that make pictures of the pancreas and the area around it. The process used
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to find out if cancer cells have spread within and around the pancreas is
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called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. Tests and procedures
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to detect, diagnose, and stage pancreatic cancer are usually done at the same
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time. To plan treatment, it is important to know the stage of
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the disease and whether the pancreatic cancer can be removed by
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surgery. </p><p id="CDR0000062957__266"> In addition to asking about your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642019/" class="def">personal</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000642015/" class="def">family health history</a> and doing a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">physical exam</a>, your doctor may perform the following tests and procedures:</p><ul id="CDR0000062957__133"><li class="half_rhythm"><div><b>Blood chemistry study </b>is a laboratory test in which a blood sample is checked to measure the amounts of certain substances, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044518/" class="def">bilirubin</a>, released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
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</div></li><li class="half_rhythm"><div><b>Tumor marker test</b> is a procedure in which a sample of blood, urine, or tissue is checked to measure the amounts of certain substances, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000633729/" class="def">CA 19-9</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000357558/" class="def">carcinoembryonic antigen</a> (CEA), made by organs, tissues, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> cells in the body. Certain substances are linked to specific types of cancer when found in increased levels in the body. These are called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046636/" class="def">tumor markers</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
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resonance imaging)</b> uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT
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scan)</b> uses a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044983/" class="def">spiral</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044460/" class="def">helical CT</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046570/" class="def">scan</a> makes a series of very detailed pictures of areas inside the body using an x-ray machine that scans the body in a spiral path. </div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron
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emission tomography scan)</b> uses a small amount of radioactive sugar (also called glucose) that is injected into a vein. Then a scanner rotates around the body to make detailed, computerized pictures of areas inside the body where the glucose is taken up. Because cancer cells often take up more glucose than normal cells, the pictures can be used to find cancer cells in the body. A PET scan and CT scan may be done at the same time. This is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000742485/" class="def">PET-CT</a>.
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</div></li><li class="half_rhythm"><div><b>Abdominal ultrasound</b> makes pictures of the inside of the abdomen. The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000367430/" class="def">ultrasound transducer</a> is pressed against the skin of the abdomen and directs high-energy sound waves (ultrasound) into the abdomen. The sound waves bounce off the internal tissues and organs and make echoes. The transducer receives the echoes and sends them to a computer, which uses the echoes to make pictures called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046587/" class="def">sonograms</a>. </div></li><li class="half_rhythm"><div>
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<b>Endoscopic
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ultrasound (EUS)</b> is a procedure that uses an endoscope inserted into the body, usually through the mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. An endoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. This procedure is also called endosonography.</div></li><li class="half_rhythm"><div><b>Endoscopic
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retrograde cholangiopancreatography (ERCP)</b> is a procedure to x-ray the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046441/" class="def">ducts</a> (tubes) that carry <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046508/" class="def">bile</a> from the liver to the gallbladder and from the gallbladder to the small intestine. Sometimes pancreatic cancer causes these ducts to narrow and block or slow the flow of bile, causing jaundice. An endoscope (a thin, lighted tube) is passed through the mouth, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046408/" class="def">esophagus</a>, and stomach into the first part of the small intestine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> (a smaller tube) is then inserted through the endoscope into the pancreatic ducts. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> is injected through the catheter into the ducts and an x-ray is taken. If the ducts are blocked by a tumor, a fine tube may be inserted into the duct to unblock it. This tube (or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044903/" class="def">stent</a>) may be left in place to keep the duct open. Tissue samples may also be taken.</div></li><li class="half_rhythm"><div><b>Percutaneous
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transhepatic cholangiography (PTC)</b> is a procedure to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If a blockage is found, a thin, flexible tube called a stent is sometimes left in the liver to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000407759/" class="def">drain</a> bile into the small intestine or a collection bag outside the body. This test is done only if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046424/" class="def">ERCP</a> cannot be
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done.</div></li><li class="half_rhythm"><div><b>Laparoscopy</b> is a surgical procedure to look at the organs inside the abdomen to check for signs of disease. Small <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046353/" class="def">incisions</a> (cuts) are made in the wall of the abdomen and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044360/" class="def">laparoscope</a> (a thin, lighted tube) is inserted into one of the incisions. The laparoscope may have an ultrasound probe at the end in order to bounce high-energy sound waves off internal organs, such as the pancreas. This is called laparoscopic ultrasound. Other instruments may be inserted through the same or other incisions to perform procedures such as taking tissue samples from the pancreas or a sample of fluid from the abdomen to check for cancer.</div></li><li class="half_rhythm"><div><b>Biopsy</b> is the removal of cells or tissues so they can be viewed under a microscope by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. There are several ways to do a biopsy for pancreatic cancer.
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A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045691/" class="def">fine needle</a> or a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000641799/" class="def">core needle</a> may be inserted into the pancreas during an x-ray or
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ultrasound to remove cells. Tissue
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may also be removed during a laparoscopy or surgery to remove the tumor.</div></li></ul></div><div id="CDR0000062957__642"><h3>Some people decide to get a second opinion.</h3><p id="CDR0000062957__643">You may want to get a second opinion to confirm your pancreatic cancer diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. They may agree with the first doctor, suggest changes or another treatment approach, or provide more information about your cancer.</p><p id="CDR0000062957__644">To learn more about choosing a doctor and getting a second opinion, see <a href="https://www.cancer.gov/about-cancer/managing-care/finding-cancer-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Finding Cancer Care</a>. You can contact <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI’s Cancer Information Service</a> via chat, email, or phone (both in English and Spanish) for help finding a doctor, hospital, or getting a second opinion. For questions you might want to ask at your appointments, see <a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>.</p></div><div id="CDR0000062957__134"><h3>Certain factors affect prognosis (chance
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of recovery) and treatment options.</h3><p id="CDR0000062957__227">The prognosis and treatment options depend on:</p><ul id="CDR0000062957__228"><li class="half_rhythm"><div>whether the tumor can be removed by surgery</div></li><li class="half_rhythm"><div>the stage
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of the cancer (the size of the tumor and whether the cancer has spread outside
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|
the pancreas to nearby tissues or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph
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|
nodes</a> or to other places in the body)</div></li><li class="half_rhythm"><div>the patient’s general
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health</div></li><li class="half_rhythm"><div>whether the cancer has just been diagnosed or has recurred (come back)</div></li></ul><p id="CDR0000062957__137">Pancreatic cancer can be controlled only if it is found before it
|
|
has spread, when it can be completely removed by surgery. If the cancer has spread,
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative treatment</a> can improve the patient's
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> by controlling the
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symptoms and complications of this disease. </p></div></div><div id="CDR0000062957__139"><h2 id="_CDR0000062957__139_">Stages of Pancreatic Cancer</h2><div id="CDR0000062957__139.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062957__143">The following stages are used for pancreatic
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cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062957__230">Stage 0 (Carcinoma in Situ)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__145">Stage I (also called stage 1) pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__148">Stage II (also called stage 2) pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__151">Stage III (also called stage 3) pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__154">Stage IV (also called stage 4) pancreatic cancer</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062957__302">The following groups are used to plan treatment:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062957__304">Resectable pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__307">Borderline resectable pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__310">Locally advanced pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__313">Metastatic pancreatic cancer</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__321">Recurrent pancreatic cancer</a></div></li></ul></li></ul></div><p id="CDR0000062957__335"><div class="milestone-start" id="CDR0000062957__140"></div>Cancer stage describes the extent of cancer in the body, such as the size of the tumor, whether it has spread, and how far it has spread from where it first formed. It is important to know the stage of the pancreatic cancer to plan the best treatment.   </p><p id="CDR0000062957__336">There are several staging systems for cancer that describe the extent of the cancer. Pancreatic cancer staging usually uses the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000672851/" class="def">TNM staging system</a>. You may see your cancer described by this staging system in your pathology report. Based on the TNM results, a stage (I, II, III, or IV, also written as 1, 2, 3, or 4) is assigned to your cancer. When talking to you about your cancer, your doctor may describe it as one of these stages. </p><p id="CDR0000062957__337">To learn how doctors stage pancreatic cancer, see <a href="#CDR0000062957__130">tests to diagnose and stage pancreatic cancer</a>. Learn more about <a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Staging</a>.</p><p id="CDR0000062957__338">The information in this section is about staging for exocrine pancreatic cancer, the most common type of pancreatic cancer. <div class="milestone-end"></div></p><div id="CDR0000062957__143"><h3>The following stages are used for pancreatic
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cancer:</h3><div id="CDR0000062957__230"><h4>Stage 0 (Carcinoma in Situ)</h4><div id="CDR0000062957__285" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%200%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000793188.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000793188.jpg" alt="Stage 0 pancreatic cancer; drawing shows abnormal cells in the pancreas." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage 0 pancreatic cancer. Abnormal cells are found in the lining of the pancreas. These abnormal cells may become cancer and spread into nearby normal tissue.
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</p></div></div><p id="CDR0000062957__232">In stage 0, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> cells are found in the lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.</p></div><div id="CDR0000062957__145"><h4>Stage I (also called stage 1) pancreatic cancer</h4><div id="CDR0000062957__259" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000687928.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000687928.jpg" alt="Stage I pancreatic cancer; drawing on the left shows stage IA pancreatic cancer. The cancer is in the pancreas and the tumor is 2 centimeters or smaller. An inset shows 2 centimeters is about the size of a peanut. The drawing on the right shows stage IB pancreatic cancer. The cancer is in the pancreas and the tumor is larger than 2 centimeters but not larger than 4 centimeters. An inset shows 2 centimeters is about the size of a peanut and 4 centimeters is about the size of a walnut." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I pancreatic cancer. Cancer is found in the pancreas only. In stage IA, the tumor is 2 centimeters or smaller. In stage IB, the tumor is larger than 2 centimeters but not larger than 4 centimeters.</p></div></div><p id="CDR0000062957__147">In stage I, cancer has formed and is
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found in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a> only. Stage I is divided into
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stages IA and IB, depending on the size of the tumor.</p><ul id="CDR0000062957__222"><li class="half_rhythm"><div>Stage IA: The tumor is 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> or smaller.</div></li><li class="half_rhythm"><div>Stage IB: The tumor is larger than 2 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a> but not larger than 4 centimeters.</div></li></ul></div><div id="CDR0000062957__148"><h4>Stage II (also called stage 2) pancreatic cancer</h4><p id="CDR0000062957__150">Stage II is divided into
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stages IIA and IIB, depending on the size of the tumor and where the
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cancer has spread.</p><ul id="CDR0000062957__223"><li class="half_rhythm"><div>Stage IIA: The tumor is larger than 4 <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354457/" class="def">centimeters</a>.<div id="CDR0000062957__260" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIA%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000687932.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000687932.jpg" alt="Stage IIA pancreatic cancer; drawing shows cancer in the pancreas and the tumor is larger than 4 centimeters. An inset shows 4 centimeters is about the size of a walnut." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIA pancreatic cancer. The tumor is larger than 4 centimeters.</p></div></div></div></li><li class="half_rhythm"><div>Stage IIB: The tumor is any size, and cancer has spread to 1 to 3 nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.<div id="CDR0000062957__261" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIB%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000742418.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000742418.jpg" alt="Stage IIB pancreatic cancer; drawing shows cancer in the pancreas and in 1 to 3 nearby lymph nodes." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIB pancreatic cancer. The tumor is any size and cancer has spread to 1 to 3 nearby lymph nodes.</p></div></div></div></li></ul></div><div id="CDR0000062957__151"><h4>Stage III (also called stage 3) pancreatic cancer</h4><div id="CDR0000062957__262" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20III%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000687940.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000687940.jpg" alt="Stage III pancreatic cancer; drawing shows cancer in the pancreas and in (a) 4 or more nearby lymph nodes and (b) the common hepatic artery. Also shown are the portal vein, celiac axis (trunk), and superior mesenteric artery." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage III pancreatic cancer. The tumor is any size and cancer has spread to (a) 4 or more nearby lymph nodes; or (b) the major blood vessels near the pancreas. These include the portal vein, common hepatic artery, celiac axis (trunk), and superior mesenteric artery. </p></div></div><p id="CDR0000062957__283">In stage III, the tumor is any size, and cancer has spread to:</p><ul id="CDR0000062957__284"><li class="half_rhythm"><div>four or more nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or</div></li><li class="half_rhythm"><div>the major <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> near the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>.</div></li></ul></div><div id="CDR0000062957__154"><h4>Stage IV (also called stage 4) pancreatic cancer</h4><div id="CDR0000062957__263" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IV%20pancreatic%20cancer&p=BOOKS&id=602734_CDR0000687943.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK65959.13/bin/CDR0000687943.jpg" alt="Stage IV pancreatic cancer; drawing shows other parts of the body where pancreatic cancer may spread, including the lung, liver, and peritoneal cavity. An inset shows cancer cells spreading from the pancreas, through the blood and lymph system, to another part of the body where metastatic cancer has formed." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IV pancreatic cancer. The tumor is any size and cancer has spread to other parts of the body, such as the lung, liver, or peritoneal cavity (the body cavity that contains most of the organs in the abdomen). </p></div></div><p id="CDR0000062957__156">In stage IV, the tumor is any size, and cancer has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, or peritoneal cavity (the body cavity that contains most of the organs in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>). </p><p id="CDR0000062957__339">Stage IV pancreatic cancer is also called metastatic pancreatic cancer. Metastatic cancer happens when cancer cells travel through the lymphatic system or blood and form tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor. For example, if pancreatic cancer spreads to the liver, the cancer cells in the liver are actually pancreatic cancer cells. The disease is called metastatic pancreatic cancer, not liver cancer. Learn more in <a href="https://www.cancer.gov/types/metastatic-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Metastatic Cancer: When Cancer Spreads</a>.</p></div></div><div id="CDR0000062957__302"><h3>The following groups are used to plan treatment:</h3><div id="CDR0000062957__304"><h4>Resectable pancreatic cancer</h4><p id="CDR0000062957__306"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044568/" class="def">Resectable</a> pancreatic cancer can be removed by surgery because it has not grown into important blood vessels near the tumor.</p></div><div id="CDR0000062957__307"><h4>Borderline resectable pancreatic cancer</h4><p id="CDR0000062957__309">Borderline resectable pancreatic cancer has grown into a major blood vessel or nearby tissue or organs. It may be possible to remove the tumor, but there is a high risk that all of the cancer cells will not be removed with surgery.</p></div><div id="CDR0000062957__310"><h4>Locally advanced pancreatic cancer</h4><p id="CDR0000062957__312"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045955/" class="def">Locally advanced</a> pancreatic cancer has grown into or close to nearby lymph nodes or blood vessels, so surgery cannot completely remove the cancer.</p></div><div id="CDR0000062957__313"><h4>Metastatic pancreatic cancer</h4><p id="CDR0000062957__315"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">Metastatic</a> pancreatic cancer has spread to other organs, so surgery cannot completely remove the cancer.</p></div><div id="CDR0000062957__321"><h4>Recurrent pancreatic cancer</h4><p id="CDR0000062957__323">Recurrent pancreatic cancer is cancer that has recurred
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(come back) after it has been treated. The cancer may come
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back in the pancreas or in other
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parts of the body. Tests will be done to help determine where the cancer has returned in your body. The type of treatment for recurrent pancreatic cancer will depend on where it has come back.</p><p id="CDR0000062957__340">Learn more in <a href="https://www.cancer.gov/types/recurrent-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Recurrent Cancer: When Cancer Comes Back</a>. Information to help you cope and talk with your health care team can be found in the booklet <a href="https://www.cancer.gov/publications/patient-education/when-cancer-returns" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">When Cancer Returns</a>.</p></div></div></div><div id="CDR0000062957__162"><h2 id="_CDR0000062957__162_">Treatment Option Overview</h2><div id="CDR0000062957__162.kp" class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062957__163">There are different types of treatment for patients with
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pancreatic cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__167">The following types of treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062957__169">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__175">Radiation therapy
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</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__178">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__256">Chemoradiation therapy</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__253">Targeted therapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062957__188">There are treatments for pain caused by pancreatic
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cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__191">Patients with pancreatic cancer have special nutritional
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needs.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__181">New types of treatment are being tested in clinical trials.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__279">Treatment for pancreatic cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062957__247">Follow-up care may be needed.</a></div></li></ul></div><div id="CDR0000062957__163"><h3>There are different types of treatment for patients with
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pancreatic cancer. </h3><p id="CDR0000062957__341">Different types of treatments are available for people with pancreatic cancer. You and your cancer care team will work together to decide your treatment plan, which may include 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 your cancer, the goals of treatment, your treatment options and the possible side effects, and the expected length of treatment. </p><p id="CDR0000062957__342">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, how you’ll feel while going through it, and what kind of help you will need. To learn more, see <a href="https://www.cancer.gov/about-cancer/treatment/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Treatment</a>. </p></div><div id="CDR0000062957__167"><h3>The following types of treatment are used:</h3><div id="CDR0000062957__169"><h4>Surgery </h4><p id="CDR0000062957__171">One of the following types of surgery may be used to take out the
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tumor:</p><ul id="CDR0000062957__172"><li class="half_rhythm"><div>Whipple
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procedure is surgery to remove the head of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046254/" class="def">pancreas</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046395/" class="def">gallbladder</a>, part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046604/" class="def">stomach</a>, part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046738/" class="def">bile duct</a>. Enough of the pancreas is left to produce digestive juices and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046187/" class="def">insulin</a>.</div></li><li class="half_rhythm"><div>Total
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pancreatectomy is surgery to remove the whole pancreas, part
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of the stomach, part of the small
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intestine, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046466/" class="def">common bile
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duct</a>, the gallbladder, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046593/" class="def">spleen</a>, and nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044519/" class="def">Distal pancreatectomy</a> is surgery to remove the body and the tail of the
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pancreas. The spleen may also be removed if cancer has spread to the spleen.</div></li></ul><p id="CDR0000062957__173">If the cancer has spread and cannot be removed, the following
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types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative surgery</a> may be
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done to relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>:</p><ul id="CDR0000062957__174"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000775967/" class="def">Biliary bypass</a>: If cancer is blocking the bile duct
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and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046508/" class="def">bile</a> is building up in the
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gallbladder, a biliary bypass may be done. During this operation, the doctor
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will cut the gallbladder or bile duct in the area before the blockage and sew it to the small intestine to
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create a new pathway around the blocked area. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046428/" class="def">Endoscopic</a>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044903/" class="def">stent</a> placement: If the tumor is blocking the
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bile duct, surgery may be done to put in a stent (a thin tube) to drain bile
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that has built up in the area. The doctor may place the stent through a
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> that drains the bile into a bag on the outside
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of the body, or the stent may go around the blocked area and drain the bile into
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the small intestine.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046770/" class="def">Gastric</a> bypass:
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If the tumor is blocking the flow of food from the stomach, the stomach may be
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sewn directly to the small intestine so the patient can continue to eat
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normally. </div></li></ul></div><div id="CDR0000062957__175"><h4>Radiation therapy
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</h4><p id="CDR0000062957__177"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation
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therapy</a> uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. Pancreatic cancer is sometimes treated with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">external beam radiation therapy</a>. This type of radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. </p><p id="CDR0000062957__349">Learn more about <a href="https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/external-beam" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">External Beam Radiation Therapy for Cancer</a> and <a href="https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy Side Effects</a>.</p></div><div id="CDR0000062957__178"><h4>Chemotherapy </h4><p id="CDR0000062957__180"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a> uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. </p><p id="CDR0000062957__343">Chemotherapy for pancreatic cancer is usually systemic, meaning it is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a vein or given by mouth. When given this way, the drugs enter the bloodstream to reach cancer cells throughout the body. </p><p id="CDR0000062957__344">Chemotherapy drugs used to treat pancreatic cancer may include: </p><ul id="CDR0000062957__345"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/capecitabine" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">capecitabine</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/fluorouracil" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">fluorouracil (5-FU)</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/gemcitabinehydrochloride" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">gemcitabine</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/irinotecanhydrochloride" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">irinotecan</a>
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</div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/leucovorincalcium" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">leucovorin</a> (a vitamin that improves the effectiveness of 5-FU)</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/oxaliplatin" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">oxaliplatin</a>
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</div></li></ul><p id="CDR0000062957__346">Combinations of these drugs may be used. Other chemotherapy drugs not listed here may also be used.</p><p id="CDR0000062957__647">Chemotherapy may also be combined with other kinds of treatment. For example, it may be combined with radiation therapy or targeted therapy.</p><p id="CDR0000062957__347">To learn more about how chemotherapy works, how it is given, common side effects, and more, see <a href="https://www.cancer.gov/about-cancer/treatment/types/chemotherapy" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy to Treat Cancer</a> and <a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>.</p></div><div id="CDR0000062957__256"><h4>Chemoradiation therapy</h4><p id="CDR0000062957__258">Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.</p></div><div id="CDR0000062957__253"><h4>Targeted therapy</h4><p id="CDR0000062957__255"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">Targeted therapy</a> is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells.
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000508929/" class="def">Erlotinib</a> is a targeted therapy drug used to treat pancreatic cancer.</p><p id="CDR0000062957__348">Learn more about <a href="https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Targeted Therapy to Treat Cancer</a>. </p></div></div><div id="CDR0000062957__188"><h3>There are treatments for pain caused by pancreatic
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cancer.</h3><p id="CDR0000062957__190">Pain can occur when the tumor presses on <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a> or other organs
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near the pancreas. When pain medicine is not enough, there are treatments that
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act on nerves in the abdomen to
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relieve the pain. The doctor may inject medicine into the area around affected
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nerves or may cut the nerves to block the feeling of pain. Radiation therapy
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with or without chemotherapy can also help relieve pain by shrinking the tumor.
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For more information, see <a href="/books/n/pdqcis/CDR0000062845/">Cancer Pain</a>.</p></div><div id="CDR0000062957__191"><h3>Patients with pancreatic cancer have special nutritional
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needs.</h3><p id="CDR0000062957__193">Surgery to remove the pancreas may affect its ability to make <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046704/" class="def">pancreatic enzymes</a> that help to
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digest food. As a result, patients may have problems digesting food and
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absorbing <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044697/" class="def">nutrients</a> into the body. To prevent <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046014/" class="def">malnutrition</a>, the doctor may prescribe medicines
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that replace these enzymes.</p></div><div id="CDR0000062957__181"><h3>New types of treatment are being tested in clinical trials.</h3><p id="CDR0000062957__181_md_3">A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. For some patients, taking part in a clinical trial may be an option.</p><p id="CDR0000062957__181_md_4">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. Clinical trials supported by other organizations can be found on the <a href="https://www.clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p><p id="CDR0000062957__181_md_5">To learn more about clinical trials, see <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Clinical Trials Information for Patients and Caregivers</a>.</p></div><div id="CDR0000062957__279"><h3>Treatment for pancreatic cancer may cause side effects.</h3><p id="CDR0000062957__279_md_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, visit our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000062957__247"><h3>Follow-up care may be needed.</h3><p id="CDR0000062957__247_md_33">As you go through treatment, you will have follow-up tests or check-ups. Some tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> the cancer may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062957__247_md_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). </p></div></div><div id="CDR0000062957__286"><h2 id="_CDR0000062957__286_">Treatment of Resectable or Borderline Resectable Pancreatic Cancer</h2><p id="CDR0000062957__288">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044568/" class="def">resectable</a> or borderline resectable pancreatic cancer may include:</p><ul id="CDR0000062957__289"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>, followed by surgery</div></li><li class="half_rhythm"><div>surgery</div></li><li class="half_rhythm"><div>surgery, followed by chemotherapy</div></li><li class="half_rhythm"><div>surgery, followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306495/" class="def">chemoradiation</a></div></li><li class="half_rhythm"><div>a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of chemotherapy and/or radiation therapy before surgery</div></li><li class="half_rhythm"><div>a clinical trial of chemoradiation, followed by surgery and then chemotherapy </div></li><li class="half_rhythm"><div>a clinical trial of different ways of giving radiation therapy</div></li></ul><p id="CDR0000062957__324">Surgery to remove the tumor may include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046653/" class="def">Whipple procedure</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046694/" class="def">total pancreatectomy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044519/" class="def">distal pancreatectomy</a>.</p><p id="CDR0000062957__325"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">Palliative therapy</a> can be started at any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of disease. See the <a href="#CDR0000062957__298">Palliative Therapy</a> section for information about treatments that may improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> or relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> in people with pancreatic cancer.</p><p id="CDR0000062957__327">To learn more about these treatments, see the <a href="#CDR0000062957__167">Treatment Option Overview</a>.</p><p id="CDR0000062957__TrialSearch_286_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062957__290"><h2 id="_CDR0000062957__290_">Treatment of Locally Advanced Pancreatic Cancer</h2><p id="CDR0000062957__292">Treatment of pancreatic cancer that is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045955/" class="def">locally advanced</a> may include:</p><ul id="CDR0000062957__293"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a></div></li><li class="half_rhythm"><div>chemotherapy and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000306495/" class="def">chemoradiation</a></div></li><li class="half_rhythm"><div>surgery (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046653/" class="def">Whipple procedure</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046694/" class="def">total pancreatectomy</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044519/" class="def">distal pancreatectomy</a>)
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</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative</a> surgery or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044903/" class="def">stent</a> placement to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046498/" class="def">bypass</a> blocked areas in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046441/" class="def">ducts</a>
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or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a>, and possibly chemotherapy and chemoradiation to shrink the tumor to allow for surgery</div></li><li class="half_rhythm"><div>a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new anticancer therapies together with chemotherapy or chemoradiation</div></li><li class="half_rhythm"><div>a clinical trial of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> given during surgery or
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">internal radiation</a> therapy </div></li></ul><p id="CDR0000062957__326"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">Palliative therapy</a> can be started at any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of disease. See the <a href="#CDR0000062957__298">Palliative Therapy</a> section for information about treatments that may improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> or relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> in patients with pancreatic cancer.</p><p id="CDR0000062957__328">To learn more about these treatments, see the <a href="#CDR0000062957__167">Treatment Option Overview</a>.</p><p id="CDR0000062957__TrialSearch_290_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062957__294"><h2 id="_CDR0000062957__294_">Treatment of Metastatic or Recurrent Pancreatic Cancer</h2><p id="CDR0000062957__296">Treatment of pancreatic cancer that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046283/" class="def">metastasized</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> may include:</p><ul id="CDR0000062957__297"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270742/" class="def">targeted therapy</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a> of new anticancer agents with or without chemotherapy</div></li></ul><p id="CDR0000062957__319"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">Palliative therapy</a> can be started at any <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of disease. See the <a href="#CDR0000062957__298">Palliative Therapy</a> section for information about treatments that may improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> or relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> in patients with pancreatic cancer.</p><p id="CDR0000062957__329">To learn more about these treatments, see the <a href="#CDR0000062957__167">Treatment Option Overview</a>.</p><p id="CDR0000062957__TrialSearch_294_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062957__298"><h2 id="_CDR0000062957__298_">Palliative Therapy</h2><p id="CDR0000062957__320"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">Palliative therapy</a> can improve the patient's <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a> by controlling the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and complications of pancreatic cancer.</p><p id="CDR0000062957__299">Palliative therapy for pancreatic cancer may include:</p><ul id="CDR0000062957__300"><li class="half_rhythm"><div>palliative surgery or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044903/" class="def">stent</a> placement to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046498/" class="def">bypass</a> blocked areas
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in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046441/" class="def">ducts</a> or the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046582/" class="def">small intestine</a></div></li><li class="half_rhythm"><div>palliative <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to help relieve pain by shrinking the tumor</div></li><li class="half_rhythm"><div>an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injection</a> of medicine to help relieve pain by blocking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000373935/" class="def">nerves</a> in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a></div></li><li class="half_rhythm"><div>other palliative medical care alone</div></li></ul><p id="CDR0000062957__330">To learn more about these treatments, see the <a href="#CDR0000062957__167">Treatment Option Overview</a>.</p><p id="CDR0000062957__TrialSearch_298_19">Use our <a href="https://www.cancer.gov/research/participate/clinical-trials-search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062957__235"><h2 id="_CDR0000062957__235_">To Learn More About Pancreatic Cancer</h2><p id="CDR0000062957__236">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about pancreatic cancer, see:</p><ul id="CDR0000062957__237"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/types/pancreatic" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Pancreatic Cancer Home Page</a>
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</div></li><li class="half_rhythm"><div>
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<a href="/books/n/pdqcis/CDR0000798745/">Childhood Pancreatic Cancer Treatment</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/treatment/drugs/pancreatic" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Pancreatic Cancer</a>
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</div></li></ul><p id="CDR0000062957__235_md_40">For general cancer information and other resources from the National Cancer Institute, visit:</p><ul id="CDR0000062957__235_md_41"><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a>
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</div></li><li class="half_rhythm"><div>
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<a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a>
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</div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
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</div></li></ul></div><div id="CDR0000062957__AboutThis_1"><h2 id="_CDR0000062957__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062957__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062957__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062957__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062957__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062957__AboutThis_6">This PDQ cancer information summary has current information about the treatment of adult pancreatic cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062957__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062957__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.
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</p><p id="CDR0000062957__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="https://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
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</p></div><div id="CDR0000062957__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062957__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
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</p><p id="CDR0000062957__AboutThis_12">Clinical trials can be found online at <a href="https://www.cancer.gov/research/participate/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. For more information, call the <a href="https://www.cancer.gov/contact/contact-center" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Cancer Information Service</a> (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).
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</p></div><div id="CDR0000062957__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062957__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
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</p><p id="CDR0000062957__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062957__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Pancreatic Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389396]</p><p id="CDR0000062957__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 3,000 scientific images.
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</p></div><div id="CDR0000062957__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062957__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062957__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062957__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK65959</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389396" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389396</a></span></div></div></div>
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2016</li><li><span class="bk_col_itm"><a href="/books/NBK65959.1/">NBK65959.1</a></span> July 2, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062957__110" ref="log$=inpage&link_id=inpage">General Information About Pancreatic Cancer</a></li><li><a href="#CDR0000062957__139" ref="log$=inpage&link_id=inpage">Stages of Pancreatic Cancer</a></li><li><a href="#CDR0000062957__162" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062957__286" ref="log$=inpage&link_id=inpage">Treatment of Resectable or Borderline Resectable Pancreatic Cancer</a></li><li><a href="#CDR0000062957__290" ref="log$=inpage&link_id=inpage">Treatment of Locally Advanced Pancreatic Cancer</a></li><li><a href="#CDR0000062957__294" ref="log$=inpage&link_id=inpage">Treatment of Metastatic or Recurrent Pancreatic Cancer</a></li><li><a href="#CDR0000062957__298" ref="log$=inpage&link_id=inpage">Palliative Therapy</a></li><li><a href="#CDR0000062957__235" ref="log$=inpage&link_id=inpage">To Learn More About Pancreatic Cancer</a></li><li><a href="#CDR0000062957__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" 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xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31661214" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Pancreatic Cancer Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Childhood Pancreatic Cancer Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389463" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Esophageal Cancer Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Esophageal Cancer Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389400" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Gallbladder Cancer Treatment (PDQ®): Patient Version.</a><span 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