The pancreas is located underneath your stomachPancreatic cancer is cancer in any part of the pancreas. The pancreas is an organ at the top of your tummy. It helps the body to digest food and produces hormones including insulin.

About pancreatic cancer

Pancreatic cancer develops due to an accumulation of changes in the DNA of the cells in the pancreas. (DNA is the genetic material that tells cells what to do.) As these faulty cells divide and multiply, they eventually cause a cancer. 

Anyone can get pancreatic cancer but you may be more at risk if you:

  • Are aged 65 or over – pancreatic cancer is not very common in people aged under 40
  • Have certain medical conditions such as pancreatitis
  • Have a family history of pancreatic cancer 

You can reduce your risk by:

  • Losing weight if you are overweight
  • Stopping smoking
  • Reducing alcohol intake

Symptoms of pancreatic cancer may not be obvious or you may have no symptoms at all. 

Symptoms can include:

  • Whites of your eyes turning yellow or your skin turning yellow (jaundice) – this may be less obvious on brown or black skin
  • Itchy skin, darker pee and paler poo than usual
  • Loss of appetite or losing weight without trying
  • Feeling tired or having no energy
  • Having a high temperature or feeling hot or shivery 
  • Recently developed diabetes

Sometimes pancreatic cancer can affect your digestion and cause symptoms including:

  • Feeling or being sick
  • Diarrhoea (runny poo) or constipation
  • Pain at the top part of your tummy or your back – it may feel worse when eating or lying down; it may feel better when you lean forward
  • Feeling full very quickly when eating, heartburn, burping or farting
  • Swollen tummy not related to when you eat

It is important to see a health professional if you have symptoms or changes in your body that are unusual for you.

Ask for an urgent GP appointment, call 111 or visit 111.nhs.uk if:

  • Your skin or the whites of your eyes turn yellow
  • You're being sick for more than 2 days

Treatment depends on a range of factors including the type, size, stage and location of your tumour. It may also depend on your age, general health and genetic factors (linked to the DNA changes in your cells) that tell us how your cancer developed. 

Treatment options can include one or more of the following:
•    Surgery – this may be before or after other treatments
•    Drug therapies such as chemotherapy. The general term for these is systemic anti-cancer therapies (SACT)
•    Radiotherapy

When you are diagnosed, your care will be discussed at a multidisciplinary team meeting (MDT) where different specialists will consider the best treatment options for you. Your doctor will discuss this with you so you can decide what is right for you.

Sometimes it might be decided that none of the above treatment options are appropriate for you, usually if your disease is very advanced. Your care will be palliative – concentrating on your quality of life and symptom management – and will be led by your community team of your GP, district nurses and palliative care team. 

Genomics and cancer

Genomics is the study of a person’s genes (or ‘genome’) – the material in DNA that makes each person unique. Cancer is caused by changes in the DNA of a cell and tell it to multiply out of control. 

Understanding where this change has occurred – for example, which gene is faulty – can help us know which treatment will give you the best chance of killing the cancer cells and stopping new ones from growing. 

Your clinical team will explain this to you in more detail at your appointment. 

Our treatments

At The Clatterbridge Cancer Centre, we provide specialist non-surgical treatment for pancreatic cancer. We also work closely with other specialists and surgical teams in other hospitals to plan and coordinate your care every step of the way. 

Systemic anti-cancer therapy (SACT)

SACT is a term used to describe the different drug therapies for cancer. These include: 

  • Chemotherapy – which aims to kill cancer cells
  • Immunotherapy – which aims to train your immune system to attack cancer.
  • Targeted therapies – which aim to target the DNA and cell changes that cause cancer.

The treatments we offer for pancreatic cancer include:

Chemotherapy
  • Treatment for pancreatic duct cancer that can be removed: You might have chemotherapy after your surgery, to reduce the risk of the cancer coming back.
  • Treatment with chemotherapy before surgery: You might have chemotherapy to try to shrink your tumour so it can be removed with surgery. This is often used to treat cancers that are too big to be removed by surgery at the time of diagnosis (called locally advanced cancers).
  • Treatment for pancreatic cancer that cannot be removed or has come back (recurrence): The aim of chemotherapy is to try to control the cancer, slow its growth and to relieve any symptoms you may have.

Because different cancers are sensitive to different chemotherapy drugs, everyone’s treatment plan is designed according to the specific type of cancer. Your general health and fitness is also important when deciding on your treatment plan. 

Targeted therapies

This may be used in a small group of patients with specific genetic mutations. These drugs can be used to treat some advanced pancreatic cancers that cannot be removed by surgery or have spread to distant areas after at least one previous chemotherapy treatment. 

Immunotherapy

You might have immunotherapy for pancreatic cancer if your cancer has a particular genetic profile. This is very rare in pancreatic cancer, but if your tumour has such a genetic profile there may be an option to give immunotherapy in a second line setting (i.e. if the first line of chemotherapy has stopped working).

For more information on immunotherapy click here.

All treatment options will be discussed with you at your outpatient appointment.

Find out more about systemic anti-cancer therapy at The Clatterbridge Cancer Centre. 

Radiotherapy

Radiotherapy can sometimes be used to treat pancreatic cancer as a complement to surgery and chemotherapy.

We use different types of radiotherapy, depending on the type, size, location and stage of the cancer. 

The radiotherapy treatments we offer for pancreatic cancer include:

  • Traditional external beam radiotherapy – where radiation is delivered from outside the body
  • Stereotactic ablative radiotherapy (SABR) – a way of very precisely targeting radiotherapy to certain cancers

Find out more about radiotherapy at The Clatterbridge Cancer Centre. 

Clinical trials

Research and trials of new cancer treatments are an important part of our work. Your consultant will tell you about any clinical trials that may be suitable for you.

You are also very welcome to ask us about clinical trials during your appointments. We will be happy to answer any questions you have. 

Find out more about clinical trials. 

Treatment locations

We have a multi-site model where we visit hospitals across Cheshire and Merseyside to provide treatment and consultations closer to patients’ homes. 

We provide systemic anti-cancer therapies (e.g. chemotherapy, targeted therapies and immunotherapy) for breast cancer at the following sites:

We provide radiotherapy for pancreatic cancer in two of our specialist sites:

Clinical trials for pancreatic cancer are delivered at most of our sites. Some trials may only be available at our main hospital: Clatterbridge Cancer Centre – Liverpool.

The team consists of medical oncologists, advanced nurse practitioners, clinical nurse specialists, radiographers, pharmacy, research practitioners and administrative support. 

Our operational management team makes sure the service runs smoothly.

Consultants 

Medical Oncologists

Professor Dan Palmer
Dr Olusola Faluyi
Dr Nils Elander

Nurses 

Advanced Nurse Practitioners

Sarah Stevenson
Diane Foster

Clinical Nurse Specialists

Abbey Phudaphatt
Alison Griffin

Cancer Support Worker

Sarah Wallace

Other team members

Dietitian

Lauren Roberts

HPB nursing and support team

Virtual tour of Radiotherapy unit (CCC-Liverpool)

Our Cancer Information and Support Centres can provide individualised help and support for patients and families affected by cancer. The team’s main base is in Clatterbridge Cancer Centre – Liverpool but they also work at our Aintree and Wirral hospitals.

There are also local Macmillan services in other hospitals across our region.

External sites that offer extra support and information about liver cancer include: