Chemotherapy for pancreatic cancer

You may have chemotherapy after an operation to remove the cancer. The chemotherapy usually starts within 3 months of the operation and lasts about 6 months.

The most commonly used chemotherapy treatments are:

• gemcitabine and capecitabine (Xeloda®) - you may have these on their own or together in a combination called GemCap
• a combination of drugs called FOLFIRINOX.

Another drug that may be used is fluorouracil (5FU). You will have this as a drip (infusion) into a vein.

Gemcitabine

You have gemcitabine as a drip into a vein over 30 minutes. You will usually have this once a week for 3 weeks. You will then have a week of rest. These 4 weeks make up a cycle of treatment.

Capecitabine

You have capecitabine as tablets, twice a day. You should swallow them whole with a glass of water. You need to take them within 30 minutes after eating a meal.

You usually take the tablets every day for 2 weeks. This is then followed by a week of no tablets. These 3 weeks make up a cycle of treatment.

GemCap

If you are having gemcitabine and capecitabine together (GemCap), each cycle usually takes 4 weeks. You have a drip of gemcitabine once a week for 3 weeks and also take the tablets for 3 weeks. Then you will have no treatment in week 4.

FOLFIRINOX (FOLFOXIRI)

Sometimes, you may have a combination of drugs called FOLFIRINOX. It combines:

• folinic acid (leucovorin or calcium folinate)
• fluorouracil (5FU)
• irinotecan (Campto®)
• oxaliplatin.

Folinic acid is not a chemotherapy drug. But you may have it with 5FU, as it has been shown to make 5FU work better.

FOLFIRINOX can cause more side effects because it contains 3 chemotherapy drugs. It is only suitable for people who are well enough to cope with these side effects.

Each cycle of treatment lasts 2 weeks. Your doctor or nurse will tell you more about this and how many cycles you will likely have. You may have a PICC line put into a vein to have this treatment.

Cancer research trials aim to improve the results of treatment for pancreatic cancer. Your doctor or nurse may talk to you about research trials if there is one suitable for you.

Sometimes research trials may use new drugs or drug combinations to treat pancreatic cancer. Sometimes the research trials may look at different ways of using existing treatments to see if they can be more effective.

Some research trials are looking at drug treatments called targeted therapy and immunotherapy for pancreatic cancer.

Targeted therapy drugs interfere with the way cancer cells grow.

Olaparib is a type of targeted therapy called a PARP inhibitor. It is used to treat cancer of the pancreas that has a genetic change in the cancer cells called BRCA 1 or BRCA 2. It might be used after chemotherapy.

Immunotherapy tries to trigger the body’s immune system to attack cancer cells. The body’s immune system fights infection and disease. Immunotherapy is not yet widely used for pancreatic cancer.

Chemotherapy drugs may cause some unpleasant side effects, but they can also make you feel better. This is because they relieve the symptoms caused by the cancer.

Most people have some side effects, but they can usually control these with medicines. The side effects usually go away once treatment has finished. Treatment with a combination of chemotherapy drugs may have more severe side effects than a single chemotherapy drug. You can talk to your doctor or nurse about what to expect from your treatment.