NCCN Guidelines for Patients
Pancreatic Cancer, Version 1.2014
Making treatment decisions
Have a treatment plan
Your treatment team
Treating pancreatic cancer takes a team approach.
NCCN recommends that treatment decisions
involve a multidisciplinary team—doctors and other
professionals who are experts in different areas of
health care. A medical oncologist is a doctor who’s
an expert in treating cancer with drugs. A surgeon
is an expert in operations to remove or repair a part
of the body. A radiation oncologist is an expert at
treating cancer with radiation. A pathologist is an
expert in testing cells and tissue to find disease. A
gastroenterologist is an expert in diseases of the
digestive system—organs that break down food for
the body to use.
Your primary care doctor can also be part of your
team. He or she can help you express your feelings
about treatments to the team. Treatment of other
medical problems may be improved if he or she is
informed of your cancer care. Besides doctors, you
may receive care from nurses, social workers, and
other health experts. Ask to have the names and
contact information of your health care providers
included in the treatment plan.
There is no single treatment practice that is best for
all patients. There is often more than one treatment
option, including clinical trials. Clinical trials study
how well a treatment works and its safety. Treatment
planning for pancreatic cancer takes into account
many factors, such as:
• Location of the cancer,
• Your general health,
• Treatment side effects,
• Costs of treatment,
• Changes to your life,
• What you want from treatment, and
• Your feelings about side effects.
A guide to pancreatic cancer treatment options can
be found in Part 5. The cancer treatment that you
and your doctors agree on should be reported in the
treatment plan. It is also important to note the goal
of treatment and the chance of a good treatment
outcome. In addition, all known side effects should be
listed and the time required to treat them should be
noted. See Part 3 on page 27 for a list of some of the
possible side effects of pancreatic cancer treatments.
Your treatment plan may change because of new
information. You may change your mind about
treatment. Tests may find new results. How well
the treatment is working may change. Any of these
changes may require a new treatment plan.
Stress and symptom control
Cancer and its treatments can cause bothersome
symptoms. The stress of having cancer can also
cause symptoms. Such symptoms may include pain,
sleep loss, and anxiety. Helping you to be comfortable
and stay active are key goals of the treatment plan.
There are ways to treat many symptoms, so tell your
treatment team about any symptoms you have. Some
of the challenges you may face are discussed next.
You may lose sleep before, during, and after
treatment. Getting less sleep can affect your
mood, conversations, and ability to do daily tasks.
If possible, allow yourself to rest, let people do
things for you, and talk with your doctor about sleep
medication. Behavioral sleep medicine—a type of talk
therapy—may also help.
Feelings of anxiety and depression are common
among people with cancer. You may feel anxious
before testing and while waiting for the results.
Likewise, you may have a passing depression during
a hard part of treatment. Feeling distressed may be a
minor problem or it may be more serious. Serious or
not, tell your treatment team so that you can get help
if needed. At your cancer center, cancer navigators,