Chemotherapy destroys cancer cells using anti-cancer drugs called cytotoxic drugs. Here people talk about their experiences of having chemotherapy for pancreatic cancer.
When is chemotherapy used for pancreatic cancer?
Chemotherapy can be used to treat pancreatic cancer:
- After surgery to remove the cancer, to try to stop the cancer coming back.
- If you cant have surgery to remove the cancer, it can be used to shrink the cancer. This can help treat the symptoms and help you to live longer.
- Some people may be able to have chemotherapy before surgery (neoadjuvant chemotherapy). This is to help shrink the cancer and make it easier to remove. This is not available everywhere yet because doctors are still testing it.
A consultant explains when chemotherapy is used for pancreatic cancer.
Deciding whether to have chemotherapy
The people we interviewed usually had a choice about whether or not to have chemotherapy. Some people said that their doctors had made all the treatment decisions and that was fine. Others wanted to be more say it what happened.
People we spoke to were keen to have chemotherapy where the aim was to shrink the tumour to make surgery possible (neoadjuvant chemotherapy). They felt it was the only option. Where chemotherapy was offered after surgery people usually agreed without question. Usually their doctors had recommended it. A few people, like Ann, weren’t keen to start treatment (see below).
Tony didn’t know what chemotherapy involved and felt scared. Some people are not able to have surgery to remove the cancer. Chemotherapy can be offered as a way to treat their symptoms. People we spoke to felt that they didn’t have enough information to make a choice. A few decided to stop treatment and others chose not to have any treatment at all. Their doctor had said that there would be few benefits when compared to the side effects.
Ann feared the side effects of chemotherapy and found the decision to start the treatment very…
Dorothy felt well. She decided not to have chemotherapy because her doctor said that it would…
What happens during chemotherapy?
Most people we interviewed had the standard treatment of chemotherapy. This means the drug gemcitabine is given as drip into your vein. Some also had the drug capecitabine in tablets.
Chemotherapy is given in cycles of four weeks. You get treatment for three weeks with 1 week off to rest. During the three weeks you are given Gemcitabine once a week and take capecitabine pills every day.
Treatment usually lasts for six cycles with regular check-ups. Some people we spoke to had fewer. For instance, Adrian’s chemotherapy was stopped after only one cycle because he became more unwell. Maureen had an allergic reaction after her first treatment and this delayed her second treatment.
Peter had three cycles of chemotherapy. Then he had a scan and was delighted to hear that his…
Some people had other drugs. Alison had gemcitabine with cisplatin. David had fluorouracil.
Peter had a neuroendocrine tumour. He had three chemotherapy drugs: streptozocin, fluorouracil and adriamycin. He stayed in hospital for a week each month for three months, to have his chemotherapy treatment. The rest of the time he was at home. Search Streptozocin on the Macmillan Cancer Support website for more information.
Peter had chemotherapy. The aim was to shrink his neuroendocrine tumour to make surgery possible.
How is chemotherapy given?
Chemotherapy can be given in different ways, depending on the treatment. Gemcitabine is given by a drip into the vein (intravenous chemotherapy). People we spoke to had the drip attached through
- A cannula – a short tube that goes into a vein in your hand or arm)
- A central line – a long thin tube that goes into your chest or arm. A central stays there for the whole course of your chemotherapy. A small bit of the tube stays on the outside of your body.
- A port or portacath – this goes into a vein and makes an opening under the skin.
People said that the nurses sometimes find it difficult to put the needle or cannula into a vein. This made some people dread their treatment. One man said that his veins ‘went into hiding’ when he went for his chemotherapy and it took nurses three or four attempts before they found a vein. Carol also said that she ‘hated those needles’.
Alison had her chemotherapy via a type of central line called a Groshong line (see ‘Radiotherapy and chemoradiotherapy‘). Rory, a woman we interviewed, recommended having a portacath.
Rory got in a terrible state wondering if the nurse would find a vein so she had a portacath…
You may have a scan before chemotherapy treatment starts. The doctors use this to check later whether the treatment has worked.
Before each intravenous chemotherapy infusion, people had blood tests to check that their blood was healthy enough. Some also had their blood pressure and body weight checked.
Before each of her chemotherapy treatments Alison had her weight and blood pressure checked and…
Most people had their chemotherapy in an NHS outpatient clinic. A few people had private treatment and had their own room, even as an outpatient.
Michael had his chemotherapy in a private clinic. The doctors and nurses were brilliant. He…
What happens during chemotherapy?
Chemotherapy usually means spending several hours in the clinic. You will see a nurse or doctor, have tests and wait for the drugs to be prepared before having the treatment itself.
Most people described the atmosphere in the clinic as ‘pleasant’. They said the nurses were excellent and tried to make them feel relaxed. Some told us there were comfortable arm chairs, books, DVDs and refreshments. People said that it was nice to chat to other people who were having treatment and it could be a source of support.
William described what happened when he had chemotherapy. He liked the atmosphere in the clinic…
However, others didn’t like sharing their treatment sessions with lots of other people. They didn’t want to chat. Phil was shocked to be in a room with 40 other people. He said that it was too impersonal having lots of different nurses looking after him in the same treatment session. Simon and his wife found the clinic a bit depressing.
Simon and his wife Karen found the atmosphere in the oncology clinic rather depressing. Karen…
People who didn’t like the idea of having toxic drugs put into their body tried to look on the positive side. They said that it was to help them. Carol referred to her treatment as her ‘best friend’. After their treatment some people continued to associate certain smells with chemotherapy, such as a particular perfume worn by a nurse.
Michael felt that the gemcitabine and capecitabine were poisoning him but he also recognised that…
People often experienced side effects of chemotherapy.