# Care pathway for pancreatic cancer On this page you will find information about the different stages of examinations and treatment of pancreatic cancer at HUS. ## [ From symptoms to diagnosis ](#from-symptoms-to-diagnosis) ## [ Getting a diagnosis ](#getting-a-diagnosis) ## [ Treatments ](#treatments) ## [ After treatments ](#after-treatments) ## [ Support and information ](#support-and-information) ## From symptoms to diagnosis Primary health care ### A symptom appears or an abnormal finding is made --- The symptoms of pancreatic cancer resemble those of many other upper abdominal complaints, and in the early stages the disease may be asymptomatic. The most common symptoms caused by pancreatic cancer are weight loss, upper abdominal pain, back pain, and jaundice. Bowel function often changes, which can lead to diarrhea, nausea, and vomiting. ### Required additional examinations in primary health care and a physician’s assessment --- Because pancreatic cancer causes vague symptoms, it is often discovered regrettably late. Pancreatic cancer is difficult to detect: the pancreas is hidden behind other organs, where the cancer has room to grow. A large proportion of pancreatic cancers are found in abdominal ultrasound or computed tomography scans as an incidental finding in connection with the examination of another disease. In these cases, the cancer may still be in its early stages and operable with a curative treatment goal. The spread of the tumor is investigated with ultrasound scans, computed tomography, or magnetic resonance imaging. These often also provide an idea of how far the cancer has spread. ### A physician writes a referral --- If an abnormal examination result or finding is made, the physician will make a referral to HUS. ## Getting a diagnosis Comprehensive Cancer Center and other specialized medical care ### The referral arrives at specialized medical care and an invitation is sent to the patient --- When the referral arrives at HUS, a specialist reviews it, assesses the urgency of the referral and plans the necessary additional examinations, such as various imaging examinations and blood sampling. You will receive an invitation letter by mail. The invitation will indicate when and in which hospital you will need to arrive, the procedure for which you have been booked, and instructions on how to prepare for coming to the hospital. You can reschedule or cancel your appointment by calling the number indicated in the invitation letter. ### If necessary, additional examinations can be carried out --- In case of a suspicious finding indicative of pancreatic cancer, a needle biopsy can be taken through the abdominal wall during the computed tomography or ultrasound scanning. The biopsy can also be taken during an endoscopic retrograde cholangiopancreaticography (ECRP), esophagogastroduodenoscopy, or a PTC examination. PTC (percutaneous transhepatic cholangiography) is a biliary tract examination performed through the skin and the fibrous capsule of the liver. If pancreatic cancer is suspected, a blood sample can be examined for the marker CA 19-9, which is secreted by some pancreatic cancer cells. Since it is not always possible to obtain a representative tissue sample for pancreatic cancer, the diagnosis is confirmed on the basis of imaging findings and elevated levels of the marker detected in the blood sample. ### Appointment with a physician and a nurse --- Planning your treatment begins with an appointment with a specialist or surgeon. At the appointment, we will go through your examination results, the diagnosed disease and its treatment options. We will go through the pros and cons of your treatment options. Your physician will plan the necessary further examinations and the treatment you have opted for together. If necessary, we can also make a referral for other support measures, such as nutritional therapy, physiotherapy, or services at the Palliative Care Center or Psychosocial Support Unit. During appointments, the nurse and physician work as a team. You will meet the nurse during your first appointment and, if necessary, you may be referred to guidance or counseling with the nurse also during your other visits. If necessary, you can also meet the nurse during subsequent physician’s appointments and contact the nurse via the unit treating you. ## Treatments Specialized medical care ### Treatment begins --- The primary treatment for curing localized pancreatic cancer is surgery. Your treatment also involves chemotherapy. If necessary, we can enhance chemotherapy with radiation therapy. [ Read more about the treatment of localized pancreatic cancer ](/en/patient/treatments-and-examinations/cancer/care-pathway-pancreatic-cancer/treatment-local) ### Healing and follow-up --- Follow-up continues every three months at the Comprehensive Cancer Center or the surgical unit for five years. ### If the disease recurs or treatments do not help --- Unfortunately, pancreatic cancer often recurs despite the initial surgical treatment. The cancer may have already spread more widely when initially diagnosed, usually to the liver or nearby lymph nodes. The treatment of metastatic pancreatic cancer aims to effectively slow down the disease and, hence, maintain as good a quality of life as possible. Curative treatments for metastatic pancreatic cancer have not yet been found. Since the expected benefits of pharmacotherapy are uncertain, we aim to accurately assess which treatments are likely to benefit you the most. If you are very weak, it may be wisest to refrain from drug treatments against cancer cells and focus on taking care of your wellbeing by alleviating the symptoms of the disease through various treatments. We can also administer radiation therapy for metastases that cause difficult symptoms. [At the Clinical Trial Unit,](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/clinical-pharmaceutical-research-unit "Clinical Pharmaceutical Research Unit C3, Comprehensive Cancer Center") we offer an increasing number of patients the opportunity to be among the first to receive new research treatments. ### Palliative care --- Good palliative care and psychosocial support are an integral part of cancer treatment. The Palliative Care Center provides help in the stressful life situation caused by the illness or cancer treatments. We help treat difficult symptoms and offer conversational support. A decision on palliative, i.e. symptomatic, treatment is made when the focus of your treatment shifts from slowing down the progression of cancer to managing the symptoms. In this case, treatment aims to alleviate symptoms and, as far as possible, to ensure a good and active with the illness until death. Typically, at this stage, your care responsibility is transferred to the palliative care unit or to the palliative outpatient clinic or a hospital-at-home unit in your area. [ Read about the Palliative Care Center ](/en/patient/hospitals-and-other-units/comprehensive-cancer-center/palliative-center-comprehensive) ## After treatments ### Follow-up in specialized medical care ends --- Your follow-up at HUS usually ends within five years if your illness does not recur. After this, your treatment will be transferred to primary health care. ## Support and information Getting cancer is a big life change. Here you will find information and support for living with the disease. ### [ Support during cancer treatment ](/en/patient/treatments-and-examinations/support-during-cancer-treatment) Here you can find discussion help and support for rehabilitation for cancer patients.  ### [ Instructions and additional information for cancer patients ](/en/patient/treatments-and-examinations/cancer/instructions-and-additional-information-cancer-patients) Here you will find our patient guide and more information about cancer treatments.  Updated: 10.10.2024