Detection

It is likely that the patient’s current symptoms will progressively worsen. This should be managed following discussion by a multidisciplinary team in consultation with palliative care specialists.

Treatment

Evaluate each patient for whether referral to the original multidisciplinary team is appropriate. Treatment will depend on the location and extent of disease, previous management and the patient’s preferences.

Advance care planning

Advance care planning is important for all patients but especially those with advanced disease. It allows them to plan for their future health and personal care by thinking about their values and preferences. This can guide future treatment if the patient is unable to speak for themselves.

Survivorship and palliative care

Specialist palliative care is recommended for all patients with pancreatic cancer. Survivorship and palliative care should be addressed and offered early. Early referral to palliative care can improve quality of life.

Communication

The lead clinician and team’s responsibilities include:

• explaining the treatment intent, likely outcomes and side effects to the patient and/or carer and the patient’s GP.

Checklist