Pancreatic cancer is inoperable when the cancer cannot be completely removed with surgery. Some treatment options include chemotherapy, radiation, and targeted therapy.

Pancreatic cancer is inoperable when doctors cannot completely remove it with surgery. It usually does not present symptoms until it is advanced, and many of its symptoms can be caused by other conditions.

Because of this, many people with a diagnosis of pancreatic cancer find that it is already inoperable at the time of their diagnosis. This means a doctor may need to use alternative approaches such as radiation and chemotherapy. In some cases, palliative care is the best option.

Read on to learn more about inoperable pancreatic cancer.

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Inoperable pancreatic cancer, also called unresectable pancreatic cancer, cannot be treated with surgery.

There are two types: locally advanced and metastatic. Other terms for these are regional and distant.

Pancreatic cancer is locally advanced when it has spread outside the pancreas to nearby lymph nodes or blood vessels. It is metastatic when it has spread to other organs, such as the lungs or liver.

If a person’s pancreatic cancer is locally advanced or metastatic, a doctor cannot completely remove it with surgery. At this point, it is inoperable.

Research suggests that pancreatic cancer remains in the pancreas for 10 or more years before developing into a tumor and spreading to other areas. However, once a tumor has formed, pancreatic cancer can develop from an early to an advanced stage in just over 1 year.

This means that from its earliest detectable stage, pancreatic cancer can become inoperable in just over 1 year.

There are several treatment options for people with inoperable pancreatic cancer. Doctors may administer these on their own or in combination with other treatments.

Radiation therapy

This uses high energy radiation waves, such as X-rays, to kill or stop the growth of cancer cells. Doctors can do this by targeting the cancer cells with an external device or putting a radioactive substance near them.

Radiation therapy can also reduce the size of tumors, which can help alleviate the pain caused by a tumor pressing on a person’s nerves or organs.


Chemotherapy uses medication to kill or stop the growth of cancer cells. People can take chemotherapy medication as a pill or an injection.

Chemotherapy drugs for inoperable pancreatic cancer include gemcitabine, 5-fluorouracil, and irinotecan.

Targeted therapy

This uses medication to stop specific processes that enable cancer cells to grow. Targeted therapy medications for pancreatic cancer include erlotinib, olaparib, and larotrectinib. People take these once or twice daily.

Clinical trials

Because inoperable pancreatic cancer is difficult to treat, people with a diagnosis may want to consider participating in clinical trials for new cancer treatments.

Many treatments that doctors currently prescribe for cancer have been through clinical trials. By taking part in a trial, a person can be one of the first to receive a new treatment that may later become standard.

Palliative care aims to improve the quality of life of people with serious illnesses and their families. It focuses on easing and managing symptoms and other related difficulties, rather than curative treatment.

Due to the symptoms of inoperable pancreatic cancer and the outlook for those with the condition, over 80% of people with this diagnosis go through palliative care.

Bypass surgeries

If a person’s tumor grows large enough, it can block the bile duct or duodenum, which is part of the small intestine. This can cause digestive issues and pain, and if bile builds up over time, it can also cause nausea, vomiting, and jaundice.

There are a few procedures that a doctor can perform to relieve these issues, including:

  • Endoscopic stent: This stent is a thin plastic tube that can keep a passageway open. If a person’s bile duct is blocked, a doctor can place a stent in the bile duct, allowing bile to drain.
  • Biliary bypass: This is another way to fix a blocked bile duct. By cutting the bile duct before the blockage and sewing it to the small intestine, bile can continue to drain.
  • Gastric bypass: If a tumor is blocking food moving from the stomach to the small intestine, a doctor may perform a gastric bypass. By sewing the stomach directly to the small intestine, avoiding the blockage, food is able to flow again.

Pain management

If a person’s tumor presses against their nerves or other organs, it can cause pain. To relieve this pain, a doctor may cut the nerves or use an injection to numb the nerves in the affected area.

The outlook for people with pancreatic cancer is poor compared with other kinds of cancer. This is mainly because it does not produce any symptoms until it has already reached an advanced stage. In up to 80% of people with a pancreatic cancer diagnosis, the cancer is at an advanced stage at the time of diagnosis.

A standard measure for life expectancy is the 5-year relative survival rate. This compares people with a particular stage and type of cancer against the general population in terms of their life expectancy for the next 5 years.

For regionally advanced pancreatic cancer, the American Cancer Society lists the 5-year relative survival rate as 15%. This means people with regional pancreatic cancer are 15% as likely to live for 5 years compared with the general population. Conversely, for distant pancreatic cancer, the 5-year relative survival rate is 3%.

If a person has a diagnosis of inoperable pancreatic cancer, they may have questions and concerns. Here are some example questions a person may wish to ask their doctor:

  • What is my outlook?
  • What treatment can I receive?
  • What symptoms might I get?
  • What can I do about my symptoms?
  • Do I have a medical team?
  • Where is the nearest specialist center?
  • Are there any clinical trials that might help?

Although curative surgery is not an option for people with inoperable pancreatic cancer, people with this diagnosis can still receive treatments such as chemotherapy and radiation therapy.

Palliative care can also help ease a person’s symptoms and improve their quality of life.

To assist with the emotional and mental aspects of this diagnosis, people may consider reaching out to specialist charities for advice and support.