Pancreatic cancer chemotherapy is used mainly to prolong survival. Pancreatic cancer is a fatal disease. Surgery is the only treatment that could cure it; however, it depends largely on how far the cancer has spread.

Pancreatic cancer is aggressive and locally advanced disease. It is asymptomatic especially in the early stages and hence the average survival for all the stages of pancreatic cancer is hardly 5-6 months from diagnosis especially if there is no hope for surgery.

The drugs used in treating pancreatic cancers mainly consist of 5-fluorouracil (5-FU) and gemcitabine. 5- Fluorouracil helps to prolong survival in advanced pancreatic cancer. Gemcitabine improves symptoms and prolongs survival as compared with bolus 5-FU. Many novel small molecules are still under clinical research.

Until recently, 5-fluorouracil (5-FU) was the chemotherapy drug used most often to treat pancreatic cancer. Recent studies have found that gemcitabine is more effective than 5-FU for metastatic pancreatic cancer.

5-fluorouracil or 5-FU is an antimetabolite that prevents the cancer cells from making DNA and RNA and stops their growth. This is administered intravenously and the dose depends on the patient’s height, weight and blood counts.

Irinotecan is a topoisomerase inhibitor. It stops cancer cells from growing and is administered intravenously. The dose depends on the patient’s height, weight, age, whether the patient had radiation to the abdomen or pelvis, functioning of the liver, blood counts and if the patient has side effects like diarrhea.

Oxaliplatin is an alkylating agent that stops cancer cells from growing. It is administered intravenously followed by an injection of 5-fluorouracil (5-FU). The dose depends on the patient’s weight, blood counts, and the side effects of the medicine.

Gemcitabine is an antimetabolite that prevents the cancer cells from making DNA and RNA. It is administered intravenously. The dose depends on the patient’s height, weight and blood counts.

Cisplatin is a platinum compound that acts like an alkylating agent. It stops cancer cells from growing and is administered intravenously. The dose depends on the patient’s height weight and the functioning of the kidneys.

Paclitaxel is a taxane or a mitotic inhibitor as it affects the cells during mitosis i.e. cell division. It is administered intravenously. The dose depends on the patient’s height, weight and the functioning of the liver.

Capecitabine is an antimetabolite that prevents the cell growth. Capecitabine is converted in the body to 5-fluorouracil (5-FU). This drug is given in pill form. The dose depends upon the patient’s height and weight. However, it needs to be lowered in case of side effects.

Streptozocin is an alkylating agent called nitrosoureas that stops the cell growth. It is administered intravenously and the dose mainly depends on the weight of the patient.

Although pancreatic cancer is a tumor that is almost resistant to chemotherapy, 5-fluorouracil (5-FU) and 5-FU-based combination drugs have helped in prolonging survival. They are also used in supportive care in palliative treatment trials. An important breakthrough was that gemcitabine could improve certain symptoms of pancreatic cancer like weight loss and tumor-associated pain. This drug also gives a modest survival rate compared to 5-FU although not beyond 6 months. Extensive clinical research is on to improve the effectiveness of these drugs and find new drugs that could possibly lead to a cure.