• Stereotactic body radiotherapy (SBRT / SABR): A course of one to five large, pinpoint-accurate radiation doses that destroy a tumour outside the brain almost like surgery, for patients who cannot or prefer not to have an operation.
• Neoadjuvant therapy versus surgery first for resectable and borderline resectable pancreatic cancer: For pancreatic cancers that look removable, doctors debate whether to operate at once and give chemotherapy afterwards, or to give chemotherapy first.
• Locally advanced and locoregional disease: Cancer that has grown beyond its organ into nearby tissue or lymph nodes but has not spread to distant sites.
• Resectability classes for pancreatic cancer (NCCN anatomical criteria and the 2017 international consensus): Surgeons class a pancreatic cancer as resectable, borderline resectable or locally advanced by how far it wraps around the arteries and veins behind the pancreas on the CT scan, measured in degrees of contact.
• R0 and R1 margins in pancreatic cancer: the 1 mm rule and standardised specimen reporting: After a pancreatic cancer is removed, the pathologist checks whether cancer reaches the cut edges of the specimen.
• Vascular resection in pancreatic cancer surgery (portal and superior mesenteric vein resection; arterial resection): When a pancreatic cancer touches or narrows the big vein behind the pancreas, surgeons can cut out that segment of vein and rebuild it during the operation, which turns a borderline tumour into a removable one.
• Pancreas protocol CT (pancreatic protocol CT, dual-phase thin-slice CT with structured reporting): A pancreas protocol CT is a scan tuned for the pancreas: thin slices taken at two timed moments after contrast dye so that the tumour, the arteries and the veins all show up sharply.
• Pancreatic cancer trials open today (registry snapshot and UK sites): Every phase 2 or 3 interventional trial that was recruiting, about to open or still running for pancreatic cancer on ClinicalTrials.gov in September 2026, with the hospitals in the United Kingdom that take part named where the registry lists them.
• Resectable, borderline resectable and unresectable: The surgeon's verdict on whether the tumour can be completely removed.
• CA 19-9: A sugar molecule shed into the blood by most pancreatic cancers; useful to follow treatment, not to screen.

Biomarker results to ask for: Pancreas-protocol CT with degrees of vessel contact (defines the category), CA 19-9 trend during neoadjuvant chemotherapy (falling levels predict a useful operation), Restaging CT after chemotherapy (stable disease is acceptable; shrinkage is often modest), Germline BRCA1, BRCA2, PALB2 and ATM status (platinum choice), Pathological response grade and margin status after resection, Circulating tumour DNA before surgery (investigational selection marker).

Scans and tests linked to this cancer: CT (computed tomography), Liquid biopsy (ctDNA), PDAC organoid pharmacotyping.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Neoadjuvant chemotherapy: Modified FOLFIRINOX for two to four months in fit patients, gemcitabine plus nab-paclitaxel otherwise; restage with CT and CA 19-9 before deciding on surgery (PREOPANC, ESPAC-5). (FOLFIRINOX / mFOLFIRINOX, Gemcitabine + nab-paclitaxel, PREOPANC-1, CA 19-9, Neoadjuvant / adjuvant / perioperative, ESPAC-5)
• Surgery: Pancreatoduodenectomy or distal pancreatectomy with venous resection and reconstruction where needed, arterial resection only in specialist centres; proceed on stable or improved disease with falling CA 19-9. (Whipple procedure (pancreaticoduodenectomy), Resection margins (R0 / R1 / R2), Resectable, borderline resectable and unresectable, Robotic & minimally invasive surgery)
• After surgery: Complete six months of chemotherapy in total, usually with the regimen the tumour responded to. (FOLFIRINOX / mFOLFIRINOX, Gemcitabine + nab-paclitaxel, Gemcitabine, Capecitabine)
• Progression during neoadjuvant therapy: Manage as locally advanced or metastatic disease; switch chemotherapy backbone, RAS inhibitor trials, biliary stenting for jaundice. (NALIRIFOX (liposomal irinotecan + oxaliplatin + 5-FU/LV), Daraxonrasib, Biliary stenting and drainage)
• Radiotherapy after chemotherapy: Optional; conventional chemoradiation or stereotactic radiotherapy to secure an arterial margin in selected patients, with ALLIANCE A021501 as the caution against routine use. (Chemoradiation (chemoradiotherapy, CRT), SBRT / SABR (stereotactic radiotherapy), MR-guided adaptive radiotherapy, Capecitabine)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.