Feature Article

Pancreatic ductal adenocarcinoma: optimal patient management

Justin Gundara, Jaswinder Samra, Anubhav Mittal



Patients with pancreatic ductal adenocarcinoma, the most common type of pancreatic cancer, typically present late with advanced disease. The very nature of pancreatic surgery (with its associated complication profile) means that the management of pancreatic cancer continues to pose significant challenges.

Key Points

  • The incidence of pancreatic ductal adenocarcinoma is increasing.
  • Although painless jaundice is a typical presenting feature, clinicians should be alert for atypical symptoms.
  • Timely referral to a dedicated pancreatic surgeon is key to establishing a timely diagnosis.
  • Management of pancreatic cancer requires multidisciplinary subspecialist expertise and should ideally be undertaken in high volume centres.
  • Following diagnosis, pancreatic cancers are broadly classified into resectable, borderline resectable or unresectable.
  • Good outcomes can be achieved if patients are referred early and the disease is localised to the pancreas.

    Picture credit: © John Bavosi/SPL.