Pancreatic cancer

Data regarding the role of monitoring patients with resectable pancreatic cancer are limited. Based on consensus, the National Comprehensive Cancer Network panel recommends symptom assessment by history and physical examination, as appropriate.[1]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma [internet publication]. https://www.nccn.org/guidelines/category_1 ​ This should also include cancer antigen (CA) 19-9 level and a chest computed tomography (CT) and CT or magnetic resonance imaging of the abdomen and pelvis with contrast (unless contraindicated). However, elevation of CA 19-9 without other evidence of recurrence does not form a clear indication for further treatment.[1]National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: pancreatic adenocarcinoma [internet publication]. https://www.nccn.org/guidelines/category_1 ​​

Patients with advanced metastatic disease treated with chemotherapy should be closely followed up for toxicity at each cycle of chemotherapy, and assessed for response to chemotherapy every 2 months. These patients may have abrupt changes in clinical status due to rapid tumour progression with increased risk of complications. Given that there is no possibility of cure, a follow-up schedule should be discussed with the patient and designed to avoid emotional stress and economic burden for the patient.