Each year in the UK, pancreatic cancer is diagnosed in around 7,000 people. At least 80% of these present with locally advanced inoperable or metastatic disease and most patients with pancreatic cancer die within a year of diagnosis. Here, we review treatment options, dealing exclusively with adenocarcinoma (the commonest tumour type), focusing on whether they cure the disease, prolong survival, alleviate symptoms or improve quality of life.