In Finland, the 5-year survival rate of pancreatic adenocarcinoma is 3%. Surgery is the only treatment that may be curative. Adjuvant chemotherapy after radical surgery is beneficial and patients with locally advanced disease may also benefit from chemoradiotherapy. The treatment of metastatic pancreatic cancer, expert symptomatic and palliative care is essential. New therapeutic approaches, e.g. combined cytostatics and/or targeted biologic drugs are being investigated to improve patient outcome.