Pancreatic cancer is most frequently a fatal disease with many associated morbidities. Clinicians skilled in its treatment are adept at management of symptoms caused by local and systemic effects of the malignancy. Patients should be assured that there are many treatments that can be used aggressively to maintain their comfort and independence for as long as possible. Patients should be encouraged to inform their health care providers of any discomfort or medical or psychological problems they are experiencing. At times, referrals to specialists can be beneficial for consideration of specific symptom-improving interventions. Timely referral to a palliative medicine service and hospice can have significant beneficial impact on the total care of the patient and on home caregiver.