Oestrogen-binding sites are present in tissue samples of adenocarcinoma of the pancreas. Uncontrolled studies have suggested that survival of patients with this tumour may be extended by using the antioestrogen drug tamoxifen. Forty-four patients with biopsy-proven irresectable adenocarcinoma of the pancreas were recruited into a randomized placebo-controlled clinical trial of tamoxifen 20 mg twice daily. All patients were assessed at the time of diagnosis and at monthly intervals using the Karnofsky and the Hospital Anxiety and Depression scores for quality of life. Analysis of survival by life-tables and the log rank test revealed no significant difference in the duration of survival of patients treated with tamoxifen or placebo. Quality-of-life assessment revealed no significant difference between the groups. Tamoxifen does not confer significant benefit to patients with irresectable pancreatic cancer.