Treatment
There are several methods available for treating or managing pancreatic cancer. These treatments can be used alone or in combination with one another. Keep in mind that the options listed on this page are general guidelines. When determining your treatment options, your doctor will take into consideration not only the stage in which the pancreatic cancer is at time of diagnosis, but also your age, overall health, and other factors.
Surgery
Depending on the stage of the tumor, surgery can be used to cure pancreatic cancer or to alleviate symptoms associated with pancreatic tumors. In stages 0, 1 and 2, the tumor is still considered resectable, which means your doctor may be able to remove it entirely with surgery. There are three different surgical procedures which are considered potentially curative and may be used to remove all or part of the pancreas.
Pancreaticoduodenectomy
Pancreaticoduodenectomy is also known as the Whipple procedure. This operation removes the head of the pancreas, sometimes a portion of the stomach, a portion of the small intestine, a portion of the common bile duct, the lymph nodes near the pancreas, and the gallbladder. The Whipple procedure is the most common surgery for removing pancreatic tumors.
Distal pancreatectomy
Distal pancreatectomy, involves the surgical removal of the tail of the pancreas with or without the spleen.
Total pancreatectomy
Total pancreatectomy, in which the entire pancreas is removed, is uncommonly performed for cancer.
Additional Treatments
The doctor may also recommend any of the following treatments:
Chemotherapy
Chemotherapy is the use of drugs to target rapidly growing cells in an effort to eliminate cancer cells. Patients may receive chemotherapy before and/or after surgery. This combination helps either reduce the size of the tumor before it is surgically removed or aid in eliminating potentially remaining cancer cells after the tumor has been removed. In tumors that cannot be surgically removed, chemotherapy can still be used to slow the growth of the tumor. Chemotherapy is given intravenously or orally, and spreads through the bloodstream, making it appropriate for stage 4 cancers which have metastasized, or spread, to distant parts of the body.
Radiation Therapy
During radiation therapy, high-energy rays can be used to kill cancer cells in the area being treated, including the pancreas and surrounding lymph nodes. Radiation is often administered concurrent with low doses of chemotherapy, which “sensitize” the cancer to the radiation. In addition to being used independently, radiation therapy can also be used during or after surgery to minimize the chance of the cancer returning. For some patients, palliative radiation may also be used to treat metastases, especially those that are causing symptoms like pain. Unlike chemotherapy which spreads throughout the body, radiation therapy can be used locally near the affected areas of the body.
Chemoradiation
Chemoradiation is a combination of chemotherapy and radiation therapy. Combining these two treatments makes both more effective. Doctors give chemoradiation to shrink the tumor before surgery and to destroy traces of cancer left around the tumor after surgery.
Targeted Therapy
Targeted therapy refers to treatments (drugs) that attempt to block a molecular signal that pancreas cancers cells may use to grow. Most forms of targeted therapy drugs work by attaching to and blocking proteins on the surface of cancer cells. In addition, the effectiveness of some targeted therapy drugs may depend on the specific molecular changes/mutations that are detected in your cancer. Some forms of targeted therapy may also be particularly effective for pancreas cancers that are linked to certain hereditary cancer syndromes (such as BRCA1 or BRCA2). Ask your physician about targeted therapies currently being used in clinical trials.
Clinical Trials
Clinical trials are vital aspects of research and development for discovering new methods of treatment. Clinical trials involve carefully supervised testing of therapies that scientists believe can significantly increase the life expectancy and quality of life for people with pancreatic cancer. It is important that you speak with your doctor to determine if you are eligible to participate in a clinical trial. Current research in the field of pancreatic cancer
includes a vaccine which would prevent pancreatic cancer from recurring; new targeted therapy drugs, and more effective combinations of radiation and chemotherapy drugs.
