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The are three ways in which pancreatic cancer can be treated, surgery, radiation therapy and chemotherapy. Depending upon which stage the cancer is in, some of these treatment options might be combined.
Two types of surgery used for treating pancreatic cancer:
Potentially curative surgery: used when an imaging test determines that it is likely all the cancer can be removed.
Palliative surgery: can be done if image testing determines the tumor is too widespread to be completely removed. Surgery of this type is done to alleviate symptoms or to prevent certain types of complications (blockage of the bile duct or intestines).
Surgery to remove only a portion of the pancreatic cancer does not result in the patient living longer. This kind of surgery is very grueling for a patient and one of the most difficult a surgeon can perform, if the surgery is not done correctly there are possible complications which could result in a longer recovery period.
There are three procedures a physician can use to remove pancreatic cancer tumors:
- Pancreaticoduodenectomy (Whipple procedure): the most common type of operation performed to remove tumors of the exocrine pancreas. The procedure involves removing the head and sometimes the body of the pancreas, part of the small intestine, stomach and lymph nodes. A part of the bile duct and gallbladder are also removed, with the remaining bide duct attached to the small intestine. This is done so that bile from the liver can continuing entering the small intestine. The operation is very complicated and patients can end up suffering complications as a result of the surgery, such as: leaking from the connections made by the surgeon, infection, bleeding and stomach problems.
- Distal pancreatectomy: an operation that involves removing the tail or a small portion of the body of the pancreas, it is common for the spleen to be removed at this time as well.
- Total pancreatectomy: the surgery was once used for tumors in the body or head of the pancreas. This involves removing the entire pancreas and spleen, and is now seldom used as a treatment option for exocrine cancers of the pancreas.
External beam radiation therapy is the most common type of radiation therapy used to treat pancreatic cancer. The treatment involves focusing the radiation on the cancer, using a machine from the outside of the body. A regimen of radiation is usually performed 5 days a week for a period weeks or months.
Radiation treatment can be done before or after surgery has been performed. If a patient has to have surgery, it is preferable to do preoperative radiation therapy because any therapy taking place after the operation would have to be done after the patient has fully recovered, which may take several weeks.
At times, radiation therapy is combined with chemotherapy, for use in patients with tumors that are too widespread to be removed by surgery alone.
The side effects of radiation can include; mild skin changes that look like a sunburn, nausea, diarrhea, vomiting and fatigue. When on a radiation regimen it is common for patients to lose their appetite and experience weight loss, however, these side effects usually go away within a few weeks of completing treatment. Radiation can compound the side effects of chemotherapy, so it may be necessary to ask the physician for advice on side effects and how to avoid, prevent or relieve them.
Chemotherapy is sometimes referred to as “chemo”, this method of treatment involves using anti-cancer drugs injected into a vein or taken orally. The medication enters the bloodstream and reaches all areas of the body, making the treatment useful for cancers that have spread beyond the organ of origin.
Chemotherapy treatment can be used at any stage for treating pancreatic cancer, and is the favored treatment for people with advanced cancer. Chemotherapy is often used after surgery to kill off any remaining cancer cells that the surgery might have missed. For patients who are having surgery, a combination of chemotherapy and radiation is often used to shrink the tumors and make the removal easier.
Gemcitabine and 5-fluourouracil, are the most common chemotherapy medications used to treat pancreatic cancer. At times other medications may be used in conjunction with these medications, such drugs include; cisplatin, irinotecan, paclitaxel, docetaxel, capecitabine and oxaliplatin.
One of the disadvantages of using chemotherapy treatment is while it kills cancer cells, it also damages normal cells in the process. This can lead to serious side effects such as; hair loss, mouth sores, appetite loss, nausea, vomiting and low blood cell counts.
Researchers are now studying newer drugs that target specific parts of cancer cells, the medications work differently than traditional chemotherapy and often produce fewer side effects.