Sunday, December 25, 2011

Standard Treatment Options for Pancreatic Cancer

Unfortunately early symptoms of pancreatic cancer are very difficult to detect, therefore this form of cancer is known as a silent cancer. The pancreas, (an organ that is located in the lower portion of a person’s stomach), is essential for healthy digestive functioning. When the pancreas is acting normally, it creates and secrets special enzymes that help metabolize carbohydrates and other foods. The pancreas is used in the body to help release insulin and other essential hormones however the danger lies in the extra insulin that is release which can cause complication to the body which can cause death long before the cancer takes mortal effect.

If a person has pancreatic cancer, the very organ that helps keep them healthy becomes lethal. This is because with pancreatic cancer, the pancreas becomes ridden with tumors - abnormal cells that develop from cells that were originally normal. If they are not killed off by pancreatic cancer treatments, they will multiply, wreaking havoc first to the pancreas itself then spreading to other parts of the body.

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Chances of Recovery

The prognosis (chance of recovery) and treatment options depend on the following:
  • Whether or not the tumor can be removed by surgery.
  • The stage of the cancer (the size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body).
  • The patient’s general health.
  • Whether the cancer has just been diagnosed or has recurred (come back).

Pancreatic cancer can be controlled only if it is found before it has spread, when it can be removed by surgery. If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease.

Treatment Options for Pancreatic Cancer

Different types of treatment are available for patients with pancreatic cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Standard Treatment for Pancreatic Cancer

We will review the three types of standard treatment options for pancreatic cancer in this post.


One of the following types of surgery may be used to take out the tumor:
  • Whipple procedure: Whipple procedure (pancreatoduodenectomy) is considered if pancreatic cancer is located in the head of the pancreas. It involves removing the head of pancreas, as well as a portion of small intestine (duodenum), gallbladder and part of bile duct. Part of the stomach may be removed as well. The surgeon reconnects the remaining parts of your pancreas, stomach and intestines to allow you to digest food. Enough of the pancreas is left to produce digestive juices and insulin. Whipple surgery carries a risk of infection and bleeding. After the surgery, some people experience nausea and vomiting that can occur if the stomach has difficulty emptying (delayed gastric emptying). Patients should expect a long recovery after a Whipple procedure. They might spend 10 days or more in the hospital and then recover for several weeks at home.
  • Total pancreatectomy: Total pancreatectomy targets removing the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes.
  • Distal pancreatectomy: Distal pancreatectomy is the surgical procedure, when the body and the tail of the pancreas and usually the spleen are removed. This surgery carries a certain risk of bleeding and infection.

If the cancer has spread and cannot be removed, the following types of palliative surgery may be done to relieve symptoms:
  • Surgical biliary bypass: If cancer is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine to create a new pathway around the blocked area.
  • Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
  • Gastric bypass: If the tumor is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally.

Research shows pancreatic cancer surgery tends to cause fewer complications when done by experienced surgeons. Patients should not hesitate to ask about the surgeon's experience with pancreatic cancer surgery. If they have any doubts, they should seek for a second opinion.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

The way the radiation therapy is given depends on the type and stage of the cancer being treated. Patients may receive radiation treatments before or after cancer surgery, often in combination with chemotherapy. Or, the doctor may recommend to a patient a combination of radiation and chemotherapy treatments when the cancer can't be treated surgically.

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Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

The way the chemotherapy is given depends on the type and stage of the cancer being treated. Chemotherapy can also be combined with radiation therapy (chemoradiation). Chemoradiation is typically used to treat cancer that has spread beyond the pancreas, but only to nearby organs and not too distant regions of the body. This combination may also be used after surgery to reduce the risk that pancreatic cancer may recur.

In people with advanced pancreatic cancer, chemotherapy may be combined with targeted drug therapy.

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Targeted therapy

Targeted therapy uses drugs that attack specific abnormalities within cancer cells. The targeted drug erlotinib (Tarceva) blocks chemicals that signal cancer cells to grow and divide. Erlotinib is usually combined with chemotherapy for use in people with advanced pancreatic cancer.

Other targeted drug treatments are under investigation in clinical trials.

Sources and Additional Information:
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