To determine the most appropriate treatment for your situation, your doctor will consider the stage and type of cancer you have. In addition, he will consider your age and your health in general. Knowing this information, he will be able to determine which treatment is most effective to fight the cancer. After all, you will be invited to participate in the final choice.
Pancreatic cancer treatment is primarily surgery; in most cases, particularly when the cancer is diagnosed at an advanced stage, chemotherapy as well as radiation therapy can be combined with surgery to increase your chances of surviving.
Surgical Treatment
Surgical removal is the most effective treatment for a cancer that is confined to the pancreas. Unfortunately, nearly 90% of pancreatic cancers are diagnosed at an advanced stage, making surgical intervention difficult or even impossible. Sometimes, the surgery is performed as a palliative treatment to improve the life of the patient. This is applicable in the case of a tumor compressing the duodenum, which makes difficult the passage of foods in the intestine. The surgery aims to derive the biliary duct or stomach directly into the small intestine.
Usually, one of these three types of surgery is performed to remove the cancer from the pancreas:
- Whipple’s surgery – this surgical procedure is performed in cases of a cancer located in the head of the pancreas, the widest part of the pancreas. In this case, your surgeon removes the head of the pancreas and part of the small intestine, bile duct and stomach. After the removal, your surgeon will connect the stomach to the intestine, as well as anastomosis of the bile duct into the small intestine; the remaining pancreas is connected to either the stomach or the small intestine, to allow the flow of bile and pancreatic juice into the gastrointestinal tract.
- Distal pancreatectomy – during the surgery, the body and tail of the pancreas are removed if the tumor is located in one of these two regions. In addition, your surgeon will remove your spleen.
- Total pancreatectomy – this is a major surgical intervention reserved for very advanced pancreatic cancer. During the operation, the entire pancreas, part of the small intestine, part of the stomach, bile duct, gall bladder, spleen, and nearby lymph nodes are removed. Total pancreatectomy is rarely performed, because it often leads to lifelong adverse effects – for instance, inability to produce pancreatic enzyme and insulin.
Radiotherapy (Radiation therapy)
Radiotherapy is use of ionizing radiation (subatomic particles or electromagnetic waves) to treat cancer. The therapy shrinks or eliminates the tumor by stopping the development or division of cancer cells. Unlike chemotherapy, which acts on cancer cells throughout the body, radiotherapy is a local treatment that acts on a specific area. The radiation is often performed after the surgery. Radiation therapy is painless procedure, and cause minimal or no side effects.
Pancreatic Cancer Chemotherapy
In the treatment of pancreatic cancer, chemotherapy is often used after the surgery. Chemotherapy can also be used to treat advanced pancreatic cancers for which surgery is not possible. Unlike surgery and radiotherapy, chemotherapy is a systemic treatment that affects the entire organism. The chemotherapy drugs designed to destroy cancer cells or prevent them from multiplying. These drugs can be taken by mouth, infusion or injection.
However, chemotherapy drugs affect both cancer cells and healthy cells that divide rapidly, which often lead to side effects:
- fatigue
- nausea
- vomitting
- hair loss
- abdominal pain
- and more…
Targeted Therapy
Targeted cancer therapy is less harmful to normal cells, and can be very effective in the treatment of pancreatic cancer. Targeted therapy drugs stop multiplication of cancer cells by interfering with specific targeted molecules that they need to survive. The drug used in the treatment of pancreatic cancer can be an antibody against a gene expressed at the surface or in the cancer cell, or a molecule capable of blocking the transmission of the signal of cell division. The drug may also be antibody directed against the new vessels produced by the tumor to feed. Targeted therapy can be administered sometimes alone, sometimes in combination with chemotherapy or radiation.