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Pancreatic Treatment Options
The treatment plan for pancreatic cancer differs from patient to patient. When established, treatment plans are based on several factors such as the stage and location of the cancer, the patient's age and general health state.
Pancreatic cancer treatment goals are: (1) to completely eliminate the cancer when it's in early stages, (2) to prevent further growth or spreading of tumors when the possibility of eliminating the cancer is excluded, or (3) to help relieve the symptoms and improve the patient's quality of life when the cancer cannot be treated and death is imminent.
There are three main types of potentially curative surgeries:
(1) Whipple procedure or pancreatoduodenectomy: this is a common procedure for patients with cancer of the exocrine pancreas. During this procedure, the head and sometimes the body of the pancreas is removed along with parts of the stomach, the duodenum (the first segment of the small intestine), a small part of the jejunum (the second segment of the small intestine), the adjacent lymph nodes, and sometimes the gallbladder and part of the bile duct. When the bile duct is coped, the remaining part of the duct is directly attached to the small intestine allowing the bile to drain into the intestine. This operation is a complex procedure and requires alot of experience and skills from the surgeon that performs it. If not performed properly, it can cause the death of the patient.
The main complications that can follow this intervention are:
(2) Distal pancreatectomy: This type of surgery is mostly used as a treatment option for islet cancer tumors. (The islet cells are the endocrine cells that secretes the hormones that adjust the sugar level from the blood). During this operation, the tail or the end and a portion of the body of the pancreas are removed. In most cases, the spleen is also removed during the surgery.
(3) Total pancreatectomy: During this operation, the entire pancreas is removed along with the spleen, bile duct and gallbladder, part of the small intestine, part of the stomach, and the adjacent lymph nodes. This type of procedure is not commonly used for exocrine pancreatic cancer. After this procedure, patients develop diabetes and will be dependent on insulin and pancreatic enzymes, that will be administrated through injections or pills.
When the cancer is wide-spread and a pancreatectomy is not possible, the next option is palliative treatment (a type of treatment that attempts to relieve the symptoms and improve the patient's quality of life).
If the cancer develops in the head of the pancreas, it can block the bile duct and the bile chemicals will accumulate in the bloodstream. There are three types of palliative procedures to correct blockages:
Radiation therapy or radiotherapy
A new form of radiation therapy used for patients that experience extensive local spreading of the cancer is intraoperative radiation therapy. This treatment is administrated during surgery. After the tumor is removed, the doctor exposes the patient to a high dose of radiation therapy which targets a precise area around the pancreas.
Article by Alina Morrow, MS
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