Pancreatic Cancer

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:

• Possible leaking from various connections that the surgeon performs during surgery. (One of the main functions of the pancreas is producing the pancreatic juice that contains enzymes. The role of the enzymes is to help digest food. If these enzymes are released in the body after the surgery, the pancreas, along with the surrounding tissues, are in danger of being digested.)
• Infections
• Bleeding
• Impairment of the stomach function (problems in eliminating the stomach waist)

(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:

1. Surgical biliary bypass: The purpose of this procedure is to reroute the flow of the bile duct directly into the small intestine. This is possible through a bypass of the pancreas. The gallbladder or the bile duct is cut and sewn back into the small intestine - allowing the bile to drain into the intestine and avoid blockage.

2. Gastric bypass: The purpose of gastric bypass surgery is to reroute the stomach flow. This procedure is performed when the tumor blocks the food flow from the stomach. During a gastric bypass, the stomach is sewn directly to the small intestine.

3. Endoscopic stent placement: The purpose of this procedure is to help the bile to drain when the bile duct is blocked by the tumor. During this procedure, the doctor places a stent (a thin tube) to help the bile to drain outside the body into a collection bag or into the small intestine.

Radiation therapy or radiotherapy
Radiation therapy is a form of cancer treatment that uses high-energy rays or particles to destroy cancerous cells. It can be administrated in combination with chemotherapy or alone, usually after surgery. The role of radiotherapy is to prevent a possible recurrence. The most common form of radiotherapy used to treat pancreatic cancer is external beam radiation therapy. External beam radiation therapy uses an external device (linear accelerator) to generate high-energy rays that are focused on the targeted area.

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.

Chemotherapy
Chemotherapy is a treatment option that uses anticancer drugs to restrain the abnormal growth process of cancerous cells by killing them or stopping them from dividing. Usually, chemotherapy is used as a treatment plan for advanced forms of cancer and for tumors that cannot by removed surgically. The purpose of chemotherapy is to reduce the growth rate of the tumor, to slow down the spreading rate of the cancer, or to prevent a cancer relapse. The disadvantage of this treatment option is that chemotherapy drugs not only destroy cancerous cells but healthy cells as well. This is the reason why chemotherapy has several, infamous side effects such as: nausea and vomiting, mouth sores, fatigue, loss of appetite, loss of energy, and hair loss.

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Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com

Page Covers: What is the treatment for pancreatic cancer? How is treated?

Sources:
American Cancer Society, Pancreatic Cancer, April 2009
MayoClinic.com, Pancreatic Cancer, April 2009
Pancreatica.org, Confronting Pancreatic Cancer, September 2009
Memorial Sloan-Kettering Cancer Center, Pancreatic Cancer, December 2006
Association of Cancer Online Resources, Pancreatic Cancer, April 2009

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