Treatments for pancreatic cancer can include surgery, chemotherapy, radiation therapy and supportive care. These treatments are often combined.
Surgery to remove the tumor is the only way to cure pancreatic cancer. If this cancer is limited to one defined area, surgery is the preferred treatment.
In many cases, surgery is not possible because the tumor is too big or has already spread by the time it is found. If the cancer can't be removed, then radiation therapy along with chemotherapy may be suggested. These can help control the disease and improve quality of life.
Chemotherapy can be used for cancer that has spread (metastatic cancer). Radiation therapy may be added to control symptoms.
Surgery
Several surgical procedures are used to treat pancreatic cancer. The decision of which one to use depends on where the tumor is located, how large it is and if it has spread. Surgery options include:
- Whipple procedure. This can be used when the tumor is small and contained within the pancreas. It involves the removal of all or part of the pancreas as well as part of the stomach and small intestine, the gallbladder and some surrounding lymph nodes. This is a very complex surgery with a high rate of complications. It should be done by a surgeon who has a lot of experience with this procedure.
- Distal pancreatectomy. This procedure involves the removal of the tail of the pancreas or removal of the tail and the spleen. It is used in some cases of endocrine cell pancreatic cancer (when the cancer is in the pancreatic tail).
Surgery also can be used to open blockage of the bile ducts or the small intestine (duodenum). In some cases, blockages can be treated with a stent, a mesh tube placed through the blocked area to keep it open.
Radiation therapy
Radiation therapy uses high-energy x-rays to destroy cancer cells. The most common type used to treat pancreatic cancer is external beam radiation therapy. This focuses an x-ray beam into the cancer from a large machine outside the body. Sometimes this treatment is used before surgery to shrink the tumor. It is often used with chemotherapy to help treat pancreatic cancer when a surgery is not possible.
Chemotherapy
Chemotherapy uses medications given by vein or by mouth to destroy cancer cells. It may be used along with surgery. The drugs may be given either before surgery to help shrink a tumor or after surgery to kill any cancer cells that remain. Chemotherapy can also be used with radiation therapy to treat cancer when surgery is isn't an option.
Palliative therapy
Palliative therapy is the name given to treatments that do not cure cancer but help ease pain or other symptoms. Its aim is to improve quality of life for the person with cancer. It may be used along with curative treatment or alone. Even when pancreatic cancer is found in later stages, palliative treatment can help provide comfort and relieve symptoms.
Pain relief is a major issue in pancreatic cancer. The tumor can cause pain by pressing against nerves and other organs. Your doctor or a specialist in pain control can relieve or reduce pain in several ways, including:
- Pain medicine.
- Radiation, which helps relieve pain by shrinking a tumor that is pressing on nerves or organs.
- Nerve block. Often, narcotics (such as morphine) or alcohol can be placed near a nerve to help block pain without affecting normal sensation.
- Surgery. Cutting certain nerves can help block pain signals.
