Carly West, 2020
This article will discuss treatments that are considered to be proven to have benefits that outweigh the risks for most patients. Keep in mind that not all patients will benefit from those treatments, and in some cases the benefits might not last long. We will separately list several treatments that are being tested in clinical trials, which are studies conducted on pancreatic cancer patients. The purpose of clinical trials are to see if the treatment being tested has benefits that outweigh the risks and in some cases will compare a new treatment to other treatments.
If the cancer has not spread and the tumor can be removed, these are the different types of surgery to remove the tumor:
- Whipple procedure: In this surgery, the entire gallbladder and bile duct are removed, as well as part of the pancreas, stomach, and small intestine. Enough of the pancreas is left to produce digestive juices and insulin.
- Total pancreatectomy: This operation removes 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: This removes parts of the pancreas and usually the entire spleen.
- 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, the surgeon may decide 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.
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or stop 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 that has been sealed in needles, seeds, wires, or catheters that are placed inside the body directly into or near the cancer. The type of radiation therapy depends on the type and stage of the cancer being treated.
Chemotherapy 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 can reach cancer cells throughout the body. When chemotherapy is placed directly into the spinal column, or an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
There are Treatments for Pain Caused by Pancreatic Cancer.
Pain can occur when the tumor presses on nerves or other organs near the pancreas. When pain medicine is not enough, there are treatments that act on nerves in the abdomen to relieve the pain. The doctor may inject medicine into the area around affected nerves or may cut the nerves to block the feeling of pain. Radiation therapy with or without chemotherapy can also help relieve pain by shrinking the tumor.
Patients with Pancreatic Cancer Have Special Nutritional Needs.
Surgery to remove the pancreas may interfere with a person’s ability to digest food and absorb nutrients. To prevent malnutrition, the doctor may prescribe medicines that replace enzymes that will help with digestion.
Biologic therapy uses the patient’s immune system to fight cancer. It uses natural or synthetic cells to boost or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
This therapy is often experimental, so patients who are interested may need to consider taking part in a clinical trial. Clinical trials are conducted to find out if new cancer treatments are safe and effective or better than the standard treatment.
New types of treatment are being tested in clinical trials. They are being tested because they are not yet proven to be safe or effective. Participating in clinical trials is therefore risky, and is most likely to be chosen if no other treatments are available or if all other treatments have failed.
Many of today’s standard treatments for cancer are based on clinical trials conducted years ago. Patients who take part in a clinical trial are usually randomly assigned to either receive the standard treatment or to receive a new treatment.
Patients who take part in clinical trials may benefit, or might not. Either way, they help improve the way cancer will be treated in the future. Patients can enter clinical trials before, during, or after starting their cancer treatment.
Explanations of some commonly used words in the article:
Metastasis is the spread of cancer cells from the place where they first formed to another part of the body. When that happens, the tumor in the new location is the same type of cancer as the initial tumor. For example, if breast cancer spreads to the lung, the cancer cells in the lung are breast cancer cells, not lung cancer cells.
Palliative care aims to improve the quality of life of patients who have a serious or life-threatening disease. The goal of palliative care is to prevent or treat the symptoms of a disease, side effects caused by treatment of a disease, and psychological, social, and spiritual problems related to a disease or its treatment. Also called comfort care, supportive care, and symptom management. Palliative care can be provided instead of or in addition to treatment of the disease itself.
Recurrent cancer is cancer that has come back, weeks, months, or years after the cancer was removed or could not be detected. The cancer may come back to the same place as the original tumor or to another place in the body.
Resectable means the cancer can be removed by surgery.
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