Pancreatic Cancer Treatment

Written by: SERO Board-Certified Physicians

Pancreatic cancer includes malignant or cancerous tumors originating in the cells of the pancreas. The pancreas is a gland located in the right side of the abdomen near the stomach, liver, spleen, and gallbladder. The gland is about six inches in length and serves two primary functions: to generate enzymes that move into the small intestine to help with the digestion of food, and to produce two important hormones, insulin and glucagon, which work together to maintain the proper levels of sugar in the blood stream.

30%

Men are 30% more likely to develop pancreatic cancer than women

4th

Pancreatic cancer is the fourth most common cause of cancer death in the US

25%

Approximately 25% of all cases involve smoking

85%

Up to 85% of people diagnosed have diabetes or hyperglycemia

What To Know

    Individuals who are at a higher risk of developing pancreatic cancer should discuss possible screening methods with their doctors. Some risk factors include:
  • Family history
  • Smoking or tobacco use
  • Obesity
  • Chronic pancreatitis
  • Diabetes
  • Alcoholism

Symptoms

The symptoms of pancreatic cancer are often vague and difficult to identify until the cancer has reached advanced stages. The onset of the certain symptoms often leads to a diagnosis of pancreatic cancer.

  • Headaches
  • Weight loss
  • Pain
  • Digestive problems
  • Changes in bowel movements
  • Blood clots

Diagnosing Pancreatic Cancer

There are a couple ways that a medical professional can diagnose pancreatic cancer. After an initial screening, or if a patient is experiencing associated symptoms, an endoscopic retrograde cholangiopancreatography (ERCP) can be performed to confirm the diagnosis. ERCP is a procedure used to create images of the digestive tract. During the procedure, doctors insert a thin, lighted tube into the mouth and down through the stomach to produce an image of the surrounding organs and glands.

Another way to reach a pancreatic cancer diagnosis is through magnetic resonance cholangiopancreatography (MRCP). An MRCP is like an MRI, except that is uses specialized software to target the pancreas and bile ducts and create detailed images. X-ray, CT, MR and PET scans are often needed to show the location and extent of the cancer.

To confirm a diagnosis, doctors will need to remove a small piece of tissue from a tumor for testing. Often, a biopsy sample can be collected during an ERCP procedure, if one is performed.

Pancreatic Cancer Treatment

If the patient receives a positive diagnosis, they are quickly entered into a treatment plan. Treatment for pancreatic cancer depends on several factors, including the type of cancer, the size and stage, its location, and your overall health.

Surgery may be possible for pancreatic cancers and offers the best chance for long term control of the cancer. Typically, surgery is only considered if the pancreatic cancer has not spread beyond the pancreas and does not involve any major arteries.

Chemotherapy is often used in combination with radiation therapy, although the doses of radiation given might be lower for patients concurrently taking chemotherapy. Gemcitabine, fluorouracil, and, most recently, albumin-bound paclitaxel have been approved by the FDA in the US for treatment of pancreatic cancer.

Targeted therapy is available for pancreatic cancer. Targeted therapy refers to drugs that target certain aspects of cancer cells, thereby killing the cancer cells while causing little harm to healthy cells.

Radiation Therapy

Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat cancer.

  • Cancer doctors called radiation oncologists use radiation therapy to try to cure cancer, to control cancer growth or to relieve symptoms, such as pain.
  • Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
  • Healthy cells are also affected by radiation, but they are able to repair themselves in a way cancer cells cannot.
  • After a diagnosis of pancreatic cancer has been established, it’s important to talk about your treatment options with a radiation oncologist.

Internal Radiation Therapy

External beam radiation therapy involves a series of daily outpatient treatments to accurately deliver radiation to the area at risk. Before beginning treatment, you will be scheduled for a simulation to map out the area being treated. This will involve having X-rays and/or a CT scan. You will also receive tiny tattoo marks on your skin to help the therapists precisely position you for daily treatment. Treatment is given once a day, Monday through Friday, for about six weeks.

Newer technologies like 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy (IMRT) are being evaluated for use in treating pancreatic cancers. Ask your radiation oncologist for more information on these treatments.

Possible Side Effects

Common side effects of radiation therapy for patients with pancreatic cancer include loss of appetite, nausea, diarrhea, and fatigue. Side effects tend to accumulate over the course of treatment and subside within weeks or months of the final treatment.

Senior man and family member having discussion at table