Treatment of pancreatic cancer is often aimed at improving a patient’s quality of life, meaning that it has metastasized, before the diagnosis is made. The only proven course of treatment, most affective to date, is radiation and chemotherapy.
Radiation Therapy uses high energy rays, aimed at the tumours being treated. The radiation is used in the attempt to damage cancerous cells and or prevent more cancerous cells from growing. It is often paired with chemotherapy. Patients who have had surgery (the Whipple Procedure) may also have follow up treatments of radiation, depending on the pathology report.
Chemotherapy uses a drug(s) to kill cancer cells and may be used alone or with radiation therapy. This form of treatment may also be used after surgery, depending on the pathology report. Gemzar (Gemcitabine) is the most common and most effective chemotherapy drug available to patients and may be used in combination with a variety of other drugs. Click on the button to see the combo's that may be available to you as a patient.
Immunotherapy and Vaccine Therapy are other forms of treatment available and will vary depending on where you live.
The Whipple Procedure is the only treatment available which offers a possible cure for pancreatic cancer, although a very invasive procedure (one doctor speaking with us referred to it as the “atomic bomb of surgeries”).
Although The Whipple Procedure is one of the more invasive surgeries, it offers a small percentage of hope and at the very least, an extended life which would not be possible without the surgery. The surgery involves the removal of the head of the pancreas, the duodenum, part of the stomach, the gall bladder, lymph nodes and other nearby tissues. You may also require chemotherapy to destroy cancer cells and radiation therapy after you recover from the surgery, depending of the pathology report.
Another type of surgery is a total pancreatectomy. This procedure removes the entire pancreas, the duodenum, common bile duct, gallbladder, spleen, and nearby lymph nodes. You may also require chemotherapy to destroy cancer cells and radiation therapy to shrink the tumor. Because pancreatic cancer affects the production of pancreatic enzymes and insulin, you may also need to take medication to replace these enzymes and hormones.
The Distal Pancreatectomy is a surgery used to treat pancreatic cancer when the cancer is in the tail of the pancreas and/or a small portion in the body of the pancreas. The spleen is also usually removed. The removal of the spleen is to prevent blood supply from the spleen to the pancreas which are intimately connected. At times a decision is made to not remove the spleen but the blood vessels to the spleen are separated from the pancreas and preserved. This is suggested for patients who have cystic tumors and inlet cell tumours.
“The Double By-pass is a palliative surgical procedure to alleviate jaundice, nausea and vomiting for patients with advanced tumors in the head of the pancreas. The double bypass involves a bypass to the bile duct and a bypass to the stomach. Often a celiac nerve block is also performed.” (John Hopkins Pathology)
Plastic and metal stents
Plastic and metal stents are another form of treatment which is used to relive the symptoms of jaundice , which comes with pancreatic cancer. These plastic or metal stents (tubes) are placed into the bile duct, when the duct has become obstructed by a tumour. The pancreatic tumour is usually pressing up against the bile duct and prevents the bile from traveling from the liver, through to the duodenum. These stents are usually placed during day surgery, using a technique called an endoscope. Plastic stents are used as temporary measures to relieve jaundice, when the patient is thought to be a candidate for surgery. A metal stent is used for the permanent treatment of jaundice, if surgery is not an option for the patient.
Some centers many not routinely insert stents to relieve jaundice before surgery. This is to avoid delays and the slight risk of complications from the stent insertion procedure via endoscope such as infection and inflammation of the surrounding tissue. This decision will probably depend on whether the patient's symptoms are tolerable and not too severe. (Pancreatic Cancer-UK)
Many people seek new treatment methods through clinical trials in Canada and in other Countries. Understanding the different options of treatment available to you can be important, when deciding what is best for you and your family. Cancer Care Nova Scotia was developed by the provincial Department of Health, and offers information about clinical trials available to patients in Nova Scotia. Their website is also a valuable resource for patients with cancer, living within the province. The following two links will take you to Canadian based clinical trials.
Canadian Cancer Society - Clinical Trials
National Cancer Institute of Canada - Clinical Trials