Treatment options for pancreatic cancer – Part 2

Pancreatic cancer is the fifth leading cause of cancer and one of the most difficult cancers to diagnose due to the fact that cancer cells have already spread beyond the pancreas at the time of diagnosis. Treatment, therefore, is dependent on the stage of the disease, location, age of the patient and personal preferences for treatment.

Treatment options include: surgery, chemotherapy, radiation or a combination of all three.

SURGERY

Surgical removal of the pancreatic tumor is only possible when the tumor has not spread. Only a small portion of pancreatic tumors are considered “totally resectable,” because in most cases the tumor has already metastasized (spread to other parts of the body). The Whipple procedure may be an option if the tumor is located at the head of the pancreas. The surgery involves removing the head of the pancreas as well as a portion of the small intestine, the gallbladder and part of the bile duct. If the tumor is in the tail of the pancreas, the surgeon performs a pancreatectomy and will possibly remove the spleen as well.

All of the above described surgeries carry the risk of bleeding and infection. Survival rate depends on the skill of the surgeon and the institution in which the surgery is performed, preferably at a major cancer institute.

CHEMOTHERAPY

Chemotherapy may be used alone or in combination with radiation. There are new chemotherapeutic agents being introduced, such as targeted drugs like erlotinib (Tarceva) which is used in patients with advanced pancreatic cancer. The goal of chemotherapeutic agents is to kill the cancer cells or to keep them from growing and dividing. For end-stage pancreatic cancer, chemotherapy is used to relieve symptoms. This is called palliative chemotherapy. Another chemotherapeutic agent which is being used in clinical trials is cetuximab (Erbitus) which is like the drug erlotinib, but acts in a slightly different way.

RADIATION

Radiation therapy can be used before surgery, after surgery, or in combination with chemotherapy. If the pancreatic cancer is inoperable, the surgeon may recommend a combination of treatments which include both radiation and chemotherapy. Unlike chemotherapy, radiation uses high energy beams to destroy cancer cells. There are two types of radiation procedures: one is external beam radiation, which is performed outside the body and the other is intraoperative radiation in which radiation is used during surgery.

FUTURE TREATMENTS

New treatments currently under investigation include gene therapy, clinical trials in which new drugs and approaches to surgery and radiation are explored, drugs to stop new blood vessels from forming to stop cancer cells from growing (angiogenesis), and pancreatic cancer vaccines. Unlike traditional vaccines that prevent a disease from forming, vaccines for pancreatic cancer will be targeted to keep intruding cancer cells from invading the pancreas.

Although pancreatic cancer is one of the most deadly cancers, there is promising new hope on the horizon with continued research, so in the future no one will have to hear the words, “you have pancreatic cancer.”

References:

http://www.mayoclinic.com/heal th/pancreatic-cancer/DS00357/D SECTION=treatments-and-drugs

http://www.cancer.gov/cancerto pics/types/pancreatic

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