If you have been diagnosed with pancreatic cancer, your doctor will look at following criteria to create a treatment plan:
- The size and location of tumor.
- How far it has spread (stage of the pancreatic cancer).
- The overall health condition of patient.
The main goal of treatment is to eliminate the cancer cells and prevent it from spreading or recurring. When diagnosed at an advanced stage (stage IV) where it can not be cured, the goal may be to manage pain and other symptoms to increase a person’s lifespan.
Pancreatic Cancer Treatment Options
The treatment options for pancreatic cancer include surgery, chemotherapy, radiation therapy, targeted therapy, and immunotherapy, or a combination of these. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.
Surgery is the most common treatment for pancreatic cancer. It used to take out the tumors from pancreas. Here are some of the common surgical procedures:
- Whipple procedure (Pancreaticoduodenectomy)
This is the most common operation to remove a cancer in the head of the pancreas. In this procedure, the surgeon removes the head of the pancreas, part of the bile duct, and some of the nearby tissues.
The remaining bile duct and pancreas are then attached to the small intestine so that bile and digestive enzymes can still go into the small intestine.
- Distal Pancreatectomy
This surgeon removes the tail and/or portion of the body of the pancreas, but not the head. This surgery is uncommon for pancreatic cancer, because most tumors arising outside the head of the pancreas within the body or tail are unresectable.
- Total pancreatectomy
In this procedure, the entire pancreas is removed. This operation also removes bile duct, gallbladder, spleen, and part of the stomach and small intestine. This surgery might be an option if the cancer has spread throughout the pancreas but can still be removed.
It’s possible to live without a pancreas. But when the entire pancreas is removed, patient need to take insulin shots for the rest of their lives because the pancreas is responsible for producing insulin to regulate the blood sugar levels in the body. People who have had this surgery also need to take pancreatic enzyme pills to help them digest certain foods.
Surgery side effects
Side effects of surgery will depend mainly on the type and location of the surgery, as well as the patient’s overall health.
Some possible side effects of surgery for pancreatic cancer include:
- Leaking of bile, stomach acid or pancreatic juices from where the duodenum or a bile duct were joined during surgery
- Dumping syndrome (when food moves too fast from the stomach into the small intestine)
Most of these side effects will go away on their own or can be treated, but some may last a long time or become permanent.
Tell your healthcare team if you have these side effects or others you think might be from surgery. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Chemotherapy is a type of cancer treatment that uses anti-cancer drugs to kill the cancer cells or prevent them from spreading. It can either be taken orally (by mouth) or injected into vein. You may receive one chemotherapy drug or a combination of them.
Chemotherapy can be used before surgery to help shrink the tumor. Sometimes, it is used after surgery to reduce the risk that pancreatic cancer may recur.
Chemotherapy can also be combined with radiation therapy. It is known as chemoradiation. In people with advanced pancreatic cancer, chemotherapy is often used to control cancer growth and relieve symptoms.
Chemotherapy side effects
Chemotherapy can cause side effects to the patient. However, these effects are temporally and will gradually subside once the treatment has stopped. Some of the common side effects include:
- Loss of appetite
- Mouth sores
- Hair loss
- Nausea and vomiting
Radiation therapy, or radiotherapy, is a type of cancer treatment that uses high-energy x-rays to kill cancer cells or stop them from dividing. Radiation therapy usually comes from a machine that directly pointed on your body.
You may receive radiation treatments before or after surgery. Your doctor may recommend a combination of radiation and chemotherapy treatments when your cancer can’t be treated surgically.
Radiotherapy side effects
Side effects from radiation therapy may include:
- Loss of appetite
- Skin irritation
- Nausea and vomiting
Most side effects go away within a few weeks after treatment has completed.
Targeted therapy is a newer type of cancer treatment that uses drugs to stop the growth and spread of cancer cells while limiting damage to healthy cells.
This is done by targeting specific genes or proteins. These genes and proteins are found in cancer cells or in cells related to cancer growth, like blood vessel cells.
Targeted therapy can be used as the main treatment for some cancers, but in most cases, it used with other treatments such as chemotherapy and/or radiation therapy.
Targeted therapy side effects
Although targeted therapy minimize harm to healthy cells but it can still cause side effects. These vary greatly for each person depending on the drug you have and how your body responds. Some people don’t experience any side effects, while others have several. Some common side effects include:
Immunotherapy, also called biological therapy, is a type of cancer treatment that stimulate a person’s immune system to fight cancer. It uses substances made either by the body or in a laboratory. These substances allow the immune system to identify cancer cells as a threat and target them for destruction.
Immunotherapy can be given in different ways, including orally (pills or liquid), intravenously (injected into a vein), topically (cream), and intravesically.
Certain types of immunotherapy that can be used to treat pancreatic cancer include PD-1 inhibitors and immune checkpoint inhibitors.
Immunotherapy side effects
Different types of immunotherapy can cause different side effects. These can be mild, moderate, or even life-threatening. Your doctor may pause the treatment or prescribe a type of medication called corticosteroids. If side effects worsen or do not improve, your doctor may stop immunotherapy.
The most common side effects of immunotherapy include:
- Skin reactions, such as skin redness, blistering, and dryness.
- Flu-like symptoms, such as fatigue, fever, chills, weakness, nausea, vomiting, dizziness, and muscle or joint aches.
Other possible side effects you may experience include:
- Muscle aches
- Shortness of breath
- Sinus congestion
- Swelling of legs (edema)
- Hormone changes
Many side effects will go away on their own, but others can be very serious and require immediate attention. Talk with your doctor about possible side effects of the immunotherapy recommended for you.