Tuesday, February 24, 2009

Pancreatic cancer treatments

pancreatic cancer treatments


One of the pancreatic cancer survivors we came across had first chemotherapy and radiotherapy to shrink her tumor. She then underwent pancreatic cancer surgery to get her cancer totally removed.


 


This is only 1 pancreatic cancer story of the 40.000 people that get diagnosed with pancreatic cancer in the US each year. For all patients combined:


 



  • the one-year pancreatic cancer survival rate is 24%
     

  • the five-year pancreatic cancer rate is about 5%.


 


Please participate and join your pancreatic cancer story to help others coping
with their pancreatic cancer.


 


Which pancreatic cancer treatment to choose


 


If the answer was only as straightforward as the question. Just like liver cancer, pancreatic cancer is difficult to treat depending on:


 



  • pancreatic cancer stage, with as usual less success when the cancer has spread
     

  • age, physical and mental health of the cancer patient.


 


We will highlight the 6 most common treatments:


 



 


Pancreatic Cancer Surgery


 


pancreatic cancer surgery


 


Pancreatic cancer surgery is still the most successful pancreatic cancer treatment when the cancer hasn't spread beyond the pancreas to:


 



  • other organs,
     

  • blood vessels or
     

  • lymph nodes.


 


The good news is that theoretically a person can live without his pancreas. Of course this will be a mayor drawback when it comes to digesting food since the pancreas produces enzymes necessary to digest your food. Yet it can be dealt with by nutritional care and counseling. Removing the total pancreas is called 'total pancreatectomy'.


 


Most pancreatic cancer surgery will "only" remove part of the pancreas. Surgery on the top part of the pancreas will remove the cancer including:


 



  • the right-most part of the pancreas,

  • the gallbladder,

  • part of the stomach,

  • the lower half of the bile duct and part of the small intestine.


 


The wounds are then all joined together to the small intestine. Removing part of the pancreas this way is called 'pancreatoduodenectomy' or 'Whipple procedure'.


 


Surgery on the bottom part of the pancreas will remove the body and bottom -tail- of the pancreas. This surgery is called 'distal pancreatectomy' : named after the removal of the so called 'islet cell cancer' or (endocrine) cancer.


 


The more experienced your surgeon is, the less likely complications will show up during the surgery, so in case of surgery, do ask around where and by whom it is normally done.


 


Pancreatic cancer radiation treatment


 


If the pancreatic cancer cannot be removed surgically, there is still an option to remove it using radiation therapy called 'external beam radiation therapy'.


 


external beam radiation therapy


 


Radiation therapy can also be used during surgery called 'intraoperative radiation therapy'. The patient will be cut open and the surgeon will remove the visible pancreatic cancer tumors. Then the organs around the pancreas will be pushed aside so an "higher than normal dose of radiation therapy" will be given (since the other organs won't be affected like during external beam radiation therapy).


 


Radiation therapy together with chemotherapy is also used after pancreatic cancer surgery to prevent the recurrence of the cancer.


 


Pancreatic cancer chemotherapy


 


As stated above, chemotherapy may be used after pancreatic cancer surgery to prevent the recurrence of pancreatic cancer.


 


When surgery is no longer an option, chemotherapy can be used to reduce the rate of cancer growth. In other words it will be a cancer treatment when the patient is in palliative care to prolong life or for pain management.


 


Pancreatic cancer research is done on the following pancreatic cancer drugs:


 



  • gemcitabine,
     

  • irinotecan,
     

  • paclitaxel,
     

  • flavopiridol and
     

  • exatecan.


 


The idea is to combine chemotherapy with radiation therapy in order to make the radiation therapy more effective and is called 'chemoradiation'. Chemoradiation is typically used to treat pancreatic cancer that has spread but only to nearby organs.


 


Chemoradiation may also be used after surgery to reduce the risk that pancreatic cancer may recur.


 


Targeted therapy for pancreatic cancer


 


tarceva pancreatic cancer


 


Targeted drug therapy uses drugs like erlotineb or Tarceva and cetuximab or Erbitux to attack specific abnormalities within cancer cells. These drugs form an emerging area in cancer treatment.


 


The best known targeted drug is erlotinib or Tarceva. It blocks chemicals that signal cancer cells to grow and divide. It's usually combined with chemotherapy to treat patients with advanced pancreatic cancer.


 


erbitux


 


Another drug now under investigation in clinical trials is cetuximab or Erbitux. This drug targets the same signals as Tarceva but in a different way.


 


Pancreatic cancer vaccine


 


So far research is done on pancreatic cancer vaccines for pancreatic cancer survivors.


 


The idea of the vaccine is to prevent recurrence after cancer has appeared. Unfortunately this sounds misleading when you though that the vaccine was like any other vaccine: to prevent a disease from ever occurring in the first place.


 


Biological treatment


 


Biological treatment means your body needs to fight the cancer. Like with any other disease, biological therapy uses the body’s immune system for fighting cancer. Also called 'biological therapy' or 'biological response modifier therapy' (BRM therapy).


 


All sounds fancy and logical, but unfortunately it's only in a research stage. The idea is to use materials made by your body or made in the laboratory to direct, enhance or restore your body’s natural defences against the cancer.


 


Again, the most logical way to fight and prevent any disease.


 


Although there are at least 6 different pancreatic cancer treatments,
still more than 30.000 people will die of pancreatic cancer in the US in 2008
.

Wednesday, February 18, 2009

Surviving pancreatic cancer

surviving pancreatic cancer


Not many patients are surviving pancreatic cancer after the second year of their diagnosis, no matter whether they are taking chemotherapy or not treating the cancer with any known cancer treatment.


 


What happens when pancreatic cancer treatment no longer work?


 


When there are no more pancreatic cancer cures available, the medical world kind of leaves you in a bitter cold. You become a terminal cancer patient and doctors prefer to put their efforts and attention in curing patients.


 


This means you can still get cancer treatments, but they will only try to improve your quality of life. Where quality of life with chemotherapy side effects most often boils down to living longer therefore not in a better shape.


 


Palliative care


 


The new word in a pancreatic cancer end stage will be called"palliative care".


 


When a cancer patient has received different cancer treatments and they do not work, then over time the cancer tends to become resistant to all treatment.


 


At this time it is important to weight the cost and benefits of new treatment against possible downsides. For father the choice was:


 



  • die because of cancer or
     

  • die because of the side effects of chemotherapy


 


It may come to a point where you just have to plan on surviving as long as you can with the odds against you.. This is likely the most difficult time in your battle against pancreatic cancer.


 


Hospice and palliative care


 


What is important is living your life in the best comfort possible.


 


You do need to seek hospice and palliative treatments during this time.


 


Palliative treatments will help relieve the symptoms of your cancer, especially the pain it involves, and its main purpose is to improve your quality of life.


 


It’s quite hard to talk about quality of life when one of your body organs is shutting down...


 


At some point you may benefit from hospice care in the hospital but most of the time, this can be given at home.


 


Pancreatic cancer survival : gemcitabine is no miracle cure


 


Like what we thought about the other "miracle cancer cure" Xeloda - which is a chemotherapy in a pill - gemcitabine is no miracle cancer treatment either.


 


According to Dr. Tempero, gemcitabine improved survival duration in comparison with 5-fluorouracil (5-FU), with 6-month and 12-month rates of 46% and 18% vs 31% and 2%, respectively. 5-FU would have been the chemotherapy of choice is father would have opted for chemotherapy.


 


The best way of surviving pancreatic cancer is combining:


 



  • conventional chemotherapy while
     

  • boosting your immune system with alternative cancer treatments.


 


As long as conventional drugs don't promise pancreatic cancer cures, your best defense in surviving pancreatic cancer lies in your own immune system.