Sep 08 2008
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 radiation treatment
- Pancreatic cancer chemotherapy
- Pancreatic cancer vaccine
- Targeted therapy for pancreatic cancer
- Biological treatment
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‘.
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
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.
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.
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