Pancreatic Cancer Treatment
Win the Fight Against Pancreatic Cancer!
Pancreatic Cancer Treatment
Many people with pancreatic cancer want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices.
However, the shock and stress that people may feel after a diagnosis of cancer can make it hard for them to think of everything they want to ask the doctor.
Often it helps to make a list of questions before an appointment. To help remember what the doctor says, patients may take notes or ask whether they may use a tape recorder.
Some patients also want to have a family member or friend with them when they talk to the doctor-to take part in the discussion, to take notes, or just to listen.
Cancer of the pancreas is very hard to control with current pancreatic cancer treatments.
For that reason, many doctors encourage patients with this disease to consider taking part in a clinical trial.
Clinical trials are an important pancreatic cancer treatment option for people with all stages of pancreatic cancer.
At this time, pancreatic cancer can be cured only when it is found at an early stage, before it has spread.
However, other pancreatic cancer treatments may be able to control the disease and help patients live longer and feel better.
When a cure or control of the disease is not possible, some patients and their doctors choose palliative therapy. Palliative therapy aims to improve quality of life by controlling pain and other problems caused by this disease.
The doctor may refer patients to an oncologist, a doctor who specializes in treating cancer, or patients may ask for a referral.
Specialists in pancreatic cancer treatments include surgeons, medical oncologists, and radiation oncologists.
Treatment generally begins within a few weeks after the diagnosis. There will be time for patients to talk with the doctor about treatment choices, get a second opinion, and learn more about the disease.
Methods of Pancreatic Cancer Treatment
People with pancreatic cancer may have several treatment options.
Depending on the type and stage, pancreatic cancer treatments may include surgery, radiation therapy, or chemotherapy. Some patients have a combination of therapies.
Surgery may be used alone or in combination with radiation therapy and chemotherapy.
The surgeon may remove all or part of the pancreas. The extent of surgery depends on the location and size of the tumor, the stage of the disease, and the patient's general health.
Whipple procedure: If the tumor is in the head (the widest part) of the pancreas, the surgeon removes the head of the pancreas and part of the small intestine, bile duct, and stomach. The surgeon may also remove other nearby tissues.
Distal pancreatectomy: The surgeon removes the body and tail of the pancreas if the tumor is in either of these parts. The surgeon also removes the spleen.
Total pancreatectomy: The surgeon removes the entire pancreas, part of the small intestine, a portion of the stomach, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes.
Sometimes the cancer cannot be completely removed. But if the tumor is blocking the common bile duct or duodenum, the surgeon can create a bypass. A bypass allows fluids to flow through the digestive tract. It can help relieve jaundice and pain resulting from a blockage.
The doctor sometimes can relieve blockage without doing bypass surgery. The doctor uses an endoscope to place a stent in the blocked area. A stent is a tiny plastic or metal mesh tube that helps keep the duct or duodenum open.
After surgery, some patients are fed liquids intravenously (by IV) and through feeding tubes placed into the abdomen. Patients slowly return to eating solid foods by mouth. A few weeks after surgery, the feeding tubes are removed.
Surgery for pancreatic cancer is a major operation. Patients need to stay in the hospital for several days afterward. Patients may feel weak or tired. Most need to rest at home for about a month. The length of time it takes to regain strength varies.
The side effects of surgery depend on the extent of the operation, the person's general health, and other factors. Most patients have pain for the first few days after surgery. Pain can be controlled with medicine, and patients should discuss pain relief with the doctor or nurse. The section on "Pain Control" has more information.
Removal of part or all of the pancreas may make it hard for a patient to digest foods. The health care team can suggest a diet plan and medicines to help relieve diarrhea, pain, cramping, or feelings of fullness. During the recovery from surgery, the doctor will carefully monitor the patient's diet and weight. At first, a patient may have only liquids and may receive extra nourishment intravenously or by feeding tube into the intestine. Solid foods are added to the diet gradually.
Patients may not have enough pancreatic enzymes or hormones after surgery. Those who do not have enough insulin may develop diabetes. The doctor can give the patient insulin, other hormones, and enzymes.
These are some questions a person may want to ask the doctor before having surgery:
What kind of operation will I have?
How will I feel after the operation?
How will you treat my pain?
What other treatment will I need?
How long will I be in the hospital?
Will I need a feeding tube after surgery? Will I need a special diet?
What are the long-term effects?
When can I get back to my normal activities?
How often will I need checkups?
Radiation therapy (also called radiotherapy) is another pancreatic cancer treatment using high-energy rays to kill cancer cells. A large machine directs radiation at the abdomen. Radiation therapy may be given alone, or with surgery, chemotherapy, or both.
Radiation therapy is local therapy. It affects cancer cells only in the treated area. For radiation therapy, patients go to the hospital or clinic, often 5 days a week for several weeks.
Doctors may use radiation to destroy cancer cells that remain in the area after surgery. They also use radiation to relieve pain and other problems caused by the cancer.
Radiation therapy may cause patients to become very tired as treatment continues. Resting is important, but doctors usually advise patients to try to stay as active as they can. In addition, when patients receive radiation therapy, the skin in the treated area may sometimes become red, dry, and tender.
Radiation therapy to the abdomen may cause nausea, vomiting, diarrhea, or other problems with digestion. The health care team can offer medicine or suggest diet changes to control these problems. For most patients, the side effects of radiation therapy go away when treatment is over.
These are some questions a person may want to ask the doctor before having radiation therapy:
Why do I need this treatment?
When will the treatments begin? When will they end?
How will I feel during therapy? Are there side effects?
What can I do to take care of myself during therapy? Are there certain foods that I should eat or avoid?
How will we know if the radiation is working?
Will I be able to continue my normal activities during treatment?
Chemotherapy is the use of drugs to kill cancer cells. Doctors also give chemotherapy to help reduce pain and other problems caused by pancreatic cancer. It may be given alone, with radiation, or with surgery and radiation.
Chemotherapy is a systemic pancreatic cancer treatment. The doctor usually gives the drugs by injection. Once in the bloodstream, the drugs travel throughout the body.
Usually chemotherapy is an outpatient treatment given at the hospital, clinic, doctor's office, or home. However, depending on which drugs are given and the patient's general health, the patient may need to stay in the hospital.
The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives as well as how the drugs are given. In addition, as with other types of pancreatic cancer treatment, side effects vary from patient to patient.
Systemic chemotherapy affects rapidly dividing cells throughout the body, including blood cells. Blood cells fight infection, help the blood to clot, and carry oxygen to all parts of the body. When anticancer drugs damage healthy blood cells, patients are more likely to get infections, may bruise or bleed easily, and may have less energy. Cells in hair roots and cells that line the digestive tract also divide rapidly. As a result, patients may lose their hair and may have other side effects such as poor appetite, nausea and vomiting, diarrhea, or mouth sores. Usually, these side effects go away gradually during the recovery periods between treatments or after treatment is over. The health care team can suggest ways to relieve side effects.
Patients may want to ask these questions about chemotherapy:
Why do I need this treatment?
What will it do?
What drugs will I be taking? How will they be given? Will I need to stay in the hospital?
Will the treatment cause side effects? What can I do about them?
How long will I be on this pancreatic cancer treatment?
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