2. How is Pancreatic Cancer treated?
This information represents the views of the doctors and nurses serving on the
American Cancer Society’s Cancer Information Database Editorial Board. These views
are based on their interpretation of studies published in medical journals, as well as
their own professional experience.
The treatment information in this document is not official policy of the Society and is
not intended as medical advice to replace the expertise and judgment of your cancer
care team. It is intended to help you and your family make informed decisions,
together with your doctor.
Your doctor may have reasons for suggesting a treatment plan different from these
general treatment options. Don’t hesitate to ask him or her questions about your
treatment options.
3. General treatment information
After the cancer is found and staged, your cancer care team will discuss treatment
options with you. It is important that you take time to think about your choices. You
will want to weigh the benefits of each treatment option against the possible risks and
side effects. In choosing a treatment plan, two of the main factors to consider are
whether or not the cancer can be removed (resected) with surgery and your overall
health.
The main types of treatment for pancreatic cancer are:
Surgery
Ablative techniques
Radiation therapy
Chemotherapy and other drugs
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4. Surgery
There are 2 general types of surgery used for pancreatic cancer:
Potentially curative surgery is used when the results of exams and tests suggest that
it is possible to remove all the cancer.
Palliative surgery may be done if imaging tests show that the tumor is too
widespread to be removed completely. This surgery is done to relieve symptoms or to
prevent certain complications like a blocked bile duct or intestine, but it is not meant
to try to cure the cancer.
Several studies have shown that removing only part of the cancer does not help
patients live longer, so potentially curative surgery is only done if the surgeon thinks all
of the cancer can be removed. Even then, this is one of the most difficult operations a
surgeon can do. It is also one of the hardest for patients. It can cause complications
and take several weeks to recover from. Patients need to weigh the potential benefits
and risks of such surgery carefully.
5. Ablation or Embolization Treatments
These treatments are different ways of destroying tumors, rather than removing them
with surgery. They can sometimes be used to help treat pancreatic cancer that has
spread to other sites, especially the liver. But these treatments are very unlikely to
cure cancers on their own. They are more likely to be used to help prevent or relieve
cancer symptoms, and are often used along with other types of treatment.
Pancreatic neuroendocrine tumors (NETs): When these tumors have spread to other
sites, these treatments can often improve symptoms and help people live longer.
Exocrine pancreas cancers: These treatments are used much less often for exocrine
cancers (which account for most pancreatic cancers), but they might sometimes be
used to treat areas of spread when there are only a few of them.
6. Radiation Therapy
Radiation therapy uses high-energy x-rays (or particles) to kill cancer cells. It can be
helpful in treating some exocrine pancreatic cancers. Pancreatic neuroendocrine
tumors (NETs) don’t respond well to radiation, so it is rarely used to treat these
tumors. Radiation is sometimes used to treat pancreatic NETs that have spread to the
bone and are causing pain. It may also be used to treat these tumors in the form of
radioembolization.
Radiation can be used in different situations for exocrine pancreas cancers:
Radiation therapy (combined with chemotherapy) may be used in people whose
cancers have grown beyond the pancreas and can’t be removed by surgery (locally
advanced/unresectable cancers).
Radiation is sometimes used to help relieve symptoms such as pain in people with
advanced cancers or in people who aren’t healthy enough have other treatments like
surgery.
7. Chemotherapy and other drugs
Chemotherapy (chemo) uses anti-cancer drugs injected into a vein or taken by mouth.
These drugs enter the bloodstream and reach all areas of the body, making this
treatment potentially useful for cancers that have spread beyond the organ they
started in.
Chemotherapy for exocrine pancreatic cancer
Chemo may be used at any stage of pancreatic cancer:
Chemo can be given before surgery (sometimes along with radiation) to try to shrink
the tumor. This is known as neoadjuvant treatment.
Chemo can be used after surgery (sometimes along with radiation) to try to kill any
cancer cells that have been left behind (but can’t be seen). This type of treatment,
called adjuvant treatment, lowers the chance that the cancer will come back later.
Chemo is commonly used when the cancer is advanced and can’t be removed
completely with surgery.