How is Pancreatic Cancer Treated

Treatment Option Overview

How cancer of the pancreas is treated

     There are treatments for all patients with cancer of the pancreas. Three kinds of treatment are used:

• surgery (taking out the cancer or relieving symptoms caused by the cancer)
  
• radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
  
• chemotherapy (using drugs to kill cancer cells)

     Surgery may be used to take out the tumor. A doctor may take out the cancer using one of the following operations:

• A Whipple procedure removes the head of the pancreas, part of the small intestine, and some of the tissues around it. Enough of the pancreas is left to continue making digestive juices and insulin.
  
• Total pancreatectomy takes out the whole pancreas, part of the small intestine, part of the stomach, the bile duct, the gallbladder, spleen, and most of the lymph nodes in the area.
  
• Distal pancreatectomy takes out the body and tail of the pancreas.

     If the cancer has spread and it cannot be removed, the doctor may do surgery to relieve symptoms. If the cancer is blocking the small intestine and bile builds up in the gallbladder, the doctor may do surgery to go around (bypass) all or part of the small intestine. During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine. This is called biliary bypass. Surgery or x-ray procedures may also be done to put in a tube (catheter) to drain bile that has built up in the area. During these procedures, the doctor may make the catheter drain through a tube to the outside of the body or the catheter may go around the blocked area and drain the bile to the small intestine. In addition, if the cancer is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally.

     Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy).

     Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in the vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the pancreas.

     The use of biological therapy (using the body's immune system to fight cancer) is being tested in clinical trials for pancreatic cancer. Biological therapy searches for ways that the cancer tissue is different from normal pancreas tissue, and tries to get the body to fight the cancer. It uses materials made by the body or made in a laboratory to boost, direct, or restore the body's natural defenses against disease. Some biological therapies are sometimes called biological response modifier (BRM) therapy or immunotherapy.

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