Current As of May 2015
Treatment of pancreatic cancer usually involves a multi-disciplinary approach. A number of health care experts, including surgical oncologists, oncologists and radiation specialists pool their knowledge and expertise to determine the best course of treatment. The type of therapy someone with pancreatic cancer receives depends on a variety of factors, including the stage of the disease. Cancer of the pancreas is usually staged using an established staging system.
Staging of pancreatic cancer takes into consideration the size of the tumor and whether the cancer has spread to the surrounding lymph nodes, blood vessels, tissues or other organs. It involves a number of steps and procedures, including physical exam, imaging studies and biopsy – and sometimes additional tests like an exploratory laporatomy, a surgery that looks at organs inside the abdominal cavity to check for evidence the cancer may have spread.
Determining the Course of Treatment
The oncology and surgical team that treat pancreatic cancer takes into account a number of factors when deciding on the best therapy. Depending upon the stage of the disease, surgery may be an option. If the cancer has not metastasized, Whipple Surgery is recommended to remove the tumor.
The Whipple procedure, is a surgery that removes the tumor from the head of the pancreas, the common bile duct in the liver, the gallbladder and a portion of the small intestine and stomach. Whether or not the surgery is the recommended option depends on how advanced the cancer is and whether it has spread to surrounding blood vessels, lymph nodes and other organs Surgery is usually an option for stage one and some stage two pancreatic cancers.
Even after removing the tumor and the surrounding tissues, cancer cells may still be “hiding” in the body. That’s why adjuvant therapy is recommended in some cases after surgery. Adjuvant therapy may consist of radiation therapy, to stop the growth of any cancer cells that remain, chemotherapy or a combination of the two.
If a pancreatic cancer has invaded the surrounding tissues and can’t be completely removed, chemotherapy or a combination of chemotherapy and radiation may be the only option. For advanced stages of pancreatic tumors that have spread to other tissues and organs, invaded blood vessels or lymph nodes, and spread to distant organs, chemotherapy is the option.
Chemotherapy may slow down the rate at which the cancer grows and spreads. Late stage pancreatic cancer is not an automatic death sentence, but prognosis if very poor. Although there many survivors that live in excess of five years and well beyond, 75% of patients will not survive the first year. When pancreatic cancer is diagnosed while still confined to the pancreas, the five-year survival rate is about 28% versus only 2.8% after stage metastasis.
Other Factors to Consider When Determining the Course of Treatment
The multi-disciplinary team that treats pancreatic cancer also considers the overall health of the patient. If the victim is in otherwise very poor health or has other medical problems, some treatments may not be suitable. For example, the Whipple Procedure is a long and complex surgery and may be too risky for a a very unhealthy patient.
The Bottom Line
The treatment for cancer of the pancreas depends upon how much the disease has advanced, the health of the individual who has it as well as the wishes of the patient. The “medical team” typically works with each patient to ensure they get the best treatment possible.