What Are the Standard Treatments for Pancreatic Cancer?
There are different types of treatment for patients with pancreatic cancer.
Different types of treatment are available for patients with
pancreatic cancer. Some treatments are
standard (the currently used treatment), and some are being tested in clinical trials. A
treatment clinical trial is a research
study meant to help improve current treatments or obtain information on new
treatments for patients with cancer. When clinical trials show that a new treatment is better than the
standard treatment, the new treatment may become the standard treatment.
Patients may want to think about taking part in a clinical trial. Some clinical
trials are open only to patients who have not started treatment.
Five types of standard treatment are used:
One of the following types of surgery may be used to take out the tumor:
- Whipple procedure: A surgical procedure in which the head of the
pancreas, the gallbladder, part of the
stomach, part of the small intestine, and the
bile duct are removed. Enough of the pancreas is left to produce
digestive juices and insulin.
- Total pancreatectomy: This operation removes the whole pancreas, part of the
stomach, part of the small intestine, the
common bile duct, the gallbladder, the
spleen, and nearby
- Distal pancreatectomy: The body and the tail of the pancreas and usually the
spleen are removed.
If the cancer has spread and cannot be removed, the following types of
palliative surgery may be done to relieve
symptoms and improve
quality of life:
biliary bypass: If cancer is blocking the small intestine and
bile is building up in the gallbladder, a biliary bypass may be done. During
this operation, the doctor will cut the gallbladder or bile duct and sew it to
the small intestine to create a new pathway around the blocked area.
stent placement: If the tumor is blocking the bile duct, surgery may be done
to put in a stent (a thin tube) to
drain bile that has built up in the area. The doctor may place the stent
catheter that drains to the outside of the body or the stent may go around
the blocked area and drain the bile into the small intestine.
- Gastric bypass: If the tumor 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 is a cancer treatment that uses high-energy
X-rays or other types of
radiation to kill cancer
cells or keep them from growing. There are two types of radiation therapy:
- External radiation therapy uses a machine outside the body to send radiation
toward the cancer.
- Internal radiation therapy uses a
radioactive substance sealed in needles,
seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and
stage of the cancer being treated. External radiation therapy is used to
treat pancreatic cancer.
Chemotherapy is a cancer treatment that uses
drugs to stop the growth of cancer cells, either by killing the cells or by
stopping them from dividing. When chemotherapy is taken by mouth or
injected into a
vein or muscle, the drugs enter the bloodstream and can reach cancer cells
throughout the body
(systemic chemotherapy). When chemotherapy is placed directly into the
cerebrospinal fluid, an
organ, or a body
cavity such as the
abdomen, the drugs mainly affect cancer cells in those areas
Combination chemotherapy is treatment using more than one anticancer drug.
The way the chemotherapy is given depends on the type and stage of the cancer
Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.
Targeted therapy is a type of treatment that uses drugs or other substances
to identify and attack specific cancer cells without harming normal cells.
Tyrosine kinase inhibitors (TKIs) are targeted therapy drugs that block
signals needed for tumors to grow.
Erlotinib is a type of TKI used to treat pancreatic cancer.
There are treatments for pain caused by pancreatic cancer.
Pain can occur when the tumor presses on
nerves or other organs near the pancreas. When pain
medicine is not enough, there are treatments that act on nerves in the abdomen
to relieve the pain. The doctor may inject medicine into the area around
affected nerves or may cut the nerves to block the feeling of pain. Radiation
therapy with or without chemotherapy can also help relieve pain by shrinking the
Patients with pancreatic cancer have special nutritional needs.
Surgery to remove the pancreas may affect its ability to make pancreatic
enzymes that help to digest food. As a result, patients may have problems
digesting food and absorbing nutrients into the body. To prevent malnutrition,
the doctor may prescribe medicines that replace these enzymes.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical
trials. It may not mention every new treatment being studied. Information about
clinical trials is available from the
Biologic therapy is a treatment that uses the patient's
immune system to fight cancer. Substances made by the body or made in a
laboratory are used to boost, direct, or restore the body's natural defenses
against cancer. This type of cancer treatment is also called biotherapy or
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a
clinical trial may be the best treatment choice. Clinical trials are part of
the cancer research process. Clinical trials are done to find out if new cancer
treatments are safe and effective or better than the
Many of today's standard treatments for cancer are based on earlier clinical
trials. Patients who take part in a clinical trial may receive the standard
treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer
will be treated in the future. Even when clinical trials do not lead to
effective new treatments, they often answer important questions and help move
Patients can enter clinical trials before, during, or after starting their
Some clinical trials only include patients who have not yet received
treatment. Other trials test treatments for patients whose cancer has not gotten
better. There are also clinical trials that test new ways to stop cancer from
recurring (coming back) or reduce the
side effects of cancer treatment.
Follow-up tests may be needed
Some of the tests that were done to
diagnose the cancer or to find out the
stage of the cancer may be repeated. Some tests will be repeated in order to
see how well the treatment is working. Decisions about whether to continue,
change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment
has ended. The results of these tests can show if your
condition has changed or if the cancer has
recurred (come back). These tests are sometimes called
follow-up tests or check-ups.