Pancreatic Cancer Treatment Options
If pancreatic cancer can not be cured anymore, palliative treatment can be started. This type of treatment focuses on inhibiting the growth of the tumor by means of chemotherapy but can also only be intended to reduce or prevent certain complaints.
When setting up a treatment plan for pancreatic cancer, several factors are important: the stage of the disorder, the location, size and shape of the tumor and your physical condition. Depending on these factors, there are different pancreatic cancer treatment options:
- surgery
- stent placement
- chemotherapy
- radiotherapy
Surgery
A surgery is the only possibility to fully cure pancreatic cancer. The purpose of pancreatic cancer surgery to remove pancreatic tumors with adjacent tissue. This is only possible if the local tumor is not too extensive and there are no metastases to other organs. As a result, surgery is only possible for a part of the patients. Sometimes a tumor that did not seem to be removed initially after chemotherapy can be removed.
During the surgery, the head of the pancreas, gallbladder, duodenum, and part of the bile ducts are removed. Also, lymph nodes around the pancreas are removed. This surgery is called a Whipple surgery, or Pylorus Preserving Pancreatico Duodectomy (PPPD). All organs are then re-connected to the intestine so that the digestion juices can get back to the food. This surgery is drastic and takes an average of 4 hours. It is therefore important that your condition is good. After the surgery, you will stay in the hospital for an average of 10 days. The duration of this depends mainly on whether you experience complications from the surgery. The surgeon will inform you about the surgery and the chance of complications.
During the surgery, it sometimes appears that the tumor can not be removed anyway. In such a situation, for example, a closure of the bile duct or duodenum can be removed by means of a bypass. A new connection (bypass) is then made between the stomach and the small intestine and between the bile duct and the small intestine. The intestine is, as it were, guided by the tumor.
Stent placement
In the case of pancreatic cancer, it can prevent the tumor from compressing the bile ducts. A blockage of the bile duct can be removed by placing a metal or plastic tube (stent) in the bile duct. This happens during an ERCP. The tube pushes the bile ducts open again and this allows the bile to flow to the small intestine again. You do not have to be admitted to the hospital for the placement of a stent.
The stent may become blocked, causing jaundice to return and/or a high fever. In that case, the stent must be replaced by an ERCP.
It is also possible that it is no longer possible to place a stent. In this case, a Percutaneous Transhepatic Cholangiography Drainage (PTCD) will be applied. This is also called a gallow drainage. During this procedure, a tube is laid in the bile ducts through the skin and with the aid of an ultrasound. Gal can still be removed by means of this tube. The bile is then collected in a bag that is attached to your body.
For this treatment, you will receive an anesthetic and a scow. The PTCD treatment then takes 30-60 minutes.
Chemotherapy
Chemotherapy is a treatment that aims to kill cancer cells. In pancreatic cancer treatment with chemotherapy is often palliative, that is, the treatment mainly focuses on inhibiting the growth of the tumor. This reduces the complaints. In some patients, chemotherapy is used after surgery. The aim of this treatment is to kill any remaining undetectable tumor cells.
There are different types of chemotherapy. Chemotherapy can be given as a single agent, but also in combination. Most chemotherapy is administered via an infusion. The frequency of administration depends on the type of chemotherapy.
Chemotherapy can also affect healthy cells in addition to cancer cells. This may cause side effects. Common side effects are hair loss, nausea, bowel disorders, fatigue and an increased risk of infections. The side effects are different for each chemotherapy and will also differ per person. Your doctor will discuss with you the effects of chemotherapy.
Radiotherapy
Radiotherapy has a limited role in the treatment of pancreatic cancer. Sometimes radiotherapy in combination with chemotherapy can reduce the tumor. Radiotherapy can also be important for treating pain complaints.
During radiotherapy, the tumor is irradiated radioactively from outside. Cancer cells can worse against the radiation than healthy cells. Because of the radioactive radiation, the tumor cells become damaged and they break down. Radiotherapy reduces tumor growth and there is a possibility that the tumor becomes smaller.
The radiation is focused as much as possible on the tumor. However, it is not possible to prevent healthy cells from being irradiated. As a result, you will have to deal with side effects. In general, radiotherapy often causes fatigue. In addition, the irradiated skin can turn red. This is accompanied by itching and a burning sensation. With radiation in the area of the stomach, patients often have nausea symptoms. Your radiotherapist can prescribe medication for this. You can also suffer from your bowels.
Radiotherapy usually takes place several times a week, for several weeks. There is no need for hospitalization.
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