Pancreatic Cancer and treatment
Most people with pancreatic cancer have pain and weight loss, with or without jaundice (yellowing of the skin).
Pain is common. It usually develops in the upper abdomen as a dull ache that wraps around to the back. The pain can come and go, and it might get worse after eating.
Weight loss. Some people lose weight because of a lack of appetite, feeling full after eating only a small amount of food, or have diarrhea. The bowel movements might look greasy and float in the toilet bowl because they contain undigested fat.
Jaundice causes yellow colored skin and whites of the eyes. Bowel movements may not be a normal brown color and instead have a grayish appearance. Jaundice is caused by a block in the flow of bile from the gallbladder, where it is stored, to the intestinal tract where the bile assists in digestion of food. The block is caused by the cancer.
Pancreatic cancer stages range from stage I, the earliest stage, to stage IV, which means that the cancer has spread to distant organs, such as the liver. In general, lower stage cancers require less treatment than do higher stage cancers. Most physicians who care for patients with pancreatic cancer refer to patients as having surgically resectable cancer (stage I and II), locally advanced and surgically unresectable cancer (stage III), and metastatic cancer (stage IV). Sometimes you will hear physicians describe a stage that technically doesn’t exist called “borderline resectable.” This occurs because imaging doesn’t always accurately distinguish between stage I-II and stage III.
Pancreatic cancer can be treated with several approaches. Early stage pancreatic cancer can often be treated and even cured with surgery. After surgery, further treatment, called adjuvant therapy, is often recommended. This might include chemotherapy or radiation therapy.
However, surgery is often not possible; pancreatic cancer is often advanced by the time it is diagnosed. If surgery is not possible, radiation therapy chemotherapy, or both are often used to shrink the cancer, reduce symptoms, and prolong life.
The standard operation for tumors in the HEAD of the pancreas is a Whipple procedure (also called a pancreaticoduodenectomy).
Because tumors in the body or tail of the pancreas do not cause the same symptoms as those in the head of the pancreas, these cancers tend to be discovered at a later stage, when they are more advanced.
If the tumor can be removed with surgery, a laparoscopy is usually done first to make sure the cancer has not spread. If surgery is an option, part of the pancreas is removed, usually along with the spleen.
Adjuvant (additional) therapy refers to chemotherapy, radiation, or a combination of both that is recommended for people who are thought to be at high risk of having cancer reappear (termed a recurrence or a relapse) after a tumor has been removed surgically.
In people with stage II or III pancreatic cancer, there are two ways to give adjuvant therapy after surgery for pancreatic cancer:
●Give chemotherapy alone.
●Give a combination of chemotherapy and radiation therapy. This strategy is called chemoradiotherapy.
For patients who are initially diagnosed with metastatic pancreatic cancer (stage IV), chemotherapy might be recommended to slow the spread of the cancer and relieve symptoms.
Chemotherapy does not cure metastatic pancreatic cancer, but it can relieve symptoms, slow disease progression, and prolong life.
Possible means to reduce symptoms:
Jaundice — Jaundice is caused by a blockage of the flow of bile from the gallbladder into the intestine. The most common treatment is a stent, which is a small tube that is inserted into a duct to keep it open. The stent can usually be placed in a procedure called ERCP (endoscopic retrograde cholangiopancreatography).
Bowel (duodenal) blockage — Some patients with pancreatic cancer will develop a blockage in the upper intestine (duodenum) caused by the tutor. Surgery can be done to create a detour between the stomach and a lower part of the intestine. An alternative to bypass surgery is placement of a stent (a tube) in the duodenum. The stent helps to hold open the blocked area.
Pain — Pain is a common problem in people with pancreatic cancer. In some people, pain medicine alone is all that is needed. Radiation therapy can also help relieve pain by shrinking the tumor.
A procedure called celiac plexus block might also be a good option to control pain. This procedure uses injections of alcohol into nerves that transmit pain signals. The alcohol kills the nerves, preventing them from telling the brain to feel pain.
Weight loss — Weight loss is common in people with pancreatic cancer. Taking a pancreatic enzyme replacement can help your body to absorb fat. Enzyme replacements are usually taken in a capsule on a daily basis. more