Pancreatic Cancer

Even if treatment doesn't usually cure the cancer, it may help you live longer and feel better. The most common treatments include surgery, radiation, and chemotherapy. Often a combination of these treatments is used.

Surgery

Surgery will be done to remove the tumor if possible. But most of the time the cancer has already spread so far that not all of it can be removed.

If surgery can remove all of the cancer, it can help you live longer. But even with successful surgery, the cancer often comes back.

If you are told that your cancer has spread too much for surgery, you may want to get a second opinion from a pancreatic cancer surgeon.

Surgery for pancreatic cancer includes:

• Reference Whipple procedure. This is the most common surgery for pancreatic cancer. The surgeon may remove part of the pancreas, part of the stomach, part of the small intestine, and the gallbladder and common bile duct.
• Distal pancreatectomy. The surgeon may remove part of the pancreas and the spleen.
• Total pancreatectomy. The surgeon may remove the whole pancreas, part of the stomach, part of the small intestine, the bile duct, gallbladder, spleen and nearby lymph nodes.

You'll be in the hospital for 1 to 2 weeks after the surgery. You will probably be able to return to work or your normal routine in about 1 month. It will probably take about 3 months until your strength is back to normal. You will probably need more treatment for the cancer, such as Reference chemotherapy Opens New Window or Reference radiation.

Depending on how much of your pancreas is removed, you may need to take enzyme supplements (to replace the enzymes the pancreas makes) and anti-ulcer pills from now on. If your entire pancreas is removed, you will need to replace the insulin produced by your pancreas. You may have to check your blood sugar levels and give yourself insulin shots.

Chemotherapy

Reference Chemotherapy Opens New Window, sometimes called chemo, uses medicine to destroy cancer cells. The drugs used in this treatment can also affect healthy cells and cause side effects. The most common chemo drugs used for pancreatic cancer are:

• Reference Gemcitabine.
• Reference Fluorouracil (5-FU).

Common side effects of these drugs include:

• Nausea, vomiting, and diarrhea.
• Loss of appetite.
• Reference Hair loss.
• Mouth sores.
• Low blood counts, which may increase the risk of infection and bleeding.

Radiation

Radiation treatment may be used for certain types of pancreatic tumors.

Reference External radiation is the kind of radiation most often used. It may be used along with chemotherapy. It may also be used before or after surgery.

Radiation can have side effects. The most common ones include:

• Extreme tiredness.
• Hair loss near the treated area.
• Skin darkening in the area.
• Loss of appetite.
• Nausea, vomiting, and diarrhea.
• Pain or a feeling of fullness in the belly.

Radiation can also be used to help control pain by Reference shrinking the tumor so that it doesn't press on nerves or other organs.

Clinical trials

Your doctor may talk to you about being in a Reference clinical trial. For some people with pancreatic cancer, taking part in a clinical trial may be the best treatment choice.

Among the treatments being looked at by clinical trials for pancreatic cancer is biologic therapy, a treatment that uses your Reference immune system Opens New Window to fight cancer.

Treatment to help you feel better

When pancreatic cancer gets worse or comes back, the goal of treatment in many cases is to help you feel better and live longer. This is called Reference palliative care Opens New Window.

Pain control

Pain is one of the main concerns of people with pancreatic cancer. But cancer pain can almost always be controlled. You and your doctor have several options to help your pain.

• Reference Nerve blocks are injections of alcohol or another liquid into the area of pain. The liquid numbs the nerves, interrupting the pain signal being sent to your brain. In some cases, the nerves carrying the pain sensation can actually be cut.
• Sometimes radiation or chemotherapy can be used to help ease the pain by Reference shrinking the tumor.
• And there are Reference stronger medicines your doctor can give you to help your pain.

Reference Reference Cancer: Controlling Cancer Pain

Removing a blockage

Sometimes the tumor presses on and blocks the bile duct where it passes through the pancreas. This can cause digestion problems. There are two ways to fix the blockage and help you feel better.

• Widen the blocked area so that it can drain. This may be done using an endoscope—a long, flexible tube that is inserted through your mouth all the way to the pancreas while you are sedated. Or it may be done by inserting a tube through your skin into the blocked area.
• Divert the flow of bile so that it goes around, instead of through, the pancreas. This requires surgery.

Because the pancreas is next to the stomach, the tumor can sometimes block the flow of food from the stomach to the first part of the small intestine. In that case, your doctor may do a gastric bypass, sewing the stomach directly to a lower part of the small intestine to get around the blocked area.

Additional information about pancreatic cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/pancreatic.

Supportive care

If your disease is at an advanced stage, you may choose not to have treatment because the time, costs, and side effects of treatment may be greater than the benefits. Making the decision about when to stop medical treatment aimed at prolonging life and shift the focus to end-of-life care can be difficult.

For more information, see the topics:

• Reference Hospice Care.
• Reference Care at the End of Life.
• Reference Palliative Care.

Complementary treatment

People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:

• Reference Acupuncture to relieve pain.
• Reference Meditation or Reference yoga to relieve stress.
• Reference Massage or Reference biofeedback to reduce pain and ease tension.
• Reference Breathing exercises for relaxation.

These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.

Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. They aren't meant to take the place of standard medical treatment.

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