Pancreatic Cancer Treatments

When deciding on the best pancreatic cancer treatments for you, your doctors will take several factors into consideration. This includes:

• Type of pancreatic cancer
• Stage of pancreatic cancer
• Size of pancreatic tumor
• Location of the tumor within the pancreas
• Characteristics of the genes and proteins of the cancer cells Pancreatic cancer cases, mostly those with metastatic or unresectable cancers, are commonly screened for certain biomarkers (genetic mutations and proteins) that are specific to each person’s cancer and can affect treatment selections.
• Your overall health

Your treatment plan may involve a combination of different pancreatic cancer treatments, the most common of which are described below.

Surgery refers to a medical procedure where a part of your body is cut open by your doctors to remove, repair or replace diseased or damaged tissue.

For pancreatic cancer treatment, the aim of surgery could be to remove the cancer completely (called curative surgery) or to control symptoms and/or relieve any blockages (known as palliative surgery).

There are various types of curative pancreatic surgery, such as:

• Distal pancreatectomy
• Central pancreatectomy
• Total pancreatectomy
• Whipple procedure

Meanwhile, palliative procedures for pancreatic cancer include:

• Biliary or duodenal stent placement
• Biliary or gastric bypass surgery

Chemotherapy (or chemo in short) is a type of pancreatic cancer treatment that uses cancer-killing drugs to stop or slow the uncontrolled growth of cancer cells. It works by interfering with DNA and the cell cycle, a series of phases cells undergo when forming new cells.

Some common chemotherapy drug combinations used to treat pancreatic cancer are:

• Gemcitabine and nab-paclitaxel
• FOLFIRINOX: 5-FU, folinic acid, irinotecan and oxaliplatin
• NALIRIFOX: 5-FU, folinic acid, irinotecan liposome and oxaliplatin

Chemo for pancreatic cancer is administered by mouth (orally) or as an infusion into your veins (intravenously). The drugs then travel through the bloodstream to kill cancer cells throughout the body. This is known as systemic chemotherapy.

Learn more: Chemotherapy for Pancreatic Cancer

Radiation therapy uses high-power energy rays to kill cancer cells or keep them from dividing. Pancreatic cancer is sometimes treated with external beam radiation therapy (EBRT) or stereotactic body radiation therapy (SBRT). This type of therapy involves a machine outside the body that emits radiation directed toward the abdomen.

Learn more: Radiation Therapy for Pancreatic Cancer

Targeted therapy uses drugs that are designed to identify and attack the genes, proteins and tissue environment that pancreatic cancer cells need to grow and survive. This prevents the cancer cells from growing and spreading while limiting the damage to healthy cells.

Targeted drugs used to treat pancreatic cancer and pancreatic neuroendocrine tumors (NETs) include:

• Erlotinib
• Everolimus
• Olaparib
• Sunitinib
• Zenocutuzumab-zbco

Pancreatic cancers that invade and put pressure on nerves surrounding the organ can cause a great deal of pain in the abdomen or back. To ease the pain, doctors can prescribe you with pain medication. Examples include morphine and other opioids, which can be taken in pill form once or twice a day. The drug fentanyl can even be applied as a patch every few days.

Other forms of pain control are:

• Cutting or injecting alcohol into nerves that transmit pain sensations near the pancreas. This can usually be done during surgery to remove the cancer or during biliary bypass surgery.
• Injecting the surrounding nerves with an anesthetic or drug that destroys the nerves. This can be performed endoscopically or through the skin (percutaneously).
• Radiation therapy is also commonly used, either at the original pancreatic site or at painful metastases, for pain control as a palliative intervention.

Finding the most suitable type of cancer treatment and drug regimen plays a very important part in your care. Please consult your doctors and cancer care team to discuss which pancreatic cancer treatments would work best for you.