Pancreatic Cancer Treatment

Pancreatic Cancer Treatment

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    Unlike some other forms of cancer, pancreatic cancer is often detected only in advanced stages, making it one of the most deadly forms of cancer overall. Surgical removal of tumors is possible in only 10% to 20% of people. Chemotherapy is not nearly as beneficial as doctors would hope, and the risk of recurrence after treatment is high. Given these conditions, researchers are working hard to develop alternative therapies that extend people's lives past the average survival time, 20 months after diagnosis.

    For locally advanced pancreatic cancer without evidence of distant metastasis the treatment of choice is curative surgical resection followed by chemotherapy plus or minus radiation. Even patients with invasion of the cancer into the surrounding vasculature, surgeons at Columbia University have been successful at surgical resection with comparable postoperative complications as those tumors without vascular invasion. Interdisciplinary treatment strategy involving medical oncologists, interventional gastroenterologists, radiologists, radiation oncologists and surgeons with expertise in pancreatic cancer should share in the coordination of care for patients with pancreatic cancer.

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    Meditation: There is good evidence that various types of meditation may help improve quality of life in cancer patients. Studies have shown benefits for mood, sleep quality, and the stresses of treatment. The specific effects of meditation are not fully understood. Additional research is needed in this area.

    Use cautiously with underlying mental illnesses. People with psychiatric disorders should consult with their primary mental healthcare professional(s) before starting a program of meditation, and should explore how meditation may or may not fit in with their current treatment plan. Avoid with risk of seizures. The practice of meditation should not delay the time to diagnosis or treatment with more proven techniques or therapies, and should not be used as the sole approach to illnesses.

    Yoga: Yoga is an ancient system of relaxation, exercise, and healing with origins in Indian philosophy. Several studies report enhanced quality of life in cancer, lower sleep disturbance, decreased stress symptoms and changes in cancer-related immune cells after patients received relaxation, meditation and gentle yoga therapy. Yoga is not recommended as a sole treatment for cancer but may be helpful as an adjunct therapy.

    Yoga is generally considered to be safe in healthy individuals when practiced appropriately. Avoid some inverted poses with disc disease of the spine, fragile or atherosclerotic neck arteries, risk for blood clots, extremely high or low blood pressure, glaucoma, detachment of the retina, ear problems, severe osteoporosis, or cervical spondylitis. Certain yoga breathing techniques should be avoided in people with heart or lung disease. Use cautiously with a history of psychotic disorders. Yoga techniques are believed to be safe during pregnancy and breastfeeding when practiced under the guidance of expert instruction (the popular Lamaze techniques are based on yogic breathing). However, poses that put pressure on the uterus, such as abdominal twists, should be avoided in pregnancy.

    You should read product labels, and discuss all therapies with a qualified healthcare provider. Natural Standard information does not constitute medical advice, diagnosis, or treatment.



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    You can take people with stage IV colorectal cancer in their liver, which they’re told it's inoperable, and you give them chemotherapy for several months, and they get such a tremendous, remarkable response that you’d actually consider taking out part of their liver or part of their colon tumor.

    That type of surgery is unheard of in pancreatic cancer. But have I ever re-operated on a patient for pancreatic cancer? I’ve done that, but only on a handful of people.
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    There are few proven, effective second-line treatments that are available to us. Any time that we can look at newer therapies that are available, or new combinations of therapies that are available, I think that is the appropriate route to take. If I’m talking about chemotherapy, then it has to be for an individual who's going to be able to tolerate the treatment. We have to make sure that the side effects of chemotherapy aren’t going to be too great to warrant the potential benefit of the treatment.
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    The reality is that not all intraductal papillary mucinous neoplasms, or IPNMs, are the same, and they don’t all harbor the same risk. When you talk about risk, pancreatic cancer surgery is safer than it has ever been, but it’s still a tough operation. It’s still an operation that if you don’t need it, you don’t want it. But if you need it, you want to have it done early and selectively.

    We now categorize IPNMs. If the neoplasms are coming off the side branches of the pancreatic duct instead of the main duct -- think of it like a tree trunk; you have your normal tree trunk and you have these little branches coming off of it -- and if it’s just isolated to the side branches, then your chance of getting pancreatic cancer is very low, probably less than 1 percent per year for the rest of your lifetime.

    We put those people into what we call an active surveillance program. I like to say active surveillance rather than observation because people say, “Doc, aren’t you going to operate on me? You’re going to observe me, you’re going to do nothing?” No, we’re going to actively follow you. And we’ll get an MRI on those people once a year, maybe sometimes once every other year.

    If the cancer, or the neoplasm, involves the main duct, the main trunk of the tree, then we know those people have a much higher risk for malignancy. If we can isolate the cancer in one part of the pancreas, the left side or the right side, those are the people we’re going to operate on.
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    AAurora Health Care answered
    Radiation therapy for the treatment of pancreatic cancer uses high-energy rays to kill cancer cells. Radiation is a local therapy. It affects cancer cells only in the area being treated. You will often receive low doses of chemotherapy along with radiation to increase the effectiveness of the treatment. Radiation may be given alone, with surgery, with chemotherapy, or both.
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    AAurora Health Care answered
    Chemotherapy is a systemic treatment. Chemotherapy drugs are given intravenously (through a needle in a vein) and travel in your bloodstream throughout your body. Even after surgery, pancreatic cancer can sometimes metastasize (spread). Chemotherapy is often given after surgery to try to prevent the cancer from coming back (adjuvant therapy). Chemotherapy may be given alone, with radiation, or with surgery and radiation. If you have tumors that are potentially resectable (removable by surgery), you may receive chemotherapy before or after surgery.
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    AJohn A. Chabot, Endocrinology Diabetes & Metabolism, answered on behalf of Columbia University Department of Surgery

    Foods to avoid soon after a pancreatic resection include:

    • Fibrous meats: beef, pork, lamb, veal
    • Raw fruits with skin: apples, pears, plums, peaches, cherries, etc.
    • Raw berries: strawberries, blueberries, raspberries
    • White rice (but brown rice is usually okay)
    • Fresh citrus fruit (but pulp-free juices are usually okay)
    • Nuts (but smooth nut butters are usually okay)
    • Fresh bread 
    • Raw vegetables
    • Legumes
    • Carbonated beverages

    If you are diabetic, you may need to adjust these suggestions to meet your dietary restrictions.

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    AJohn A. Chabot, Endocrinology Diabetes & Metabolism, answered on behalf of Columbia University Department of Surgery

    Foods that are more easily digested soon after pancreatic resection include:

    • Eggs: soft boiled, hard-boiled, scrambled, poached
    • Well-steamed vegetables, carrots, squash, zucchini
    • Potatoes: mashed, steamed, boiled, baked (without the skin)
    • Chicken: broiled or grilled (without breading or skin)
    • Hard crackers: saltines or graham crackers (in small amounts)
    • Fish: steamed or broiled
    • Soft cheeses: cottage cheese, ricotta
    • Shredded or melted cheese
    • Farina, grits, oatmeal
    • Yogurt 
    • Stewed fruit or canned fruit 
    • Applesauce
    • Well-ripened melons
    • Well-cooked pastas
    • Peanut butter

    If you are diabetic, you may need to adjust these suggestions to meet your dietary restrictions.

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    Pancreatic cancer is one of the deadliest cancers. Even with aggressive treatment, the prognosis is poor. Early detection is uncommon. Few pancreatic cancers are found in the early stages of the disease when the cancerous cells can be surgically removed. Pancreatic cancer also tends to spread quickly. The pancreas lies at the junction of several very important structures in your abdomen, making it easy for the cancer to spread into these structures and organs.

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