Pancreatic Cancer Treatment

Pancreatic Cancer Treatment

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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    Anatomically, the pancreas lies just beneath the stomach. Surgical dissection and resection in this area can cause a condition known as a “gastric ileus,” or temporary paralysis of the stomach. This condition can manifest itself with symptoms such as nausea, vomiting, heartburn, or abdominal pain after eating.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of

    The most commonly used drugs used for treating pancreatic cancer, are gemcitabine (Gemzar®), docetaxel (Taxotere®), cis-platinum (Platinol®), 5-fluorouracil (5-FU), and mitomycin C. These drugs are sometimes used alone or in combination.


    Currently, there are clinical trials examining other new drug combinations, as well as targeted therapies that kill only cancer cells and not normal cells, such as erlotinib (Tarceva®), for their effectiveness against pancreatic cancer.

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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    The side effects of chemotherapy vary on the type and dose of drugs given, as well as the length of treatment. Some of the more common side effects associated with chemotherapy are hair loss, fatigue, mouth sores, nausea and vomiting. These side effects typically go away when treatment is stopped.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    Like chemotherapy, radiation therapy is sometimes used before surgery, after surgery, or both. When it is administered before surgery, the intent is to shrink the tumor enough to enable a surgeon to remove it. When it is given after an operation, the intent is to destroy any remaining cancer cells that may be present in the area. Radiation therapy is usually administered as an outpatient procedure at a hospital or clinic and is given 5 continuous days a week for 2 to 6 weeks. 
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    The treatments for pancreatic cancer in general include those that remove the cancer, those that prevent the cancer from advancing, and those that relieve symptoms. However, only a small percentage of pancreatic cancers are discovered in time to be surgically removed, and most stage 4 cancers cannot be treated this way because the cancer has spread too far by the time it is discovered. Surgery may still be used as a treatment, but the surgery involved is meant to relieve symptoms, not eliminate the cancer. Stents may be inserted in the body to help bile drain or to allow the intestines to function. Chemotherapy may also be used to keep the cancer from advancing quickly.

    In addition, there are a variety of newer treatment options under investigation. These include new drugs, surgeries, and genetic approaches to treating pancreatic cancer. They also include biologic therapies, in which the person's own immune system is stimulated to fight the cancer.

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    What are the risks of pancreatic surgery?
    The risks of pancreatic surgery involve bleeding, nerve damage and diabetes, says Steven Goldin, MD, with Fawcett Memorial Hospital. Watch this video to learn about the different risks of pancreatic surgery.
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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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    A Whipple procedure is one method of surgically removing the pancreatic cancer when the tumor is located in the head of the pancreas. In this procedure, the head of the pancreas is removed. The gallbladder is also removed, as well as parts of the bile duct, small intestine, and possibly the stomach. Then the rest of the pancreas is reattached to the stomach and intestines so that digestion can take place.

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    What can I expect after pancreatic surgery?
    The day after pancreatic surgery, is usually tough for most patients. Watch Steven Goldin, MD, with Fawcett Memorial Hospital, talk about the importance of the first day post-surgery.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of

    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.