Understanding Pancreatic Cancer Treatment Choices

Pancreatic cancer involves malignant cells forming in the tissues of the patient’s pancreas. It’s one of the more difficult cancers to diagnose at an early stage. In 2020, an estimated 495,000 new pancreatic cancer cases were recorded worldwide. Cancer of the pancreas can result in Jaundice, upper and mid abdomen pain, back pain, tiredness, and weight loss. Navigating treatment options can feel overwhelming for a patient, but advancements in diagnostics and therapies have improved the survival rates.

Learn more about how pancreatic cancer is treated and what influences the treatment decision.

Factors Influencing Pancreatic Cancer Treatment Options

When diagnosed with pancreatic cancer, different factors influence the choice of treatment.

• The location of cancer in the pancreas (head, body, or tail)
• The stage of pancreatic cancer
• The patient’s medical history and current health

Some of the treatments for pancreatic cancer include:

• Surgery
• Chemotherapy/Immunotherapy
• Radiation therapy

Staging of Pancreatic Cancer

One of the first things that doctors and specialists will usually do is to stage the cancer. This may involve multiple scans including CT, MRI, and PET scans.

Staging aims to help in planning treatment and understanding the prognosis of the disease. Following staging investigations specialist will be able to inform you if the cancer is resectable ( curative intent) or is unresectable and locally advanced or metastatic.

Surgery for Pancreatic Cancer

Surgery is the only curative option in case of pancreatic cancer. A pancreatic surgeon will evaluate the cancer stage and your condition in detail to assess if the cancer can be removed completely as this gives the best chance for cure or long-term survival.

There are different kinds of surgeries available, and they focus on removing the tumor and sometimes the surrounding tissues, too.

Your specialist first needs to understand if the cancer is localized or metastatic.

Surgery may involve:

• Whipple’s procedure
• Distal pancreatectomy
• Total pancreatectomy
• Palliative surgery

Whipple Procedure

The Whipple procedure is carried out for cancers in the head or uncinate process of the pancreas. In this surgery, part of the pancreas is removed along with the gall bladder, bile duct, and duodenum or part of the stomach. This surgery is done to provide prolonged survival or attempted cure from cancer. Unfortunately, only 20 -25% of patients with pancreatic cancer may be suitable to undergo this procedure

Distal Pancreatectomy

A procedure that involves removing both the tail and the body of your pancreas. There are also cases where the surgeon removes the spleen.

This procedure is mostly suitable for cases where the cancer is confined in the tail or body of the pancreas, and in an early stage.

Total pancreatectomy

In a total pancreatectomy, the surgeon will remove your entire pancreas. This is usually done in very few patients who have multiple cancers in the pancreas.

Palliative Surgery and procedures

Sometimes in cases where curative surgery is not possible surgeon may consider doing other surgery like a biliary bypass to make you more comfortable.

The goal of these surgeries is to ease some of the symptoms that pancreatic cancer causes. By improving symptoms, quality of life can be enhanced.

• Gastric bypass: In scenarios where the tumor grows in such a way that it causes a blockage in the stomach, a gastric bypass can help. During a gastric bypass, the surgeon usually sews the stomach directly onto the small intestine.
• Biliary bypass: This surgery is recommended if the tumor causes a blockage at the bile duct. When this happens, bile continues to accumulate in the gallbladder. The surgeon cuts the gallbladder (or the bile duct) at the area where the tumor causes a blockage. They then sew the gallbladder or bile duct directly onto the small intestine.
• Endoscopic stent: Sometimes, a biliary bypass isn’t needed when the tumor blocks a bile duct. Your doctor may place an endoscopic stent into the bile duct that is blocked. This allows the duct to drain normally.

Chemotherapy for Pancreatic Cancer

In most patients, treatment of pancreatic cancer will involve chemotherapy. In some cases, chemotherapy will be given before or after surgery and sometimes chemotherapy may be the sole treatment option.

The goal of chemotherapy is to use specific drugs that prevent cancer cells from continuing to grow. There are different types of chemotherapy drugs that doctors use to treat pancreatic cancer

Radiation Therapy for Pancreatic Cancer

Radiation can offer a useful technique for killing cancerous cells. This is called radiation therapy. It focuses on either killing the cells or stopping their growth.

If the patient undergoes radiation therapy, a machine is used to send these rays into the body. The doctor performing the therapy will position the machine in such a way as to target the specific area where the cancer cells are.

There are some cases where the patient undergoes radiation therapy and chemotherapy simultaneously.

Targeted Treatments/Immunotherapy

Immunotherapy is the use of medicines to stimulate a person’s immune system to recognize and destroy cancer cells more effectively. Certain types of immunotherapy can be used to treat pancreatic cancer. Immunotherapy is usually given along with chemotherapy or in patients who have not responded to chemotherapy or whose cancer has come back after chemotherapy.

Pancreatic Cancer Follow-Up Care

All patients following treatment for pancreatic cancer must follow up with their doctor regularly  Aim is to monitor if the cancer that has disappeared after treatment is coming back or partially treatment cancer is growing again. Following successful treatment, follow-up care remains an important part of the patient’s life.

Understanding any long-term side effects that can persist even after treatment is successful plays an important role. This helps to ensure patients are educated and know what to expect going forward. There are also cases where patients develop late side effects, which can happen a while after treatment stops.

Patients should keep their health records and check back with their doctor often. This helps to ensure active monitoring is done to detect any potential recurrence of the cancer as early as possible.

Pancreatic Cancer Treatment at King’s College Hospital London in Dubai

At King’s College Hospital London, located in Dubai, we focus on giving patients access to a team of international specialists who are highly experienced in working with cancer. Our team is well-trained in all areas of cancer, and we provide help with different kinds of cancerous diseases. Our team carefully assesses every patient with pancreatic cancer to create a customized and highly personal treatment program that focuses on cancer location, severity, and other important factors. This brings you the highest level of care. We don’t just focus on cancer but also help to improve your or your loved one’s quality of life.

If you or your loved one was diagnosed with pancreatic cancer, schedule an appointment to find out what treatment options we can offer.