Treatment
The treatment depends upon the stage and type of pancreatic cancer. Some of the treatment options include:
- Surgery: The surgery may be curative surgery or palliative surgery. Curative surgery is performed to treat the patients, and palliative surgery relieves them of cancer symptoms. The oncologists may perform the staging laparoscopy before the main surgery to determine the cancer stage and the possibility of resecting the tumor.
Whipple procedure (pancreaticoduodenectomy) removes the pancreatic head if it is affected by cancer.
Distal pancreatectomy is done to remove the tail and body of the pancreas
Total pancreatectomy is the process of removing the entire pancreas. The surgeon may perform surgeries to repair the affected blood vessels in patients with advanced cancer.
- Chemotherapy: Chemotherapy involves the administration of drugs that kill rapidly dividing cells. Chemotherapy is administered when cancer spreads out of the pancreas or surgery is not viable for resecting the affected part. The drug can be given either through injection or orally. Chemotherapy may also be combined with surgery. When chemotherapy is administered before surgery, it is known as neoadjuvant chemotherapy. If it is given after the surgery, it is known as adjuvant chemotherapy. Chemotherapy is also combined with radiation, a technique known as chemoradiation.
- Radiation therapy: Radiation therapy is often used for the treatment of pancreatic cancer. It can be given along with surgery (before, during, and after) to kill the cancer cells and lower the risk of recurrence. Traditional radiation therapy involves the use of X-rays to destroy cancer cells. However, advanced radiation therapy, such as proton therapy, can also be used in some cases. Proton therapy has relatively lower side effects compared to standard radiation therapy.
- Targeted therapy: Advanced knowledge about the cellular activity of the pancreatic cells allows the development of various targeted therapies to target the vital proteins and genes essential for the growth and division of cancer cells. Targeted therapies are implemented in case the patients do not respond to standard chemotherapy. The side effects of targeted therapy are also different from conventional chemotherapy. Targeted therapy targets EGFR protein, PARP enzymes, and proteins synthesized by NTRK genes. EGRF protein and proteins synthesized by NTRK are required to grow cancer cells. PARP enzymes help in repairing the DNA of cancer cells.
- Immunotherapy: Immunotherapy uses the patient's immune system to kill cancer cells. Normally, the immune cells identify and destroy any abnormal growth of cells in the body. However, these abnormal cells sometimes evade the immune system through different mechanisms and form tumors. Immunotherapy aims to make the cancer cells vulnerable to attack by the immune system by interfering in the evasion mechanism. Further, immunotherapy also stimulates the immune system to fight against cancer cells.
- Ablative and embolization procedures: These procedures are not often used for pancreatic cancer. Ablative treatment includes destroying the cancer cells with extreme heat or cold. The techniques for performing ablative procedures are microwave thermotherapy, radiofrequency ablation, ethanol ablation, and cryosurgery. An adequate blood supply is necessary for the growth of the tumor. The cancer specialist, through the embolization technique, blocks blood flow to cancer cells.
