Overview of treatment options
Treatment options for pancreatic cancer
Before deciding on the best course of
treatment, various tests are usually carried out such as blood
tests and scans (see the section on diagnosis).
A number of factors have to be taken into consideration before
doctors can decide which course of treatment would be most
appropriate. These include:
- The type of cancer - some cancers respond
better to being surgically removed (such as endocrine cancers)
while others may come back after surgery
- The stage of the cancer - this means how
advanced the cancer is and whether or not it has spread beyond the
pancreas
- Where it is located within the pancreas -
sometimes the tumour is very close to major blood vessels and other
important organs which makes surgery too risky
- The general health of the patient - including
age and fitness
The treatment options fall into three main types:
A minority of patients will be considered suitable for immediate
surgery to remove their cancer. This involves a sophisticated
operation that should only be performed at a regional specialist
centre. Also, surgery can only be considered if you are fit
enough to undergo such an operation and if the doctors believe they
can remove all the cancer. This usually means cancers that are
small and at an early stage of development.
Unfortunately because pancreatic cancer is often symptomless
until advanced stages of the disease, it has usually grown quite
large or even spread beyond the pancreas by the time of deciding
treatment options. These patients may be offered chemotherapy and
or radiotherapy to help control the growth and symptoms of the
tumour and possibly shrink it.
Quite often a combination of all three treatments will be used
to help deal with the symptoms of the cancer. Surgery to insert a
plastic or metal tube called a stent which keeps open the bile duct
or the pancreatic duct will help manage the symptoms of jaundice.
Radiotherapy can help alleviate pain. Chemotherapy is helpful if
the cancer has spread to other organs such as the liver. Very
occasionally chemotherapy and radiotherapy is given before surgery
in an attempt to shrink the cancer sufficiently to be completely
removed, but this is very rare.
Deciding on the course of treatment
Once a patient is diagnosed, a multi-disciplinary team (MDT) involving
surgeons, oncologists, other doctors and specialist nurses at a regional/specialist centre
is responsible for recommending whether treatment should be
pursued, and these options are discussed with you to reach a
mutually agreeable decision about your case.
Getting a second opinion
Patients are entitled to ask for a second opinion from a GP or a
specialist - but the right to get one is not automatic. If your GP
supports your request, they will raise the issue with your
consultant or specialist who should then ask for the second
opinion. It is important to note that getting a second opinion
should not affect your care.
Clinical trials for pancreatic cancer
Clinical trials involving patients are conducted to get further
information about new drugs and treatments or new combinations of
treatments with the aim of improving outcomes. Your consultant or
oncologist may offer you the option to take part in a trial. If
not, it may be worth raising the issue yourself. However there is
no obligation to agree to take part in a trial.
The Pancreatic Cancer UK website contains a list of current
trials for pancreatic cancer in the UK. Click here to find out more about
trials.