The proper cure and remedy of pancreatic cancer depend upon the age of pancreatic cancer of your body. In terms of medicines, the spread of cancer is measured in stages. Hence, to understand the proper treatment processes of cancer, you must understand the stages first.
Stages of Pancreatic Cancer
Doctors have divided into five stages of pancreatic cancer. The five stages are classified as per the size and spread of tumors in the body.
- Stage 0 – If cancer has not spread at all from its place of origin or has not mitigated further from the top layer of cells in the ducts of the pancreas, then it is called to be in stage zero. At this stage, the cancer is undetectable through imaging techniques. It cannot be identified even with naked eyes.
- Stage 1 – When cancer has grown to a size of fewer than two cms, then it is considered at the stage of 1A cancer. If the size is more prominent than two cms but less than four cms, it is regarded as a stage 1B cancer.
- Stage 2 – In this stage, pancreatic cancer has grown to a size which is exceeding four cms and is either limited to the pancreas or grown a bit outside of it to nearby lymph nodes.
- Stage 3 – Stage 3 is quite an alarming stage for pancreatic cancer to be discovered. At this stage, pancreatic cancer may have ventured into dangerous demon-like essential blood vessels and nerves near the pancreas.
- Stage 4 – Stage 4 is the stage where cancer has metastasized. Stage 4 is the final stage of pancreatic cancer. Diagnostics of pancreatic cancer at stage 4 means that cancer has spread to distant organs of the body. Curing cancer at this stage is almost impossible with current knowledge and technology.
Only imaging techniques or tests are not adequate methods to diagnose pancreatic cancer, whereas These tests only give us an idea but are not reliable assurance. Surgery is also required to determine the stage of cancer precisely. However, surgery also brings certain risks with it. Hence, doctors opt to determine whether a tumor is resectable or not.
- Resectable tumors — Through surgery, doctor can remove respectable tumors. After conducting imaging tests, if a doctor determines that cancer has not spread very far and is removable through surgery, then he calls it resectable.
- Unresectable tumors – When the imaging tests diagnose that the cancer has spread to nearby nerves and blood vessels, then it is considered unsafe to remove the tumor. Surgical removal is not prescribed as a treatment procedure for pancreatic cancer at this stage.
- Metastatic tumor – A doctor may call a tumor to be metastatic if cancer has propagated to other vital organs of the body. In the case of metastatic tumors, removal of the tumor through surgery is considered impossible.
Types of Surgeries for Pancreatic Cancer
When pancreatic cancer is resectable, then the treatment of pancreatic cancer can also include surgery, which is followed by chemo or radiation therapy. Pancreatic cancer surgery can be any of the three types –
Whipple Procedure
According to the medical terms, Whipple procedure surgery is also known as a pancreaticoduodenectomy. In Whipple procedure surgery, the doctor removes the head of the pancreas. Sometimes, the doctor may also remove other parts of the pancreas, some parts of the stomach, gallbladder, small intestine, lymph nodes, and the common bile duct. To ensure that the digestion is not affected, the doctor would join the disjointed organs in a new functional way. Whipple procedure is a complex and challenging procedure to perform, and the success possibility is not very high due to the complexity.
Half of the time, the procedure is abandoned as cancer, which appeared to be resectable during imaging, turns out to be unresectable during the surgical procedure.
Distal Pancreatectomy
Distal pancreatectomy is a different surgery for the treatment of pancreatic cancer. In the following procedure, the tailor portions of the body of the pancreas (not the head) are removed. It is uncommon because most of cancer arising from the tail or shape of the pancreas are unresectable.
Total Pancreatectomy
Total pancreatectomy is also an uncommon procedure in which the whole of the pancreas and spleen are removed through surgery.
Chemotherapy for Pancreatic Cancer
Chemotherapy is useful for resectable as well as unresectable cancer. In this process, cancer-killing drugs are injected in the body of the patient which then travel through the whole body and kill cancer cells in the primary tumor as well as those which have spread to different locations.
The two popular drugs used are –
- 5-fluorouracil (5-FU) or capecitabine
- Gemcitabine
Both of these drugs are injected through veins during regular visits to the oncologist by the patient. In the case of radiation therapy, 5-FU may be substituted by oral medication, capecitabine.
Radiation Therapy
Radiation therapy involves passing high energy beams of X-rays through the pancreas to kill cancerous cells. Radiation therapy is done as a daily treatment over a period of weeks. Both chemotherapy and radiation therapy have side-effects
The Side-Effects of Chemotherapy and Radiation Therapy
Since both the procedures also kill some healthy cells, a patient may witness symptoms like nausea, vomiting, loss of appetite, apparently the loss of weight, fatigue, and even toxicity of blood cells. However, the symptoms go away within weeks of completion of the therapy.
Treatment of Locally Advanced (Unresectable) Pancreatic Cancer
In locally advanced pancreatic cancer, it is not possible to remove cancer through surgery. Removing only parts of cancer has proven to be non-helpful in the past. Hence, it is avoided.
Therefore, treatment consists of non-surgical ways which are chemotherapy and radiation therapy. The drugs 5-FU and gemcitabine are known to prolong the life of cancer patients.
Treatment of Metastatic Pancreatic Cancer
Although surgery is used during the treatment of metastatic cancer, the purpose is to relieve the symptoms rather than curing the disease. At advanced stages, pancreatic cancer can be quite painful. Hence, surgical procedures are used to control pain, suppress jaundice, or relieve gastric outlet obstructions.
Chemotherapy and radiation therapy are used to quell symptoms as well as cure cancer. Different combinations of drugs are given to patients. Gemcitabine is the most popular drug used to treat metastatic pancreatic cancer.
Other popular combinations of medicines are gemcitabine with erlotinib, gemcitabine with capecitabine, gemcitabine with cisplatin, and gemcitabine with nab-paclitaxel.
Gemcitabine can also be given alone or with other drugs like (nab)-paclitaxel or capecitabine. Some patients may receive oxaliplatin/fluoropyrimidine or irinotecan liposome (Onivyde) in combination with fluorouracil plus leucovorin.
Since pancreatic cancer is detected in stage 4 in almost all cases, the treatment becomes not only challenging but also very costly. You are required to undergo chemotherapy treatment or radiation therapy, along with one or more surgeries for several weeks or even months.
Palliative Treatment of Pancreatic Cancer
As cancer grows in the body of a person, it starts creating a number of problems. Therefore, with the spread of disease, the focus during its treatment continues to shift from extending a patient’s life to suppressing the symptoms. Numerous types of remedies are given to reduce the discomfort faced by the patient, such as –
- In order to provide relief from jaundice and itching resulting from a blockage in the flow of bile juice, a bile duct stent can be inserted through surgery.
- In order to relieve the pain, opioid analgesics (opium-based painkillers) and nerve blocking agents like celiac plexus block can be given.
- In order to help in coping with the depression associated with patients who have advanced-stage cancer, antidepressants and counseling are provided.
Clinical Trials for Pancreatic Cancer
The treatment of pancreatic cancer is a hot topic of research these days. Across the globe, scientists are endeavoring to improve the methods of diagnosis as well as a treatment to reduce the high rate of mortality linked to this rare form of cancer.