Treatment

There are several treatment options for pancreatic cancer, but only early stage cancer is curable. Late stage treatments focus on relieving pain and improving quality of life.

Surgery
If pancreatic cancer is diagnosed at an early stage, surgery may be done to remove the tumor. Types of surgery to remove the tumor are dependent on the location of the tumor within the pancreas. They include:

  • Whipple procedure: A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to produce digestive enzymes and insulin, and the remaining essential digestive organs are reconnected on the inside in a different way than they were before.
  • Total pancreatectomy: This surgery removes the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen, and nearby lymph nodes.
  • Distal pancreatectomy: The body and the tail of the pancreas and usually the spleen are removed.

If the cancer has spread and cannot be removed, palliative surgery may be done to relieve symptoms and improve quality of life. Types of palliative surgery include:

  • Surgical biliary bypass: If cancer is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done. During this surgery, the provider cuts the gallbladder or bile duct and attaches it to the small intestine to create a new pathway around the blocked area.
  • Endoscopic stent placement: If the tumor is blocking the bile duct, surgery or endoscopic retrograde cholangiopancreatography (ERCP) may be done to place a thin tube, called a stent, to drain bile that has built up in the area. If the tumor is blocking the flow of food out of the stomach, or through the first part of the small intestine where the head of the pancreas is located, a stent may be placed there to open up the lumen, or tube-like opening, to allow for food to pass.
  • Gastric bypass: If the tumor is blocking the flow of food from the stomach, and a stent cannot be placed or is unsuccessful, the stomach may be surgically attached directly to the small intestine in a different way so the patient can continue to eat normally.

Radiation Therapy
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Only external radiation therapy is used to treat pancreatic cancer.

Chemotherapy
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Systemic chemotherapy, which is taken by mouth or injected into a vein or muscle, targets cancer cells throughout the body. Regional chemotherapy, which is placed directly into the affected organ, targets cancer cells in that specific area, or region, of the body. The type of chemotherapy used depends on the type and stage of the cancer.

Other Treatments
Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.

Targeted therapy is a type of treatment that uses drugs or other substances to attack specific cancer cells without harming normal cells. Tyrosine kinase inhibitors, or TKIs, are targeted therapy drugs that block signals needed for tumors to grow. Erlotinib is a type of TKI used to treat pancreatic cancer.