The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Editorial changes were made to this summary.
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Pancreatic Cancer Treatment
Treatment Options for Recurrent Pancreatic CancerTreatment options for recurrent pancreatic cancer include the following:Palliative therapy.Chemotherapy: fluorouracil  or gemcitabine.[2,3,4]Palliative therapyPalliative therapy for recurrent pancreatic cancer includes the following:Palliative surgical bypass procedures such as endoscopic or radiologically placed stents.[5,6]Palliative radiation procedures.Pain relief by celiac axis nerve or intrapleural block (percutaneous).Other palliative medical care alone.ChemotherapyChemotherapy occasionally produces objective antitumor response, but the low percentage of significant responses and lack of survival advantage warrant use of therapies under evaluation.Treatment Options Under Clinical Evaluation for Recurrent Pancreatic CancerTreatment options under clinical evaluation include the following:Phase I and II clinical trials evaluating pharmacologic modulation of fluorinated pyrimidines, new anticancer agents, or biological
Curative surgical excision, by open laparotomy or laparoscopy, is the treatment of choice when possible. The open surgical approach is used if the tumor is suspected to be malignant, since en bloc lymphadenectomy is performed for malignant tumors without distant metastases. Intraoperative ultrasound aids the localization of tumor extent and the relationship to other anatomic structures.Standard treatment options:Single small lesion in head or tail of pancreas:[1,2,3,4]Enucleation, if feasible. Large lesion in the head of the pancreas that is not amenable to enucleation:[1,2,3,4]Pancreaticoduodenectomy.Single large lesion in body/tail:[1,2,3,4]Distal pancreatectomy.Multiple lesions: occur in 10%, often in association with multiple endocrine neoplasia syndrome type 1 (MEN-1):[1,2,3,4]Distal pancreatectomy with enucleation of tumors in the head of the pancreas.Metastatic lesions: lymph nodes or distant sites:[5,6,7,8,9,10,11,12]Resect when possible.Consider radiofrequency or