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Pancreatic Cancer Treatments by Stage

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Treating Locally Advanced (Unresectable) Pancreatic Cancer

In locally advanced pancreatic cancer, surgery can't remove the entire tumor. Since surgery to remove only part of the pancreatic cancer has been shown not to help, nonsurgical therapies are best.

Treatment consists of chemotherapy with or without radiation therapy. Either 5-FU or gemcitabine can extend life in people with locally advanced pancreatic cancer.

Treating Metastatic Pancreatic Cancer

In metastatic pancreatic cancer, surgery is used only for symptom control, such as for pain, jaundice, or gastric outlet obstruction. Radiation may be used for symptom relief, as well.  

Gemcitabine is the single most active drug for treating metastatic pancreas cancer. A recent study demonstrated that a 4-drug regimen, known as FOLFIRINOX (5-FU/leucovorin/oxaliplatin/irinotecan), is superior to gemcitabine, but it is a therapy reserved for people in fairly good health. Other drug combinations include gemcitabine with erlotinib, gemcitabine with capecitabine, gemcitabine with cisplatin, and gemcitabine with nab-paclitaxel. 

Other drug combinations to treat pancreatic cancer include oxaliplatin with 5-FU, or capecitabine or cisplatin with 5-FU, or capecitabine. 

 

Palliative Treatment for Pancreatic Cancer

As pancreatic cancer progresses, the No. 1 priority of treatment will shift from extending life to alleviating symptoms, especially pain. Numerous treatments can help protect against the discomfort from advanced pancreatic cancer:

  • Procedures like bile duct stents can relieve jaundice, thus reducing  itching and loss of appetite associated with bile obstruction.
  • Opioid analgesics can help relieve pain.
  • Antidepressants and counseling can help treat depression common in advanced pancreatic cancer.

Clinical Trials for Pancreatic Cancer

New pancreatic cancer treatments are constantly being tested in clinical trials. You can find out about clinical trials for the latest treatments for pancreatic cancer on the web sites of the American Cancer Society or the National Cancer Institute.

WebMD Medical Reference

Reviewed by David T. Derrer, MD on May 23, 2014
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