Pancreatic Cancer Treatments by Stage
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.
Chemotherapy can also help improve pancreatic cancer symptoms and survival. Gemcitabine has been the most wildly used chemotherapy drug for treating metastatic pancreas cancer. Other drug combinations include gemcitabine with erlotinib, gemcitabine with capecitabine, gemcitabine with cisplatin, and gemcitabine with nab-paclitaxel. If you’re in fairly good health you may receive FOLFIRINOX (5-FU/leucovorin/oxaliplatin/irinotecan). Other combinations include gemcitabine alone or with another agent like (nab)-paclitaxel or capecitabine. Next line drug combinations to treat pancreatic cancer include oxaliplatin/fluoropyrimidine, or irinotecan liposome (Onivyde) in combination with fluorouracil plus leucovorin.
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.