Pancreatic Cancer

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Questions to Ask Your Doctor about Pancreatic Cancer
(Free Handout)

Treatment

The choice of treatment for pancreatic cancer depends largely on the stage of the disease. Treatment options include surgery, chemotherapy, radiation, and biological therapy (also known as immunotherapy). In pancreatic cancer, tumor growth can result in abnormal levels of pressure on nerves, which can cause pain. Pain is a major concern for patients who have pancreatic cancer. Treatments can help reduce pain when the reduction of the tumor (e.g., through surgery, chemotherapy, or radiation) relieves pressure on the nerves.

Over-the-counter and prescription pain relief medications can be used alone or in combination to reduce pain. The most common side effects of pain medications are fatigue and constipation. Frequent periods of rest and taking laxatives as directed by a physician can moderate these side effects.

When pain medications alone are ineffective, the oncology team may may decide to use other treatments that affect the nerves directly. These treatments include alcohol injections in a nerve to inhibit pain response and surgically severing nerves to prevent transmission of pain impulses.

Surgery

Surgery for pancreatic cancer often is used to treat Stage 1 cancer that is resectable. In some cases, the surgeon performs a resection, which is the removal of a small part of the pancreas.

More extensive surgery, called the Whipple procedure, involves removal of the pancreas head and nearby structures (e.g., the duodenum). It also may be necessary to remove the entire pancreas, as well as the spleen, gallbladder, and bile duct. Sometimes, the tumor cannot be completely removed. Most specialists believe that partial removal is not beneficial.

In some cases, a combination of therapies, such as radiation and chemotherapy, given before or after surgery, can increase survival.

Any form of surgery has potential side effects. Surgery for pancreatic cancer often involves a large incision in the abdomen. The healing process for major surgery can be very involved.

Patients may experience postsurgical pain, weakness, fatigue, loss of appetite, and infection. Medications often are used to treat side effects from surgery. Depending upon such factors as the patient's age, general state of health, type of surgery, and extent of cancer, side effects and recovery time vary considerably.

Following surgery for pancreatic cancer, the pancreas often no longer produces digestive juices and hormones. This can lead to digestive problems and/or diabetes, conditions that may be treated with changes in diet, medications, or hormone replacement.

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