How is pancreatic cancer treated?

Treatment for pancreatic cancer depends on the following factors:

• Size, type and location of the tumour
• Stage of the disease when the cancer is found
• The patient’s general state of health

The main treatment for localised pancreatic cancer is surgery. Some patients may also require other treatments such as chemotherapy, and radiation therapy. For patients who are not suitable for curative surgery, surgery may be performed to relieve symptoms such as jaundice or nausea caused by a blockage in the bile duct.

An individual with cancer should be assessed by a specialist to determine which treatment is best suited for them.

Surgery

The surgical procedure depends on the location of the tumour and whether it can be removed.

Additional procedures to clear any obstruction of the bile ducts might be done before surgery. This can be done with a tube inserted into the bile duct via endoscopic (ERCP) access, or with a tube inserted directly through the skin into the liver, known as percutaneous transhepatic biliary drainage (PTBD).

• Whipple’s operation
  

  If the cancer is located in the head of the pancreas, a Whipple’s operation – also known as pancreaticoduodenectomy – may be performed. This involves the removal of the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, part of the bile duct and nearby lymph nodes. In some situations, part of the stomach and colon may also be removed.
  
  

• Distal pancreatectomy
  

  This is done for removal of tumours in the neck, body, or tail of pancreas. In some cases, the spleen may also be removed. This operation may be carried out via laparoscopic (keyhole) access or robotic surgery. For large tumours which extend beyond the pancreas, conventional open surgery may be required.
  

Radiotherapy/ Radiation therapy

Radiotherapy also known as radiation therapy, uses powerful energy beams to kill cancer cells. It may be used when the cancer cannot be completely removed during surgery or to reduce the risk of cancer recurrence.

Chemotherapy

Chemotherapy is sometimes recommended after surgery if there is a risk that the cancer might return. It may also be used before surgery to shrink the cancer, so that it is more likely to be removed completely during surgery.

Supportive care

Supportive care is treatment that helps to improve the symptoms of pancreatic cancer such as problems with eating and weight loss, pain, nausea, tiredness or lethargy.