Cancer continues to be one of the most impactful diseases in the United States and the world at large. Data from 2015 to 2017 show that an estimated 39.5 percent of people will be diagnosed with some form of cancer at some point in their lives. Over 57,000 Americans are estimated to get a pancreatic cancer diagnosis in 2020, averaging out to more than 158 diagnoses per day. This makes pancreatic cancer the ninth most common cancer among U.S. women and the tenth most common type of cancer among men.
If you’re wondering “Is there a cure for pancreatic cancer?”, there is currently no cure for any form of cancer. However, with the right treatment plan, you can potentially manage your symptoms and improve your health. Learn more about the pancreatic cancer treatment options below.
Understanding Pancreatic Cancer
Pancreatic cancer describes any type of cancer that originates within the cells of the pancreas. This is distinct from secondary forms of pancreatic cancer, which start in other organs before metastasizing into the pancreas. The pancreas sits behind the lower part of the stomach and is involved in digestion and regulating blood sugar levels.
Pancreatic cancer can come in several different forms based on the type of cell that is actually affected. A vast majority of pancreatic cancers affect the exocrine cells, which make up most of the organ. About 93 percent of pancreatic cancer cases are exocrine tumors. Exocrine cells form the glands and ducts responsible for synthesizing and secreting digestive enzymes into the intestines to assist with the breakdown of fats. Pancreatic adenocarcinoma, also known as exocrine pancreatic cancer, is the most common type of pancreatic cancer. It affects the cells lining the ducts within the pancreas.
Less commonly, pancreatic cancer affects the endocrine or neuroendocrine cells within the pancreas. These cells play a role in the synthesis and secretion of hormones that control blood sugar levels, particularly insulin and glucagon. Neuroendocrine tumors, also called islet cell tumors, comprise about 7 percent of pancreatic cancers.
In terms of what can cause pancreatic cancer, the disease is caused by mutations in the DNA. Some of these genes are hereditary, while other mutations develop with exposure to certain environmental risk factors such as tobacco and workplace chemicals.
Symptoms of Pancreatic Cancer
What are the signs of pancreatic cancer? Specific symptoms can vary from patient to patient. Most pancreatic cancer patients do not experience any symptoms until the cancer has spread or grown to more advanced stages. Some of the most common pancreatic cancer symptoms include:
- Jaundice (a yellowing of the skin and eyes, dark urine, lighter stools, itchy skin)
- Pain in the abdomen or back
- A new diabetes diagnosis or existing diabetes becoming more difficult to manage
- An enlarged liver or gallbladder
- Blood clots
- Sudden unintended weight loss or loss of appetite
- Nausea and vomiting
Many of these symptoms can be caused by a disease or disorder unrelated to pancreatic cancer. While this means you should not worry if you experience one or more of these symptoms, it is still highly recommended that you seek medical care to know for sure. Even if you are not diagnosed with pancreatic cancer, your doctor may be able to address the underlying issue and ensure better health and peace of mind.
How to Treat Pancreatic Cancer
Following a positive diagnosis, you will undergo a staging phase to determine the severity of the cancer and its potential spread. Determining whether your case is in the beginning or final stages of pancreatic cancer gives way to a more customized treatment plan for your specific needs. Pancreatic cancer treatment options will vary from patient to patient, and your doctor will likely make adjustments depending on your responses to treatment.
Surgery is one of the primary forms of treatment for most all types of cancer, pancreatic cancer not excluded. Surgery can come with various risks of bleeding and infection, and unless it is a purely palliative surgery, most doctors will not consider surgery unless they can completely remove the tumor. Curative surgery is most often used for treating cancers located at the head of the pancreas.
There are also various types of surgery involved. A whipple procedure, also known as a pancreaticoduodenectomy, is the most common surgery that is used for removing cancer at the head of the pancreas. This involves removing the head and sometimes part of the body of the pancreas. Any nearby structures, including the small intestine, gallbladder, bile duct, and stomach, may also be removed. Any remaining pancreatic structures are connected to the small intestine to ensure the proper transfer of bile and other digestive enzymes.
A distal pancreatectomy is a surgical procedure that involves removing the tail and potentially part of the body of the pancreas. This may also involve removal of the nearby spleen.
A total pancreatectomy refers to an entire removal of the pancreas, which may also require removal of part of the stomach, gallbladder, small intestine, or spleen. This is reserved for pancreatic cancer cases where the cancer has spread through much of the pancreas but can otherwise be easily removed. While it is possible to lead a healthy life without a pancreas, this also often means living without insulin and other hormones that manage blood sugar levels, so most people who undergo a complete pancreas removal usually get diagnosed with diabetes.
Ablation or Embolization
Ablation and embolization are different methods of destroying tumors and cancerous material. Ablation refers to destroying cancer using extreme heat or cold. This is usually reserved for tumors measuring no bigger than an inch across. Ablation procedures may include:
- Radiofrequency ablation (RFA)
- Microwave thermotherapy
- Ethanol ablation
- Cryosurgery (sometimes also known as cryotherapy or cryoablation)
Embolization is a procedure wherein the doctor injects substances into an artery to block blood flow to cancer cells, causing them to starve and die. This can be used for larger tumors measuring about two inches across.
Radiation therapy involves exposure to high-energy x-rays to destroy cancer cells. This can be administered after surgery to eliminate any cells that the surgeon may have missed, thus lowering the chances of the cancer coming back. Radiation therapy may also be combined with chemotherapy prior to surgery for borderline resectable tumors. This can potentially shrink the pancreatic tumor, allowing for an easier and more effective surgery.
Combining radiation therapy and chemotherapy is also a common primary treatment. This is particularly common among people who have cancer that is inoperable because it has spread beyond the pancreas. Radiation treatment can also be used on its own to relieve certain pancreatic cancer symptoms or in people who aren’t healthy enough to undergo surgery.
Chemotherapy involves a drug that is injected into the system intravenously or taken orally. The drug enters the bloodstream and kills cells that replicate rapidly, including cancer cells. As mentioned, chemotherapy can be given prior to surgery to shrink larger tumors, and it can be administered after surgery to kill cancer cells that the surgeon may have missed. Chemotherapy may also be used on its own if the cancer has spread to other organs or if surgery is otherwise not an option.
For pancreatic cancer, you will usually be given a combination of chemotherapy drugs. This usually means two or more drugs if you are healthy enough, but those who aren’t healthy enough may use a single drug.
Targeted therapy is a form of treatment that involves using drugs that target specific genes or proteins characteristic to cancer cells. These drugs may be more effective than chemotherapy drugs. For example, the drug erlotinib targets EGFR, a protein found on cancer cells that helps them grow. Targeted therapy may be combined with chemotherapy and other forms of treatment to increase effectiveness and the chance of success.
Immunotherapy refers to any form of treatment that stimulates your own immune system to identify and destroy cancer cells more effectively. For instance, checkpoint proteins on immune cells normally prevent them from attacking normal, healthy cells. However, cancer cells can sometimes use checkpoint proteins to hide in plain sight. Drugs known as checkpoint inhibitors allow the immune cells to better recognize and respond to cancer cells.
The treatment that best works against your pancreatic cancer will depend on your specific needs and the severity of the cancer. It’s important to talk to your doctor to determine the most optimal treatment plan for the best outcome.