Chicago Health | Homepage
Treatment plan for pancreatic cancer unique to each individual

Treatment plan for pancreatic cancer unique to each individual

Mayo Clinic Q&A

DEAR MAYO CLINIC: How do doctors determine whether or not chemotherapy or surgery is appropriate for treating pancreatic cancer? Why do some people with a late-stage diagnosis have treatment, while others are told treatment will not help their situation?

ANSWER: The treatment plan for each individual with pancreatic cancer is unique to that person’s situation and the stage of the disease when it is diagnosed. But where in the past many people were advised that no treatment was available when cancer had spread outside the pancreas, today improved chemotherapy offers new treatment possibilities for this difficult cancer.

Pancreatic cancer is uncommon compared to other kinds of cancer, such as lung, colorectal and breast cancer. Symptoms of pancreatic cancer are relatively nonspecific and can include abdominal or back pain, weight loss, new onset or worsening diabetes, and jaundice or yellowing of the skin. Smoking is the only known significant risk factor, and although a small fraction of patients have a genetic predisposition, the majority of causes are unknown. The lifetime risk of developing the disease for people in the general population is about 1 percent. Unfortunately for those who do get it, pancreatic cancer is one of the hardest kinds of cancer to successfully treat. The five-year survival rate now is just over 7 percent.

The reason pancreatic cancer is so devastating is twofold. First, there’s no early screening for it. Many cases are diagnosed at an advanced stage when cancer has already spread from the pancreas to other organs. The second reason has to do with the biology of the cancer. It’s very aggressive and has a high tendency to spread to other sites, even with very small tumors in seemingly early-stage disease. That means that for many people, the disease comes back after treatment.

In people diagnosed before cancer has spread outside the pancreas, treatment may include surgery to remove the tumor, followed by chemotherapy. But that group is in the minority and only includes about 15 percent of patients at diagnosis. In up to 50 percent of patients, the cancer has spread to other sites outside the pancreas, making surgery ineffective. In about 35 percent of patients, the tumors involve vascular structures around the pancreas, so the cancer traditionally was felt to be surgically inoperable.

It’s in this second group of patients that a new approach to treatment has been helping over the last several years. With the advent of improved chemotherapy and radiation therapy, it’s now possible to give treatment to those individuals that may, in a significant number of cases, reduce the cancer to a point that surgery is a viable option for long-term survival and even cure.

The advances in chemotherapy for pancreatic cancer have been particularly positive. Whereas the response rates to traditional chemotherapy in people with pancreatic cancer used to be at about 9 percent, that rate has almost tripled with the new chemotherapy regimens available today. It’s even higher in patients whose tumors have not spread to other sites.

Additionally, the surgery used to remove pancreatic cancer has improved. First and foremost, for surgery to be successful there can’t be any cancer cells left behind. If there are, patients do not derive any benefit from the operation. Historical data suggests that about 1 in 4 patients had some cancer remaining in the pancreas after surgery. With the use of preoperative chemotherapy and subsequent radiation therapy, along with updated surgical techniques, we have improved those percentages and increased the odds that all cancer cells will be removed. This strategy and improved care after surgery have also decreased the number of complications that happen as a result of surgery, and that improves overall survival, too.

A diagnosis of pancreatic cancer can be very frightening. But for many people, modern treatment options are available. In the past, some doctors simply told people with this disease that nothing could be done, based on poor overall historical outcomes. Today that’s often not true. If you are diagnosed with pancreas cancer and you aren’t given any treatment choices, get another opinion. Talk to an oncologist or to a surgeon who specializes in pancreatic cancer at a center that does a high number of surgeries to find out what options may be possible for you. — Mark Truty, M.D., Surgery, Mayo Clinic, Rochester, Minn.

(Mayo Clinic Q & A is an educational resource and doesn’t replace regular medical care. E-mail a question to MayoClinicQ&A@mayo.edu. For more information, visit www.mayoclinic.org.)

(c) 2016 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH. ALL RIGHTS RESERVED. DISTRIBUTED BY TRIBUNE CONTENT AGENCY, LLC.

Similar Articles

Speaking Up About Prostate Cancer

Speaking Up About Prostate Cancer

Above photo: Ken Griffey Sr. By Laura Drucker Ken Griffey Sr. had reason to be worried

Beyond Chemo

Beyond Chemo

Immunotherapy treatments rev up immune system to fight cancer By Katie Scarlett Brandt Six years ago Henry Kawell, then 72,

Can you be held responsible for your parents’ long-term-care costs?

Can you be held responsible for your parents’ long-term-care costs?

By Eleanor Laise, Kiplinger Retirement Report When an older adult racks up unpaid long-term-care bills, who's

Rare syndrome causes overly flexible joints, fragile skin

Rare syndrome causes overly flexible joints, fragile skin

Mayo Clinic Q&A DEAR MAYO CLINIC: I was recently diagnosed with vascular Ehlers-Danlos syndrome. My doctor

Calcium is crucial for long-term bone health

Calcium is crucial for long-term bone health

Mayo Clinic Q&A DEAR MAYO CLINIC: Should all postmenopausal women take calcium supplements to prevent osteoporosis,

Articles By Category

Family Health

In The Know

CH Lifestyle

January 2017
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
December 25, 2016 December 26, 2016 December 27, 2016 December 28, 2016 December 29, 2016 December 30, 2016 December 31, 2016
January 1, 2017 January 2, 2017 January 3, 2017 January 4, 2017 January 5, 2017 January 6, 2017 January 7, 2017
January 8, 2017 January 9, 2017 January 10, 2017 January 11, 2017 January 12, 2017 January 13, 2017 January 14, 2017
January 15, 2017 January 16, 2017 January 17, 2017 January 18, 2017 January 19, 2017 January 20, 2017 January 21, 2017
January 22, 2017 January 23, 2017 January 24, 2017 January 25, 2017 January 26, 2017 January 27, 2017 January 28, 2017
January 29, 2017 January 30, 2017 January 31, 2017 February 1, 2017 February 2, 2017 February 3, 2017 February 4, 2017

Categories

Recent Comments

Swing for the fences in the fight to Sideline Pancreatic Cancer

Swing for the fences in the fight to Sideline Pancreatic Cancer

Enjoy a great night of baseball at Peoples Natural

VIEW ARTICLE
Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

Cost to give birth 1943 - Page 3 - Defending The Truth Political Forum

A Hazy Shade of Healthcare: What does tort reform

VIEW ARTICLE

Archives