pancreatic Cancer treatment

The Ultimate Guide to Pancreatic Cancer

Pancreatic cancer is the 12th most common cancer in the world. In just the United States, about 67,000 people will be diagnosed with the disease in 2024—with men more likely to have it than women. The disease is one of the most serious forms of cancer, with its mortality rate being among the highest. However, it should be noted that, in general, the five-year survival rate for pancreatic cancer currently sits at 12%—an increase from recent years.

Although pancreatic cancer is lethal and the survival rates for the disease are generally low compared to many other types of cancer, a patient’s outcome can vary based on factors such as the cancer’s stage at diagnosis, the patient's overall health, and the effectiveness of treatment. According to the American Cancer Society, the five-year survival rate for the disease shoots up to about 44% if the cancer is localized or hasn’t spread outside the pancreas—which is typically the case if it is caught early. Thus, the earlier pancreatic cancer is diagnosed and treated, the better the prognosis.

Historically, the disease has often been diagnosed at an advanced stage, mainly due to the disease showing little or no symptoms until it has advanced and spread, leading to a patient being diagnosed with late-stage pancreatic cancer. It is vital then that a patient stays proactive and gets themself screened for the disease periodically, especially if they have any of the risk factors associated with the cancer.

Researchers are continually investigating new ways of screening and treating pancreatic cancer. There are currently a plethora of methods, some of which include CT, PET, and MRI scans and endoscopic ultrasound, CA 19-9 and CEA blood tests, endoscopic retrograde cholangiopancreatography, targeted therapy, and pancreatectomy. If you or someone you are close to has pancreatic cancer, understanding your choices can help you make better informed decisions about your course of action.

In this guide, you can find out all about pancreatic cancer and the best treatments available. We also cover various factors to consider when thinking about a personalized care plan, as well as what to expect for each treatment option. Let’s start!

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What is Pancreatic Cancer?

This type of cancer consists of a malignant growth in the pancreas, an organ located behind the stomach that is in charge of converting food into fuel and regulating blood sugar. Pancreatic cancers manifest in two primary ways: exocrine tumors, constituting over 90% of all cases, typically present as adenocarcinoma, originating from organ-lining cells. The less common type, neuroendocrine tumors (NETs), accounting for less than 10% of cases, are also known as islet cell carcinoma.

Pancreatic cancer may cause no symptoms in its early stages. As the disease progresses, the most common issues associated with it include pain in the upper abdomen and/or upper and middle back, loss of appetite, unintentional weight loss, nausea, vomiting, diarrhea, changes in stool consistency, blood clots, new-onset diabetes, jaundice, light stools and dark urine, and fatigue.

It’s worth noting that these issues may not always be a sign of pancreatic cancer. Another condition that causes similar symptoms is pancreatitis. Regardless, if you are experiencing any of these symptoms, be sure to talk to your doctor.

What Causes Pancreatic Cancer?

While the exact cause of pancreatic cancer remains elusive, experts have identified several factors that may increase your risk of developing the disease. Some of these risk factors include:
The likelihood of developing pancreatic cancer rises with advancing age, with most instances observed in individuals aged 65 and above.
Tobacco Use
Some of the most significant risk factors for pancreatic cancer are cigarette, cigar, and other tobacco usage. Those who smoke have double the likelihood of developing the disease compared to those who do not use tobacco. According to the American Cancer Society, about 25% of pancreatic cancers are thought to be caused by cigarette smoking.
Family History & Genetics
A heightened risk may arise from a familial background of pancreatic cancer, alongside specific genetic conditions like hereditary pancreatitis, Lynch syndrome, and familial atypical multiple mole melanoma (FAMMM) syndrome. 
Chronic Pancreatitis
Chronic inflammation in the pancreas increases the likelihood of developing pancreatic cancer.
People diagnosed with diabetes, notably type 2, face a higher chance of developing pancreatic cancer.
Excess weight, whether in the form of overweight or obesity, is associated with a heightened probability of pancreatic cancer. Individuals falling into this demographic face approximately a 20% higher risk of developing the disease. Additionally, carrying surplus weight specifically around the waist may pose a risk, even among individuals who are not significantly overweight.
Chemical Exposure
Being in contact with specific chemicals found in industries like metalworking and dry cleaning may raise the probability of developing pancreatic cancer.

Several studies have identified other pancreatic cancer risk factors, but the evidence is not conclusive. More research is needed. These other potential risk factors include heavy alcohol consumption, diets high in red and processed meats, lack of physical activity, drinking coffee, and infection with Hepatitis B.

It's crucial to understand that possessing one or more of these risk factors doesn't guarantee the development of pancreatic cancer. The key is to remain proactive by engaging in open discussions with your doctor about your individual risk profile and adhering to recommended screening protocols for the disease. Detecting pancreatic cancer early and promptly seeking treatment significantly enhances the prospects for effective management of the condition.

How is Pancreatic Cancer Diagnosed?

Detecting pancreatic cancer in its early stages is quite challenging due to the pancreas's deep location within the body. Consequently, healthcare providers typically cannot visually or physically detect early tumors during routine examinations. Symptoms often remain absent until the cancer reaches an advanced stage or spreads to other organs.  If you have symptoms of the disease or are known to be at a higher risk, doctors will recommend a combination of methods for screening and diagnosis, which may include:
Imaging Tests
Various imaging tests used to detect pancreatic cancer may include computed tomography (CT) scans, which produce detailed cross-sectional images of the pancreas and surrounding organs; magnetic resonance imaging (MRI), which can provide snapshots of the pancreas, helping to identify any tumors or abnormalities; positron emission tomography (PET) scans, an imaging test where a doctor injects into the patient’s bloodstream a radioactive material called a tracer, which shows up on a special camera to help flag cancer cells; and endoscopic ultrasound (EUS), which involves inserting a thin, flexible tube with an ultrasound probe into the mouth or nose, down the esophagus, and into the stomach and duodenum (this allows for close-up inspecting of the pancreas.)
Blood Tests
Certain blood tests can help detect markers associated with pancreatic cancer. These include tests for levels of bilirubin, liver enzymes, and tumor markers such as carcinoembryonic Antigen (CEA) and the protein CA 19-9.
Endoscopic Retrograde Cholangiopancreatography (ERCP)
ERCP combines endoscopy and X-rays to examine the bile ducts and pancreatic ducts. Using this technique, the doctor navigates the endoscope from the patient's mouth, crossing through the stomach and reaching the initial segment of the small intestine. Subsequently, a smaller catheter tube is introduced via the endoscope into the bile ducts and pancreatic ducts. Dye is then administered through the catheter, facilitating X-rays to capture images indicating potential narrowing or blockages caused by a tumor within the ducts.
Percutaneous transhepatic cholangiography (PTC)
This method involves capturing images of the liver's bile ducts by injecting dye through a fine needle inserted beneath the skin and into the liver, enabling X-ray visualization. In the absence of obstruction, the dye should flow unimpeded through the bile ducts. Through examination of the images, the doctor can discover the presence of blockages caused by tumors or other ailments. Given its invasive nature, this procedure is reserved for cases where ERCP cannot be done.
Biological and Genetic Tests
Some patients may undergo genetic testing if they have a family history of pancreatic cancer or carry genetic mutations associated with increased cancer risk, such as mutations in the BRCA1, BRCA2, or PALB2 genes.
A decisive pancreatic cancer diagnosis necessitates the microscopic examination of pancreatic cells, a process achieved via a biopsy. During a biopsy, a small tissue sample is extracted from the pancreas and examined under a microscope to detect cancerous cells. Typically, this procedure is performed by a specialist, such as a gastroenterologist, in collaboration with a pathologist. 
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How is Pancreatic Cancer Treated?

Treatment options for pancreatic cancer are multifaceted, with considerations such as disease stage and location, patient health, preferences, and potential side effects influencing decisions. Personalized care plans typically incorporate a blend of therapies and interventions to address individual needs. Below is a summary of common treatment choices:
Surgery may be an option for localized pancreatic cancer, particularly if the tumor is resectable (able to be removed.) This involves taking out the tumor and potentially nearby tissues or organs. Surgical procedures include the whipple procedure (pancreaticoduodenectomy), where doctors remove the head of the pancreas, a significant portion of the duodenum (a section of the small intestine), a segment of the bile duct, the gallbladder, and related lymph nodes; distal pancreatectomy, where surgeons remove the tail of the pancreas; and total pancreatectomy, which consists of the entire pancreas being taken out, as well as the gallbladder, part of the stomach and small intestine, and the spleen.
Ablation and embolization therapies offer alternative approaches to treating tumors, bypassing surgical removal. While less frequently employed in pancreatic cancer cases, they may serve as adjuncts in managing metastatic pancreatic cancer. However, these treatments seldom achieve curative outcomes independently. Instead, they are primarily geared towards symptom alleviation or prevention, often complementing other treatment techniques. Ablation techniques involve using heat (radiofrequency or microwave) or cold (cryoablation) to destroy cancerous tissue. Embolization involves blocking the blood supply to tumors, essentially starving them of nutrients and oxygen.
This therapy works by boosting the body's immune system to help it recognize and fight cancer cells more effectively. Certain immunotherapy drugs, such as checkpoint inhibitors, are being studied for the treatment of advanced prostate cancer, particularly in cases where other treatments have been ineffective.
This treatment uses medications to kill cancer cells or stop them from growing. It can be administered before surgery (neoadjuvant chemotherapy) to shrink the tumor, after surgery (adjuvant chemotherapy) to kill any remaining cancer cells, or as the primary treatment for advanced or metastatic pancreatic cancer.
Radiation therapy
This treatment uses high-energy rays to kill cancer cells. It can be delivered externally (outside the body) through a machine (external beam radiation therapy) or internally through implanting radioactive seeds directly into the prostate gland (brachytherapy). Radiation therapy is often used as the primary treatment for localized prostate cancer or in combination with other therapies.
Palliative Care
Palliative care focuses on improving the quality of life for patients by managing symptoms such as nausea and loss of appetite, providing pain relief, and offering emotional support. It aims to address physical, emotional, social, and spiritual needs throughout the course of the illness. Palliative care does not aim to cure the cancer but rather to enhance comfort and overall well-being, whether the patient is receiving active treatment or not.
Targeted Therapy
Targeted therapy drugs are designed to specifically target cancer cells while minimizing damage to healthy cells. Drugs like erlotinib (Tarceva) and olaparib (Lynparza) target specific pathways involved in pancreatic cancer growth. 
 Immunotherapy drugs help boost the body's immune system to recognize and attack cancer cells. While immunotherapy has shown promise in treating other types of cancer, its effectiveness in pancreatic cancer is still being studied.

Decision-Making in Pancreatic Cancer Treatment (Picking the Right Plan for You)

Treatment plans, as previously indicated, are typically customized to individuals and may encompass a blend of the aforementioned choices. Engaging in a dialogue with your healthcare team about the potential advantages, drawbacks, and adverse effects of each treatment alternative is crucial for determining the most suitable course of action. Remember: pancreatic cancer is complex and typically requires a multifaceted approach to addressing it. The assessment of the optimal treatment strategy for the disease is a pivotal phase in effectively managing the illness.

It's essential to recognize that pancreatic cancer doesn't adhere to a uniform treatment model. Each patient's situation is distinct, and the most effective treatment approach may differ from one individual to another. Collaborating with a healthcare team enables you to access care and advice tailored to your particular circumstances.

Making decisions regarding treatment involves carefully considering the potential advantages and drawbacks. For instance, chemotherapy, while addressing pancreatic cancer, may result in side effects like hair loss, mouth sores, diarrhea or constipation, and a heightened risk of infection. Similarly, the whipple procedure offers a chance to eradicate the cancer entirely, but it also poses serious risks such as diabetes, digestive issues, changes in bowel habits, organ leakage, and even death. Thus, treatment itself can significantly affect one's quality of life. Engaging in thorough discussions with your healthcare provider about the risks and benefits of each option enables you to choose treatments that align with your objectives and minimize adverse impacts.

It's important to recognize that ongoing monitoring and follow-up care remain essential for patients with pancreatic cancer post-treatment, especially to assess treatment effectiveness, monitor for recurrence, and manage long-term side effects or complications. Besides collaborating closely with your healthcare team for personalized care, seeking support from loved ones, maintaining a healthy lifestyle through balanced nutrition, adequate sleep, and regular exercise, staying informed about treatment and recovery, and connecting with fellow cancer survivors can all be invaluable throughout your journey as a survivor.

In essence, fostering effective communication between patients and healthcare providers serves as a cornerstone of pancreatic cancer care. Through this collaboration, individuals can receive tailored care, make well-informed treatment decisions, and enhance their overall outcomes and quality of life.

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Why Choose Us

BASS Cancer Center houses a comprehensive team of healthcare professionals, comprising esteemed medical and radiation oncologists, social workers, care coordinators, financial counselors, and patient education specialists dedicated to delivering advanced cancer care. Our team collaborates to tailor personalized treatment plans for each patient, providing unwavering support to them and their families throughout their journey.

Our center integrates cutting-edge PET/CT imaging technology, exemplified by the Biograph 6, and employs state-of-the-art therapeutic machinery. Among these, the MRIdian, an MRI-guided treatment system, offers non-invasive radiation therapy that enhances dose precision while minimizing exposure to healthy tissues. Additionally, the Elekta Versa HD, an innovative imaging and motion management technology, further elevates our capabilities in radiation therapy. Alongside these advancements, we offer a range of treatment options encompassing surgery, chemotherapy, and targeted therapy to ensure thorough care for our patients.

If you or someone you know has been diagnosed with pancreatic cancer, trust the team at BASS Cancer Center to provide exceptional care. Contact us today to schedule a consultation and learn more about how we can help you in your fight against pancreatic cancer.

Expertise and Compassion

At BASS Cancer Center, you will find a knowledgeable and compassionate team of healthcare professionals dedicated to providing the best possible care for pancreatic cancer patients in the San Francisco Bay Area. Dr. Chao is a highly experienced and trusted pancreatic cancer radiation oncologist with over 14 years of experience in the treatment of pancreatic cancer. BASS utilizes the most advanced surgical techniques and cancer fighting technology to ensure the best possible outcomes for all patients.

BASS Cancer Center has made it a priority to invest in the best possible cancer treating technology for it's cancer patients.

Located in Northern California in Walnut Creek at 575 Lennon Ln, STE 153, Walnut Creek, CA 94598

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Pancreatic Cancer Treatment in Walnut Creek California