Treatment for Pancreatic Cancer with Liver Metastases
The best treatment for pancreatic cancer with liver metastases - Treating pancreatic cancer, based on the extent of Cancer - Treat pancreatic exocrine cancer, the most common type of cancer of the pancreas, which is different from treating pancreatic Neuroendocrine tumors (Nets), which have been discussed elsewhere. Most of the time, pancreatic cancer is treated based on stage – how far it has spread in the body. But other factors, such as your overall health, it can also affect the treatment options. Talk to your doctor if you have any questions about the treatment plan she suggests.
It can be hard to stage pancreatic cancer accurately by using Imaging tests. Doctors did their best to figure out before treatment if there is a good chance cancer could be dissected – that if it can be removed completely. But sometimes cancer has spread further than first thought.
Treatment for Pancreatic Cancer With Liver Metastases
Treating cancer can be dissected: The surgeon usually considers pancreatic cancer will be dissected if it looks like it is still only in the pancreas or not extend far beyond the pancreas, and yet grow as it exists in major blood vessels. Someone should also are healthy enough to withstand the surgery to remove cancer, which is a major surgery. If Imaging tests demonstrate a reasonable chance of eliminating cancer completely, surgery is a treatment option if possible, as this is the only realistic chance to heal. Based on where cancer started, usually in the form of a Whipple procedure (pancreaticoduodenectomy) or distal pancreatectomy is used. (See also: Warning Signs and Symptoms of Pancreatic Cancer)Sometimes even when the cancer is considered to be dissected, it became clear during the operation that not everything can be removed. If this happens, continue the operation might do more harm than good. The operation might cease, or surgeon can continue with small operations with the aim of reducing or preventing problems such as a blockage in the bile duct.
Even when the surgeon thinks all of cancer has been removed, cancer might still come back. Administering chemotherapy (chemo), either alone or with radiation therapy (chemoradiation), after surgery (known as treatment adjuvants) can help some patients live longer. Chemotherapy drugs used most often is gemcitabine (Gemzar) or 5-FU.
Treat the limit could be dissected cancer: A small number of pancreatic cancer has reached around blood vessels but have grown deeply into them or surrounded them. This cancer can still be removed by surgery, but the possibility of removing all cancer is lower, so they considered the limit could be dissected.
These cancers are often treated first with neoadjuvant chemotherapy (sometimes along with radiation therapy) to try to shrink cancer and to make it easier to remove. Imaging tests (and sometimes a laparoscopy) which are then carried out to ensure cancer does not grow too large to be removed. As long as it has not, then surgery is done to remove it. This can be followed by chemotherapy again.
Another option might be to have surgery first, followed by adjuvant chemotherapy (and possibly radiation). If, during this operation, it became clear that not all cancers can be removed, continue the operation might do more harm than good. The operation might cease, or surgeon can continue with small operations with the aim of reducing or preventing problems such as a blockage in the bile duct.
Treating locally advanced cancer (inoperable): Cancer of advanced stage has progressed too far to nearby blood vessels or other networks can be removed by surgery, but has not spread to the liver or distant organs and tissues. Surgery to try to remove this cancer do not help people live longer. Therefore, if the operation is carried out, it is to relieve a blockage of the bile duct or to bypass blocked intestine caused by cancer pressing on other organs.
Chemotherapy, sometimes followed by chemoradiation, is the standard treatment for locally advanced stage cancer. This can help some people live longer, even if cancer does not shrink. Administering chemotherapy and radiation therapy can work together better to shrink cancer, but this combination has fewer side effects and can be hard to patients with treatment either alone.
Treating cancer metastasis (wide): Pancreatic cancer is often the first spread in the abdomen (belly) and to the heart.They can also spread to the lung, bone, brain, and other organs. This cancer has spread too far to be able to be removed by surgery. Even when the Imaging tests showed that only spread to one of the other parts of the body, it should be assumed that small groups of cancer cells (too small to be seen on Imaging tests) have reached other organs of the body.
Chemotherapy is a treatment for this cancer. Sometimes it can shrink or slow the growth of cancer for some time and may be able to help people live longer, but it is not expected to cure cancer. Gemcitabine is the most commonly used drugs. It can be used alone (especially for people in poor health) or can be combined with other drugs such as albumin-bound paclitaxel (Abraxane), erlotinib (Tarceva), or capecitabine (Xeloda).
Another option, especially for people who are not in good health, is a combination of chemotherapy drugs called FOLFIRINOX. It consists of 4 drugs: 5-FU, leucovorin, irinotecan (Camptosar), and oxaliplatin (Eloxatin). These treatments can help people live longer than to get gemcitabine alone, but can also have side effects are more severe. Other treatments may also be used to help prevent or relieve symptoms of this cancer. For example, radiation therapy or some type of nerve block can be used to help relieve the pain of cancer, or a stent may be placed during endoscopy to help keep bile ducts open.
Because the available treatments now do not work well for many people, you may want to think about taking part in clinical trials of new drugs or combinations of drugs.
Treat pancreatic cancer that lasts or recurs: If cancer has continued to grow during treatment (in progress) or come back (returning), treatment options will depend on where and how much cancer has spread, the care of what you already have, and on the health of you and your desire for more treatment. It is very important that you understand the purpose of any further treatment, as well as possible benefits and risks.
When pancreatic cancer recurs, it is most often appears first in the liver, but can also spread to the lungs, bones, or other organs. This is usually treated with chemotherapy if you are healthy enough to get it. If you have undergone chemotherapy before and it keeps cancer away for some time, the same chemo might help more. If not, unlike drugs chemo might be attempted. Other treatments such as radiation therapy or stent placement can be used to help prevent or relieve symptoms of cancer.
If cancer takes place while you get chemotherapy, another type of chemotherapy may be able to start if you are healthy enough. At some point, it may become clear that standards of care are no longer controlling cancer. If you want to continue to get treatment, you might think about taking part in a clinical trial of a new treatment of pancreatic cancer. While this is not always the best option for everyone, they may be useful for you, as well as future patients.
Treating cancer of the ampulla of Vater: In the ampulla of Vater is an area in which the common bile duct and the pancreatic duct empties into the duodenum (the first part of the small intestine). Cancer on this site (known as ampullary cancer) can start in the pancreatic duct, duodenum, or bile duct. In many patients, ampullary cancer cannot be distinguished from pancreatic cancer until the operation has been performed. These cancers often cause early symptoms like jaundice, so they often found while they still can be dissected. Operation with a Whipple procedure is often successful in treating the early stages of cancer. Adjuvants chemoradiotherapy after surgery is often recommended. More advanced ampullary cancer treated as pancreatic cancer.
Pancreatic cancer is considered stage IV if it has spread to distant locations in the body, such as the liver, lungs, or adjacent organs such as the stomach, spleen, and/or intestines. Sometimes that can only be determined that pancreatic cancer stage IV once the surgery is completed. Patients diagnosed with stage IV pancreatic cancer generally can be divided into two groups: (1) Stage IVA pancreatic cancer locally finite, but involve adjacent organs or blood vessels, thereby impeding the operation of the appointment. Stage IVA pancreatic cancer is also referred to as local or locally advanced. (2) Stage IVB pancreatic cancer has spread to distant organs, most commonly the heart. Stage IVB pancreatic cancer is also called metastasis.
The goal of treatment for patients with localized disease IVA is to induce remission or disease-free period which may last months or years. Management of patients with Stage IVB disease is often aimed at the control of symptoms and the pain from cancer.
Stage IV pancreatic cancer generally cannot be removed with surgery and therefore rarely curable and often difficult to control. The Act of surgery that can be done to reduce symptoms and improve the quality of life in some patients, but the treatment is recommended for the treatment of advanced pancreatic cancer typically consists of chemotherapy. The standard treatment of pancreatic cancer chemotherapy is Gemzar ® (gemcitabine)-based chemotherapy.
The following is a general overview of treatment for stage IV pancreatic cancer. Treatment can consist of surgery, radiation, chemotherapy, biological therapy, or a combination of these techniques in treatment. Multi-modality treatment is a treatment using two or more techniques and is increasingly recognized as an important approach to improve the chances of curing a patient or prolong survival. In some cases, participation in the clinical trial utilizing new, innovative therapies may provide the most promising treatment. Circumstances unique to each patient's situation can affect how general treatment principles applied and whether the patient decided to accept treatment. The potential benefits of multi-modality treatment, participation in clinical trials, or the standard treatment should be carefully balanced with potential risks. The information on this Web site is intended to help educate patients about their treatment options and to facilitate joint or shared decision-making process with their treating cancer physician.
Local Treatment of Stage IVA Pancreatic Cancer: Pancreatic cancer is often undiagnosed until not in Stage IVA, which means cancer has invaded adjacent organs or major blood vessels. When this occurs the cancer removal surgery (which allows a long term remedy) is rarely an option. Therefore, the purpose of the treatment of patients with Stage IVA pancreatic cancer is to induce remission, which is a cancer-free period which may last months or years, and to prevent and control the symptoms.
Treatment for Stage IVA pancreatic cancer can include surgery, chemotherapy, palliative or chemoradiation, which was chemotherapy and radiation are delivered together. Sometimes, surgical bypass procedure that can be done to reduce the complications of cancer, such as jaundice, intestinal obstruction, or pain, thereby the improving the quality of life.
Treatment of Non-Local Stage IVB Pancreatic Cancers (Metastases): Most patients with stage IV cancer have metastatic disease (Stage IVB), which means that cancer has spread to distant locations in the body that often include liver and other areas of the abdominal cavity. To kill cancer cells that have spread throughout the body, systemic treatment is needed, and usually, this is chemotherapy.Historically, patients with metastatic pancreatic cancer were considered incurable and rarely last more than a year. However, with new treatments, some patients can survive 1-2 years and can experience an increase in quality of life. In addition, the management of a patient with stage IV pancreatic cancer focused on alleviating the pain and keep nutrients. Pain relief can be achieved by destroying the nerve that provides sensation to the area around the pancreas. This is usually done by injection of alcohol or other chemicals through the skin or in a State of open abdominal surgery.
Chemotherapy: Chemotherapy is a treatment which involves the use of drugs to kill cancer cells. Cancer chemotherapy may consist of a single drug or combination of drugs and can be given through the blood vessels or delivered orally in pill form. Chemotherapy is considered systemic therapy because the drugs circulate throughout the body, and can kill cancer cells that have spread to distant locations from where cancer started. Chemotherapy is commonly used to treat locally advanced (stage IVA) and Metastatic (Stage IVB) of pancreatic cancer.
Gemzar ® (gemcitabine): currently, standard chemotherapy drugs for the treatment of advanced pancreatic cancer is Gemzar, which has been proven to improve the response to treatment, the time to cancer progression, and survival süre when compared to the older chemotherapy drugs 5-fluorouracil. In a clinical trial that compares the 5-FU, Gemzar Gemzar produces a significant improvement in disease-related symptoms, as well as extend survival. The number of patients who survive one year after treatment with Gemzar was 18%, compared with only 2% with 5-FU.
The combination of chemotherapy drugs, called the regimen, can produce better anticancer responses and improve the outcome of patients with advanced pancreatic cancer from treatment with Gemzar on its own. Various chemotherapy drugs that have been combined with Gemzar, but Tarceva ® (erlotinib) has been shown to improve survival in a direct comparison with Gemzar; 23% of the patients treated with the combination of Gemzar and Tarceva survive more than one year compared to 18% treated with Gemzar on its own.
Chemoradiation Therapy: Combining chemotherapy with radiation therapy, a technique called chemoradiation, can provide more benefits than chemotherapy alone for some patients with StageIVA pancreatic cancer, but not usually a treatment for patients with Stage IVB disease. Researchers from Taiwan have reported that patients with Stage IVA pancreatic cancer treated with radiation therapy plus chemotherapy Gemzar fared better than those who were treated with radiation therapy plus 5-FU chemotherapy. Anticancer responses occurred in 50% of patients treated with Gemzar, compared to only 17% for those treated with 5-FU. The average time to development of cancer was 14.5 months for patients treated with Gemzar, compared with only 7.1 months for those treated with 5-FU. Patients treated with Gemzar reported better pain control compared to those treated with 5-FU.
The treatment of the information in this document is not the official policy of the American or Canadian Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make decisions, together with your doctor. Your doctor may have reason to recommend a treatment plan that differs from this common treatment options. Feel free to ask a question to him about your treatment options.