Treatment options for pancreatic cancer
Factors affect chance of recovery and treatment options
-Whether or not the tumor can be removed by surgery
-The stage of the cancer
-The size of the tumor and whether the cancer has spread outside the pancreas to nearby tissues or lymph nodes or to other places in the body
-The patient’s general health
-Whether the cancer has just been diagnosed or has recurred (come back).
-Pancreatic cancer can be controlled only if it is found before it has spread, when it can be removed by surgery.
-If the cancer has spread, palliative treatment can improve the patient's quality of life by controlling the symptoms and complications of this disease.
-The 3 main types of treatment for pancreatic cancer are
.Surgery
.Radiation therapy
.Chemotherapy
- Depending on the stage of the cancer, some of these treatments may be combined.
-Surgery is the mainstay of treatment for pancreatic cancer.
-Depending on the location of the tumor within the pancreas, several operations can be performed.
-Most commonly, the tumor is located in the "head" of the pancreas, but can also be found in the body or tail
There are 2 general types of surgery used for pancreatic cancer:
-Potentially curative surgery
Used when imaging tests suggest that it is possible to remove all the cancer.
Palliative surgery
-May be done if imaging tests show that the tumor is too widespread to be completely removed.
-This is done to relieve symptoms or to prevent certain complications like a blocked bile duct or intestinal tract.
Potentially curative surgery
Whipple procedure
-A surgical procedure in which the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed.
-Enough of the pancreas is left to produce digestive juices and insulin.
.Total pancreatectomy
-This operation removes the whole pancreas, part of the stomach, part of the small intestine, the common bile duct, the gallbladder, the spleen and nearby lymph nodes.
-Distal pancreatectomy
-The body and the tail of the pancreas and usually the spleen are removed.
.Palliative surgery
-Surgical biliary bypass
- If cancer is blocking the small intestine and bile is building up in the gallbladder, a biliary bypass may be done.
- During this operation, the doctor will cut the gallbladder or bile duct and sew it to the small intestine to create a new pathway around the blocked area.
-Endoscopic stent placement
-If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin tube) to drain bile that has built up in the area.
The doctor may place the stent through a catheter that drains to the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine.
-Gastric bypass
- If the tumor is blocking the flow of food from the stomach, the stomach may be sewn directly to the small intestine so the patient can continue to eat normally
Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.
Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.
-Chemotherapy and radiation therapy are frequently used after surgery to reduce the risk of the tumor recurring, or coming back.
-Occasionally chemotherapy and radiation are given prior to surgery in an effort to reduce the tumor.
- When tumors cannot be removed surgically, chemotherapy can be used to slow the spread
-Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both.
-Targeted therapy uses drugs or other substances to identify and attack specific cancer cells without harming normal cells.
-Tyrosine kinase inhibitors (TKIs) are targeted therapy drugs that block signals needed for tumors to grow.
Erlotinib is a type of TKI used to treat pancreatic cancer.
.The area just inside the nostrils is called the nasal vestibule. A small area of special cells in the roof of each nasal passage sends signals to the brain to give the sense of smell.
.Together the paranasal sinuses and the nasal cavity filter and warm the air, and make it moist before it goes into the lungs.
.The movement of air through the sinuses and other parts of the respiratory system help make sounds for talking.
-A rare cancer that forms in tissues of a salivary gland. Most salivary gland cancers occur in older people.
-The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against infections of the mouth and throat.
-More than half of all salivary gland tumors are benign (not cancerous) and do not spread to other tissues
There are 3 pairs of major salivary glands:
-Parotid glands: These are the largest salivary glands and are found in front of and just below each ear. Most major salivary gland tumors begin in this gland.
-Sublingual glands: These glands are found under the tongue in the floor of the mouth.
-Submandibular glands: These glands are found below the jawbone.
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