Treatment of pancreatic cancer is based on establishing what stage the cancer is in by determining how much of the pancreas is involved and whether the cancer has spread. This may be done using a formal staging/naming system or by categorizing the cancer into one of the following types: resectable (can be surgically removed because still located within the pancreas), locally advanced (spread into nearby organs and not resectable), or metastatic (spread to distant organs).
Unfortunately, pancreatic cancer can be categorized as resectable less than 15% of the time. How much surgery should be done depends on where the tumor is, its size, how far it has spread, and the condition of the affected person's health.
Pancreatic surgery is very difficult. It requires an experienced surgeon, is associated with significant complications, and requires several weeks of recovery time. Procedures intended to treat pancreatic cancer include the Whipple procedure, distal pancreatectomy, and total pancreatectomy. For more on these, see the Johns Hopkins Kimmel Cancer Center's page on Pancreatic Cancer Surgery.
Radiation and chemotherapy may be used to treat pancreatic cancer and typically are necessary because often tiny, undetectable amounts of a tumor will have spread by the time a surgery is done. Regrettably, pancreatic cancer does not respond well to current treatments. Gemcitabine and 5-fluorouracil (5-FU) are the most commonly used chemotherapy agents. They may be used alone or in combination with other drugs.
Research into new treatment options known as "targeted therapies" is an active and ongoing field. Attempts to develop new drugs that have specific targets are meant to have fewer side effects than current chemotherapy drugs. Examples include pancreatic cancer growth factor inhibitors, anti-angiogenesis factors that block new blood vessels essential for cancer growth, and drugs that target substances involved in the spread of pancreatic cancer.
For those with recurring or inoperable pancreatic cancer, palliative (comfort-oriented) care is the primary priority. Radiation, chemotherapy, and surgery may be used to help relieve pain. Surgery may also be performed to cut nerves to help relieve pain that is resistant to other measures.
People with inoperable pancreatic cancer may want to consider enrollment in clinical trials that assess new treatments. Learn more about clinical trials at the National Cancer Institute website.