Pancreatic Cancer Has a Growing Array of Treatment Options

Pancreatic cancer is a kind of cancer that starts growing in the pancreas, which makes specific enzymes that can help digest foods and hormones. By doing so, it also helps manage the blood sugar in the body. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma, in which the cancer grows from the cells that line the ducts carrying the digestive enzymes.¹

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The primary challenge of pancreatic cancer is that it is rarely found at the early stages, when the treatment options could be most effective. Many patients are discovered to have pancreatic cancer in the very late stages, which can be incurable or untreatable. Pancreatic cancer typically does not present many symptoms in the early stages, so patients or their health care providers may not suspect any disease.¹ Once they appear, symptoms can include stomach pain, loss of appetite, weight loss, yellowing of the skin, light colored stools, dark-colored urine, itching, pain and swelling in the arms and legs, and unusual tiredness and weakness.¹

Causes of pancreatic cancer are still largely unknown, but may have to do with genetics, family history, and smoking. Patients with history of diabetes, obesity, and alcoholism may be at higher risk of pancreatic cancer, as well.¹

In 2023, the American Cancer Society estimated that about 64,000 Americans would be diagnosed with pancreatic cancer and about 50,000 of those would die from the disease. These numbers are significantly higher than 2015 estimates and pancreatic cancer is now the fourth deadliest cancer for both male and female individuals. The 5-year relative survival rate for pancreatic cancer is 12%.²

Diagnosis typically involves imaging tests and biopsy. Providers will typically also conduct blood tests to show specific tumor markers, including CA19-9. Genetic testing is another method that uses blood or saliva samples to detect changes in the DNA and help diagnose the cancer.¹ Based on these tests, providers or specialists will typically stage the pancreatic cancer between stages 0 and 4. The 0 stage is usually new growth and only found in the pancreas, whereas stage 4 is usually the last stage, in which the cancer has spread throughout the body.¹

Treatment options for pancreatic cancer may include surgery, radiation therapy, chemotherapy, chemoradiation therapy, and targeted therapies. Medications that are FDA-approved for pancreatic cancer include paclitaxel, everolimus, capecitabine, erlotinib, fluorouracil, gemcitabine, irinotecan, mitomycin, olaparib, irinotecan liposome, and sunitinib. There are other combination medications, including Folfirinox, gemcitabine-cisplatin, and gemcitabine-oxaliplatin.³

The primary goal of treatment is usually to eliminate the cancer, so many specialists, based on each patient’s condition, may choose a combination of the therapy options, such as medications and surgery, medications and radiation, or other options. Like other cancers, one of the last treatment options is palliative care and therapy, which is focused on relieving the symptoms of the cancer and making the patient comfortable.⁴

With rapid medication and therapy advancements over the past few years, patients impacted by pancreatic cancer now have more options than ever before. However aggressive this type of cancer may be, if detected early enough, patients can benefit from various combinations of therapies.

References

1. Pancreatic Cancer. Mayo Clinic. May 4, 2024. Accessed September 23, 2024. https://www.mayoclinic.org/diseases-conditions/pancreatic-cancer/symptoms-causes/syc-20355421

2. Post E. Five-Year Pancreatic Cancer Survival Rate Increases to 12%. Pancreatic Cancer Action Network. January 12, 2023. Accessed September 23, 2024. https://pancan.org/news/five-year-pancreatic-cancer-survival-rate-increases-to-12/#:~:text=Still%2C%20there's%20more%20work%20to,from%20the%20disease%20this%20year

3. Drugs Approves for Pancreatic Cancer. National Cancer Institute. Updated March 4, 2024. Accessed September 23, 2024. https://www.cancer.gov/about-cancer/treatment/drugs/pancreatic#1

4. Pancreatic Cancer Treatment (PDQ)–Patient Version. National Cancer Institute. Updated August 28, 2024. Accessed September 23, 2024. https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq