Located behind the stomach and stretching across the abdomen, the pancreas produces insulin and other hormones that aid in digestion. Because
the pancreas lies so deep within the body, physicians have historically had difficulty diagnosing tumors and other abnormalities.
More than 37,000 people are diagnosed with pancreatic cancer in the United States each year. Most cases occur in people over the age of 55;
however, it can occur in younger people, particularly those with a family history of the disease. While pancreatic cancer symptoms do not typically
occur until later stages, they include painless jaundice, digestive problems, abdominal pain or pressure, or dark urine. If a patient displays these or
other similar symptoms, patients will undergo a CT scan, an MRI scan, or an endoscopic ultrasound probe which uses sound waves to produce detailed
images of the pancreas.
Treatment options depend on the extent of the disease and other individual circumstances of the patient. If a pancreatic tumor is diagnosed as
cancerous, the physician team determines the stage of the cancer. Based on this conclusion, surgery may be performed to remove a portion of the
pancreas. Chemotherapy after surgery (adjuvant chemotherapy) has been shown to improve survival compared to surgery alone. If the cancer is very
advanced and not treatable with surgical methods, then medications such as chemotherapy may be used. Radiotherapy or chemotherapy can help
some patients with advanced disease. Although the opportunity to extend survival is greatest before the tumor has spread, treatment also can help to
control symptoms and complications in the later stages of the disease, improving quality of life for patients with advanced pancreatic cancer. |
Pancreatic cancer and its treatment can place extra demands on the body, which can cause difficulty with eating and maintaining weight. Weight loss,
poor appetite and changes in taste are common and can delay treatment and lengthen a patient’s recovery time. Some patients may also experience nausea
or are unable to absorb the foods they eat. An assessment by a registered dietitian is an essential part of treatment and can help patients develop a plan that
meets their individualized nutrition needs, helps manage side effects, and prevents further weight loss.
Here are some nutrition tips for patients experiencing common side effects from pancreatic cancer from St. Vincent’s Comprehensive Cancer Center’s
registered dietitian:
• For Poor Appetite: Eat small, frequent meals of nutrient dense foods. If appetite is decreased, choose a plate that
is larger than needed and put small portions on the plate. That way the amount of food does not look overwhelming.
• Malabsorption (diarrhea, gas, abdominal pain, weight loss, fatigue and dehydration): Eat a low fat diet and
take pancreatic enzyme replacements as prescribed by your physician.
• Nausea: Eat soft, bland, cold, salty or dry foods. Some examples are saltine crackers, pretzels, plain pasta,
toast, watermelon, applesauce, chicken noodle or rice soup and ginger teas.
• Changes in Taste: Often strong flavors like granny smith apples or rinsing your mouth with baking soda and water can
be helpful.
The challenges eating in patients with pancreatic cancer can be best managed through individual counseling with
a registered dietitian. The above suggestions are a good start but not a replacement for individualized care. |
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Clinical trials are done to allow us to bring promising new drugs to patients. They evaluate the safety and effectiveness of new drugs for a variety
of diseases. Although pancreatic cancer is a disease that does not have a positive prognosis at this time, it is important for health care providers to
be advocates for these patients and encourage patients to participate in trials in order to improve on the treatments available for pancreatic cancer.
Whether the trial’s goal is to improve survival, allow for potential surgery or improve symptoms they are all important.
A Phase II Study of Preoperative Gemcitabine, Oxaliplatin and Capecitabine in Patients with Resectable and Borderline-Resectable Pancreatic
Adenocarcinoma [Protocol 08-106]
Purpose
Pancreatic cancer is a serious illness that can have a poor prognosis. Studies have been performed showing it is beneficial to give chemotherapy
after pancreatic cancer has been removed surgically by prolonging the life of subjects. Whether chemotherapy given before surgical removal of the
tumor is better than chemotherapy given after surgical removal of the tumor is unknown, because there are no studies comparing the two approaches.
This study will evaluate the safety and effectiveness of giving chemotherapy prior to surgical removal of the tumor. Subjects would then receive
postoperative chemotherapy and/or chemotherapy and radiation therapy following recovery from surgery to reduce the risk of recurrent disease.
Eligibility Criteria
Several criteria must be met to be eligible for this study, including but not limited to the following:
• Pancreatic adenocarcinoma that has been determined to be operable or borderline operable
• No previous chemotherapy or radiation therapy
• Adequate cardiac, liver and kidney function
• Age 18 or older |
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Ideally, the management of pain in patients with pancreatic cancer is delivered by a
multidisciplinary approach. Pain management options include traditional pain medicines
such as morphine, a nonsteroidal anti-inflammatory drug. Chemotherapy, radiation therapy
or combination chemo-radiotherapy can also be used to reduce pain, particularly if the tumor
gets smaller. An additional method is a procedure called celiac plexus neurolysis or nerve
block. An alcohol like substance is injected into the nerves that carry pain. This injection can
block the transmission of this pain sensation and can be done during surgery, through the skin,
or through an endoscopy (a tube placed into the stomach). About 70-90% of patients achieve
long lasting benefits from this procedure. It is important that you talk to your healthcare team
about any pain you may feel and discuss what options are available to manage your pain. |
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