Pancreatic Cancer Treatment
Pancreatic Cancer Treatment Options
There are a number of pancreatic cancer treatment options available, and it may feel confusing and unsettling not knowing which will be the best for you.
Treatment of pancreatic cancer depends on its location, the stage of the cancer (how advanced it is at the time of diagnosis), and whether the person is otherwise medically fit.
The choice of treatments will be discussed with you and your whānau and your preferences will be considered. Your treatment will be discussed by a multidisciplinary team (MDT), which means that experts in different areas of cancer treatment (e.g., surgeons, gastroenterologists, radiologists, oncologists, and nurses) come together to share their expertise in order to provide the best patient care.
It is also important to note that more than one treatment may be needed to get the best results.
See below to read more about the treatment options.
*Not all the options below will be applicable to everyone's situation. Some treatments listed may not be funded and would require the patient to pay directly. It is important to discuss all your options with your specialist team.
Surgery
In a small number of cases, the tumour can be surgically removed (cut out). If surgery is not an option, there are other types of treatment which may limit the growth of the cancer and/or improve your quality of life.
If the cancer is obstructing the bile duct and cannot be removed surgically, a stent (plastic or metal tube) can be inserted to maintain the flow of bile and prevent jaundice.
Click here to view more details about the surgery
The only curative treatment for pancreatic cancer is surgery. If diagnosed early and there are no obvious signs of spread to other organs, pancreatic cancer can be removed by surgery. Unfortunately, no other therapies can cure pancreatic cancer.
Most surgeries attempting to cure pancreatic cancer are concentrated on tumours that start in the head of the organ. This surgery is called a pancreaticoduodenectomy and is commonly known as the Whipple's procedure. The Whipple's procedure involves the removal of:
Head of the pancreas
Lymph nodes near the pancreas
Gallbladder
Part of the common bile duct
Part of the stomach
Duodenum (first part of the small intestine)
A small portion of the jejunum (second part of the small intestine)
Click here to view a diagram of the surgery
If the cancer is in the tail or body of the pancreas, a distal pancreatectomy may be performed where the tail, some of the body and sometimes the spleen are removed.
If there are signs of cancer throughout the whole pancreas, a total pancreatectomy may be performed where the whole pancreas is removed. In this case, the body is unable to produce insulin and so the patient will have diabetes and will need insulin injections to regulate blood sugar levels.
Radiation Therapy
Radiation therapy may be used in conjunction with surgery and/or chemotherapy to reduce the chances of cancer recurring. Sometimes radiation therapy is used to try and reduce the tumour size enough to allow surgery,
Radiation therapy uses x-rays to kill cancer cells and stop the cancer growing. It can be given for all stages of cancer.
Click here to learn more about radiation therapy
Getting radiation therapy is similar to getting an X-Ray but the radiation is stronger. It is a painless procedure which involves lying on a table and a large machine rotating around you. It is directed at the tumour to try to kill the tumour or stop the cancer cells growing without damaging the healthy tissue nearby. Radiotherapy is usually performed in an outpatient clinic. It usually takes place everyday Monday to Friday and lasts for about 10-20 minutes. Your treatment team will be able to tell you how many weeks you will need radiotherapy for.
Stereotactic body radiotherapy (SBRT) is being used in the MASTERPLAN clinical trial for patients with tumours that are too advanced for surgery (“locally advanced”) and those for whom surgery has a low chance of removing all tumour (“high risk” and “borderline resectable”). The trial is currently recruiting in Christchurch and Wellington. ASk your treatment team about availability and eligibility.
A newer kind of radiotherapy available to treat pancreatic cancer called OncoSil, is available for people who meet specific treatment criteria. It is currently only available in Waikato (2022).
Radiation is placed directly into the tumour via stomach and bowel using an endoscope.
OncoSil is not funded in New Zealand but you may still wish to ask your treatment team if it is suitable for you.
Chemotherapy
Chemotherapy can be used for all pancreatic cancer patients, including those who have undergone successful surgery to remove the tumour to help reduce the chance of the tumour recurring. This is called adjuvant chemotherapy. For patients who are not able to undergo surgery, chemotherapy is used to slow the growth of the tumour and help lengthen life expectancy.
Chemotherapy uses drugs to kill cancer cells and stop the cancer growing and dividing.
Click here to learn more about chemotherapy
Chemotherapy is a drug which is administered either by swallowing tablets; through an injection; or through infusion which is a small tube that is inserted into a vein. The drug works by moving through the blood stream to kill the cancer cells. Unfortunately, some healthy cells can also be harmed leading to side effects. Chemotherapy can be given alone or in combination with other therapies such as targeted therapy, surgery, or radiation. It is usually administered in an outpatient clinic and sometimes a hospital stay is needed if the doctor wants to monitor you following treatment.
Targeted therapy
Targeted therapy uses drugs to attack specific features of cancer cells and stop the cancer growing. It may be used if surgery is not an option, or the cancer has spread.
Click here to learn more about targeted therapy
Targeted therapy involves blocking the processes that change normal cells into cancer cells. As the therapy treats only the cancer cells, healthy cells are not affected and fewer side effects occur.
Clinical trials
You may be eligible to take part in a clinical trial, which is a type of research study that investigates new or specialised therapies or treatments. While you are discussing therapy options with your care team, it is a good idea to ask about clinical trials that may be suitable for your condition and discuss whether participating may be right for you.
Being involved in a clinical trial may be beneficial in that you may access the latest treatments before they become generally available. Additionally, clinical trial participation is often associated with closer monitoring of your care and condition and potentially improved outcomes.
Clinical trials are free, and travel and accommodation (if needed) are provided.
Palliative care
A specialist may refer a patient to palliative care services, but this doesn’t always mean end-of-life care. Today people can be referred to these services much earlier if they’re living with cancer. Palliative care can help one to live as well as possible including managing pain and symptoms. This care may be at home, in a hospital or at another location one prefers. Additional supportive care (treatment or services that support you through a cancer experience) are also available.
Rongoā Māori | Traditional Māori Healing
Rongoā Māori is a body of knowledge that takes a holistic view to wellbeing and treatment. In particular, it focuses on hinengaro (mind), wairua (soul), mauri (life essence), ngā atua (Gods) and te taiao (the environment).
There are many providers who are able to provide rongoā services. Your Māori Health team at the hospital will be able to connect you with one nearest to where you live.
See the below websites for more information on rongoā Māori
Other complementary therapies
Complementary therapies are treatments that are used alongside standard treatments. They are often used to boost the immune system, relieve symptoms, and enhance the effectiveness of standard treatments.
Speak to your doctor if you intend to use complementary therapies to ensure that they will work well alongside your treatment.
Some examples of complementary therapies are:
Acupuncture
Meditation and mindfulness
Music therapy
Massage
Aromatherapy
Naturopathy
Tai chi
Pilates
Visualisation or Guided Imagery
Spirituality
Useful Websites & Patient Support
Information on these pages was collated with grateful assistance from the PanCare Foundation.
DISCLAIMER: Information provided by the Gut Cancer Foundation should be discussed with your healthcare professional and is not a substitute for their advice, diagnosis, treatment, or other healthcare services. In some cases, information has been gathered from Australian sources and should be discussed with New Zealand health care professionals.
