Located behind the stomach in the upper abdomen, the pancreas produces food-digesting enzymes and hormones like insulin that regulate various bodily functions. Pancreatic cancer is an abnormal growth of malignant cells in the pancreas.
The pancreas is composed of various cell types, and there are many forms of pancreatic cancer. The most common form is adenocarcinoma, which is also the most difficult to treat and the most deadly. Survival rates are generally better for non-adenocarcinoma diagnoses. Treatment is difficult because pancreatic cancers often carry few symptoms if any until the tumor is advanced or spreads beyond the pancreas. Also, this type of cancer generally doesn’t respond well to treatment.
What are the symptoms?
Early signs of pancreatic cancer are often so mild they’re overlooked. Common early symptoms include loss of appetite, mild weight loss and mild discomfort in the upper abdomen or occasionally in the middle-back. Because these symptoms can be attributed to any number of conditions, early signs are often ignored or missed. As the cancer progresses, it causes increasingly noticeable symptoms like jaundice and digestive problems like bloating or nausea from stomach obstruction. Firmness is sometimes felt in the upper abdomen in late stages.
What are the treatment options?
Pancreatic cancer treatment may involve a combination of surgery, radiation and chemotherapy. Early-stage tumors generally have a more favorable response to treatment. Unfortunately, by the time they’re found, most pancreatic cancers have spread to nearby organs, known as local invasion, or they’ve become metastatic, spreading to other areas of the body. Treatment for advanced pancreatic cancer is rarely successful and usually focuses on making patients more comfortable and improving their quality of life.
For early-stage cases, especially those that have not spread to other areas, tumors can be removed surgically in what’s known as the Whipple procedure. Though difficult and carrying risks, the surgery is viewed as offering the best chance of long-term survival. Certain cases are not good candidates for the Whipple procedure, like when the cancer appears to involve critical blood vessels going to the small bowel, for example, or other medical conditions.
Stereotactic radiosurgery treats pancreatic cancer with large-dose radiation. Clinical studies are ongoing to test the CyberKnife’s effectiveness in treating localized, non-metastatic pancreatic cancer. However, preliminary results involving patients with relatively advanced cases of pancreatic cancer suggest that CyberKnife radiosurgery treatment is well tolerated and provides some clinical benefit.
What is the CyberKnife treatment process for pancreatic cancer?
Prior to treatment, doctors implant between three to five small metal markers known as fiducials in or near the tumor that enable the CyberKnife to pinpoint the tumor location throughout treatment. Implanting the markers is an outpatient procedure that takes about an hour. About a week later, patients are fitted with a custom body mold made of soft material that they lie on during treatments. The fitting process is painless. Patients then undergo a CT scan that assists in developing a customized treatment plan.
Patients are assigned a team that can include a radiation oncologist, a pancreatic surgeon, an interventional radiologist, a diagnostic radiologist, a physicist, an oncology nurse and a radiation therapy technician.
Anti-nausea medication is administered about an hour before each treatment, which takes about three to five hours. Patients can eat normal meals and take regular medications. Following radiosurgery treatment, patients are instructed to eat a light dinner and take more anti-nausea medication in the evening.