The most common type of pancreatic cancer (90%) is ductal adenocarcinoma, which arises in the drainage ducts of the pancreas.
Surgery to remove the tumour, known as a Whipple procedure, generally provides the best results for this type of cancer. After the procedure, chemotherapy is often administered to reduce the risk of recurring disease.
The cancer must be detected at a relatively early stage to allow surgery. Unfortunately, pancreatic cancer is diagnosed at an early stage in only 15-20% of patients. Therefore, most patients do not qualify for surgery. These patients usually receive chemotherapy.
Chemotherapy is a cancer treatment that uses medication to kill cancer cells and/or limit their growth. The first option considered is FOLFIRINOX (a combination of 4 different substances). However, this requires that the patient is in a good general condition. Patients with a less optimal general condition usually receive the combination of gemcitabine and Abraxane.
Unfortunately, chemotherapy also has side effects. Side effects can range from mild to severe and can vary from patient to patient. The most common side effects of the above chemotherapies are:
Radiotherapy is another treatment option. Radiotherapy uses radiation to destroy cancer cells. The radiation damages the cancer cells’ DNA, preventing them from dividing and eventually causing them to die.
In pancreatic cancer patients, radiotherapy is usually used as a palliative treatment to relieve symptoms and improve the patient’s quality of life.
Side effects of radiotherapy may include fatigue, nausea, diarrhoea and skin reactions. These side effects are usually temporary and disappear after the treatment ends.
It is important that patients and their Health Care Prividors are aware of the different options and their expected effectiveness and side effects, so that the best treatment can be selected.
Newer therapies in cancer research focus on the surrounding microenvironment of cancer cells, such as immunotherapy and target therapy.
Immunotherapy stimulates the patient’s own immune system to attack the cancer. However, the results of clinical trials with immunotherapy in ductal adenocarcinoma are not convincing enough, and more research is needed to determine its effectiveness.
Another novel treatment option is target therapy. This involves drugs that attack specific mutations in cancer cells. This treatment can be effective in patients with specific genetic mutations in the tumour. However, these mutations are not very common in pancreatic cancer patients (5%).
Olaparib is an example of a targeted therapy (drug) used in ductal adenocarcinoma. Side effects include nausea and vomiting, fatigue and changes in blood levels.
Finally, there is also a lot of research on the effectiveness of nanotechnology in the treatment of ductal adenocarcinoma. Nanoparticles can deliver drugs into the tumour in a targeted manner, increasing the effectiveness of treatment and reducing side effects.
More treatment options are expected to become available in the coming years, possibly including combinations of different treatments.
It is important that patients and their Health Care Prividors are aware of the different options and their expected effectiveness and side effects, so that the best treatment can be selected.